Cognitive sequelae of severe malaria with impaired consciousness.

Although cerebral malaria is the most common acute encephalopathy arising in children in Africa little is known of its effect upon the longer-term cognitive development of survivors. In Kenya, we compared the performance of 87 survivors of severe malaria with impaired consciousness to matched commun...

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Main Authors: Holding, P, Stevenson, J, Peshu, N, Marsh, K
Format: Journal article
Language:English
Published: 1999
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author Holding, P
Stevenson, J
Peshu, N
Marsh, K
author_facet Holding, P
Stevenson, J
Peshu, N
Marsh, K
author_sort Holding, P
collection OXFORD
description Although cerebral malaria is the most common acute encephalopathy arising in children in Africa little is known of its effect upon the longer-term cognitive development of survivors. In Kenya, we compared the performance of 87 survivors of severe malaria with impaired consciousness to matched community controls on a wide range of tasks, not less than 42 months post illness episode. The presence of cognitive impairment was then related to both the pattern of symptoms at the time of the acute illness and the presence of gross neurological impairment on discharge. Significant group differences were found in areas of cognitive functioning suggestive of widespread impairment in the development of the ability to initiate, plan and carry out tasks (the executive functions). On tasks of more discrete cognitive skills (information processing) there were no significant group differences, although impaired performance was found more frequently in the severe malaria group. The odds ratio associated with the development of cognitive impairment following severe malaria with impaired consciousness was found to be 4.48 (95% CI 1.22, 16.47). A combination of 4 signs (coma, hypoglycaemia, seizures, and absence of hyperpyrexia) proved to have greater accuracy than the presence of gross neurological sequelae in predicting cognitive impairment (95% vs 93% specificity, 67% vs 58% sensitivity).
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spelling oxford-uuid:f7689f31-069d-46e4-9db6-6b9605807d8a2022-03-27T12:42:24ZCognitive sequelae of severe malaria with impaired consciousness.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f7689f31-069d-46e4-9db6-6b9605807d8aEnglishSymplectic Elements at Oxford1999Holding, PStevenson, JPeshu, NMarsh, KAlthough cerebral malaria is the most common acute encephalopathy arising in children in Africa little is known of its effect upon the longer-term cognitive development of survivors. In Kenya, we compared the performance of 87 survivors of severe malaria with impaired consciousness to matched community controls on a wide range of tasks, not less than 42 months post illness episode. The presence of cognitive impairment was then related to both the pattern of symptoms at the time of the acute illness and the presence of gross neurological impairment on discharge. Significant group differences were found in areas of cognitive functioning suggestive of widespread impairment in the development of the ability to initiate, plan and carry out tasks (the executive functions). On tasks of more discrete cognitive skills (information processing) there were no significant group differences, although impaired performance was found more frequently in the severe malaria group. The odds ratio associated with the development of cognitive impairment following severe malaria with impaired consciousness was found to be 4.48 (95% CI 1.22, 16.47). A combination of 4 signs (coma, hypoglycaemia, seizures, and absence of hyperpyrexia) proved to have greater accuracy than the presence of gross neurological sequelae in predicting cognitive impairment (95% vs 93% specificity, 67% vs 58% sensitivity).
spellingShingle Holding, P
Stevenson, J
Peshu, N
Marsh, K
Cognitive sequelae of severe malaria with impaired consciousness.
title Cognitive sequelae of severe malaria with impaired consciousness.
title_full Cognitive sequelae of severe malaria with impaired consciousness.
title_fullStr Cognitive sequelae of severe malaria with impaired consciousness.
title_full_unstemmed Cognitive sequelae of severe malaria with impaired consciousness.
title_short Cognitive sequelae of severe malaria with impaired consciousness.
title_sort cognitive sequelae of severe malaria with impaired consciousness
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