Evidence from a natural experiment that malaria parasitemia is pathogenic in retinopathy-negative cerebral malaria
Cerebral malaria (CM) can be classified as retinopathy-positive or retinopathy-negative, based on the presence or absence of characteristic retinal features. While malaria parasites are considered central to the pathogenesis of retinopathy-positive CM, their contribution to retinopathy-negative CM i...
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eLife Sciences Publications Ltd
2017-06-01
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| Series: | eLife |
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| Online Access: | https://elifesciences.org/articles/23699 |
| _version_ | 1818023957360541696 |
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| author | Dylan S Small Terrie E Taylor Douglas G Postels Nicholas AV Beare Jing Cheng Ian JC MacCormick Karl B Seydel |
| author_facet | Dylan S Small Terrie E Taylor Douglas G Postels Nicholas AV Beare Jing Cheng Ian JC MacCormick Karl B Seydel |
| author_sort | Dylan S Small |
| collection | DOAJ |
| description | Cerebral malaria (CM) can be classified as retinopathy-positive or retinopathy-negative, based on the presence or absence of characteristic retinal features. While malaria parasites are considered central to the pathogenesis of retinopathy-positive CM, their contribution to retinopathy-negative CM is largely unknown. One theory is that malaria parasites are innocent bystanders in retinopathy-negative CM and the etiology of the coma is entirely non-malarial. Because hospitals in malaria-endemic areas often lack diagnostic facilities to identify non-malarial causes of coma, it has not been possible to evaluate the contribution of malaria infection to retinopathy-negative CM. To overcome this barrier, we studied a natural experiment involving genetically inherited traits, and find evidence that malaria parasitemia does contribute to the pathogenesis of retinopathy-negative CM. A lower bound for the fraction of retinopathy-negative CM that would be prevented if malaria parasitemia were to be eliminated is estimated to be 0.93 (95% confidence interval: 0.68, 1). |
| first_indexed | 2024-12-10T03:52:34Z |
| format | Article |
| id | doaj.art-8e4ac2811dc44516b509a484824780a2 |
| institution | Directory Open Access Journal |
| issn | 2050-084X |
| language | English |
| last_indexed | 2024-12-10T03:52:34Z |
| publishDate | 2017-06-01 |
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| spelling | doaj.art-8e4ac2811dc44516b509a484824780a22022-12-22T02:03:12ZengeLife Sciences Publications LtdeLife2050-084X2017-06-01610.7554/eLife.23699Evidence from a natural experiment that malaria parasitemia is pathogenic in retinopathy-negative cerebral malariaDylan S Small0https://orcid.org/0000-0003-4928-2646Terrie E Taylor1Douglas G Postels2Nicholas AV Beare3Jing Cheng4Ian JC MacCormick5Karl B Seydel6Department of Statistics, The Wharton School, University of Pennsylvania, Philadelphia, United StatesDepartment of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, United States; Blantyre Malaria Project, Blantyre, MalawiDepartment of Neurology and Ophthalmology, College of Osteopathic Medicine, Michigan State University, East Lansing, United StatesDepartment of Eye and Vision Science, University of Liverpool, Liverpool, United Kingdom; St. Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, United KingdomDepartment of Preventive and Restorative Dental Sciences, University of California, San Francisco, San Francisco, United StatesDepartment of Eye and Vision Science, University of Liverpool, Liverpool, United Kingdom; Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, MalawiDepartment of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, United States; Blantyre Malaria Project, Blantyre, MalawiCerebral malaria (CM) can be classified as retinopathy-positive or retinopathy-negative, based on the presence or absence of characteristic retinal features. While malaria parasites are considered central to the pathogenesis of retinopathy-positive CM, their contribution to retinopathy-negative CM is largely unknown. One theory is that malaria parasites are innocent bystanders in retinopathy-negative CM and the etiology of the coma is entirely non-malarial. Because hospitals in malaria-endemic areas often lack diagnostic facilities to identify non-malarial causes of coma, it has not been possible to evaluate the contribution of malaria infection to retinopathy-negative CM. To overcome this barrier, we studied a natural experiment involving genetically inherited traits, and find evidence that malaria parasitemia does contribute to the pathogenesis of retinopathy-negative CM. A lower bound for the fraction of retinopathy-negative CM that would be prevented if malaria parasitemia were to be eliminated is estimated to be 0.93 (95% confidence interval: 0.68, 1).https://elifesciences.org/articles/23699cerebral malariapathogenesismalarial retinopathynatural experiment |
| spellingShingle | Dylan S Small Terrie E Taylor Douglas G Postels Nicholas AV Beare Jing Cheng Ian JC MacCormick Karl B Seydel Evidence from a natural experiment that malaria parasitemia is pathogenic in retinopathy-negative cerebral malaria eLife cerebral malaria pathogenesis malarial retinopathy natural experiment |
| title | Evidence from a natural experiment that malaria parasitemia is pathogenic in retinopathy-negative cerebral malaria |
| title_full | Evidence from a natural experiment that malaria parasitemia is pathogenic in retinopathy-negative cerebral malaria |
| title_fullStr | Evidence from a natural experiment that malaria parasitemia is pathogenic in retinopathy-negative cerebral malaria |
| title_full_unstemmed | Evidence from a natural experiment that malaria parasitemia is pathogenic in retinopathy-negative cerebral malaria |
| title_short | Evidence from a natural experiment that malaria parasitemia is pathogenic in retinopathy-negative cerebral malaria |
| title_sort | evidence from a natural experiment that malaria parasitemia is pathogenic in retinopathy negative cerebral malaria |
| topic | cerebral malaria pathogenesis malarial retinopathy natural experiment |
| url | https://elifesciences.org/articles/23699 |
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