Evidence from a natural experiment that malaria parasitemia is pathogenic in retinopathy-negative cerebral malaria

Small, Dylan S, Taylor, Terrie E, Postels, Douglas G, Beare, Nicholas AV ORCID: 0000-0001-8086-990X, Cheng, Jing, MacCormick, Ian JC and Seydel, Karl B (2017) Evidence from a natural experiment that malaria parasitemia is pathogenic in retinopathy-negative cerebral malaria. ELIFE, 6. e23699-.

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Abstract

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).

Item Type:	Article
Uncontrolled Keywords:	Humans, Parasitemia, Malaria, Cerebral, Child, Child, Preschool, Infant, Malawi, Female, Male
Depositing User:	Symplectic Admin
Date Deposited:	11 Sep 2017 10:02
Last Modified:	19 Jan 2023 06:55
DOI:	10.7554/eLife.23699
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3009389