The neuropsychology of cerebral malaria
Date
2018-06-14
Authors
Dugbartey, Anthony Tekper
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Abstract
The purpose of this study was to investigate the effects of cerebral malaria on the neuropsychological functioning of non-immune Ghanaian children. Twenty hospital-referred children between ages 7 and 16 years who met the World Health Organization (W.H.O., 1986) research criteria for the diagnosis of cerebral malaria, and who had no known history of other neurological disease were recruited for this study. Twenty matched control healthy children without a history of malaria or other neurological disease were also assessed. Each subject was administered a battery of neuropsychological tests judged to be highly sensitive to brain injury and relatively impervious to linguistic or other cultural factors.
These results (from comparisons using the general linear model) are the first to provide evidence of subacute neurobehavioural sequelae of cerebral malaria in children. Subjects demonstrated deficits in such functional domains as accuracy of visual scanning, immediate and delayed visual memory, bimanual tactile discrimination, perceptual abstraction and rule learning skills, right ear auditory information processing, and dominant hand motor speed. A strong negative association between coma duration and bimanual tactile discrimination performance was also found. Contrary to expectations, no evidence for emotional dysfunction resulting directly from cerebral malaria emerged from this study. Nonverbal reasoning, visuospatial processing, auditory attention and sequencing, verbal fluency, and fine motor dexterity were found to be intact.
The pattern of neuropsychological test performance in this study was judged to be consistent with a small-vessel cerebrovasculitis secondary to infection with plasmodium falciparum. Implications and limitations of this investigation, as well as directions for future research were discussed in the context of malaria endemicity.
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Keywords
Malaria, Neuropsychology