A new study discovered the mechanism by which severe malaria kills children. Researchers are pinning it on brain swelling. It’s not a study that changes the impact of the disease today, but scientists are hopeful that promising treatments will come fast.
Doctors in the tropics have long suspected that brain swelling was the chief cause of death in cerebral malaria, but didn’t have clear evidence. Cerebral malaria is one of the most dangerous subtypes of the disease, leading to coma and death.
Children who contract the type have a mortality rate of 15 to 25 percent. Even if the pediatric patients survive, they are often left deaf, blind or with learning disabilities.
The importance of how the disease affects a patient is important in discovering how to develop new treatments do malaria.
A team of researchers in Malawi selected 168 children who met the strict criteria of cerebral malaria. MRI scans were performed on the patients, and among the survivors of the study, only 27% did not have brain swelling.
Twenty-five of the children died during the study, 21 of which had severe brain swelling. That worked out to 84 percent of the deaths.
“What’s killing these kids is that they stop breathing, because the respiratory center in the brain stem is compressed by the swelling,” said Dr. Terrie E. Taylor, the senior author of the study.
What can be done now? Several treatment options exist, but involve serious investment from western countries. Ventilators could save some of the children, getting them through the worst of the brain swelling. Typically, in cerebral malaria, the brain swelling lasts for a few days.
Is it expensive? Yes, but saving just one child makes it worth it. Ventilators are not widely available in Africa, but getting centers set up is not beyond the scope of the world’s health capability. We spooled up Ebola centers with the help of the US military, why not malaria centers?
Other treatment options include steroids, which may reduce the swelling. Additional studies need to be conducted, but the drugs could offer a bridge while new treatments are developed.
The disease is a major killer in the tropics, and is a parasite spread by mosquitoes. In 2013, there were 198 million cases. 500,000 people died, mostly children in Africa. While the disease can be prevented with drugs and treated, there is still no vaccine.
Even with drug protocols, the disease can prove to be fatal in young children. We worked together as one to tackle Ebola last year, isn’t it time we did the same for malaria. 500,000 children dying is a number that cannot stand.
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