Surviving severe malaria – looking at the long-term impact on childhood disability
A large study to look at long-term neurological and cognitive impacts on children who survived severe malaria has begun. TDR is working with investigators in Tanzania, Bangladesh and Ghana on a new, two year grant provided by Grand Challenges Canada. The study builds on earlier research, called Study 13, which found that early treatment with an artesunate suppository averted mortality and major brain injury.
Children who survive severe episodes are sometimes left with permanent brain damage. This impairment often leads to poor school performance and higher dropout rates. Yet timely treatment and schooling may enable catch-up and this study will look at whether this occurs.
The Study 13 researchers (and other experts) are going back to the same group of children who survived one or more malaria episodes of malaria to quantify the disability associated with severe malaria and the effects of early treatment. By following up survivors, quantifying functional disabilities that are now apparent and identifying the anatomical lesions, the study will establish the relationship between central nervous system (CNS) symptoms and disability, taking into account repeated episodes, treatment, treatment delays, severity of symptoms and cause (whether it’s malaria or not). At the time of the original study, the children were between 6 months and 6 years; most children are now over 8 years of age when their cognitive performance, language, visual skills, memory and executive function can be assessed.
The study is investigating three main questions:
- What happened to children who survived one or more malaria episodes?
- For the children who had seizures, coma or altered consciousness was the disability greater than for those who did not have these symptoms?
- Was disability modified by treatment or treatment delays?
The research team is being led by Professor Abul Faiz from the Mahidol Oxford Research Unit in Bangkok, Thailand and Dr Melba Gomes from TDR. Other researchers include Professor Nicholas White from the Wellcome Trust South East Asian Tropical Medicine Research Units, Thailand and Vietnam; Professor Charles Newton, Wellcome Trust Kenya and University of Oxford; Dr Penny Holding, International Centre for Behavioural Studies in Mombasa, Kenya; Dr Charles Makasi, Dr Zakayo Mrango and Omari Kimbute from the National Institute of Medical Research Centre in Dar-es-Salaam, Tanzania; Dr Marian Warsame, World Health Organization; Dr Frank Baiden, Kintampo Health Research Centre, Kintampo, Ghana; Dr Selasi Sefenu, Dr Adote Anum , Professor Fred Binka, and Professor John Gyapong, University of Ghana; Professor Naila Khan and Prof Selina H Banu, Dhaka Shishu Children’s Hospital, Bangladesh; Prof Rasheda Samad from the Chittagong Medical College, Bangladesh; and Maclean Vokhiwa from the University of Malawi.
For more information, please contact
Dr Melba Gomes
Telephone: +41 22 791 3813