マラリアの制御と撲滅

Cerebral Malaria

Abstract

Isaac Oludare Oluwayemi

Cerebral Malaria (CM) is the most severe neurological presentation of acute falciparum malaria, the clinical hallmark of which is the presence of coma. It is a diffuse encephalopathy associated with seizures in at least 80%, and status epilepticus, in up to a third of cases. The case fatality rate of CM ranges between 5% and 50%. Although most survivors make a full recovery, neurological sequelae such as hemiplegia, speech problems, cortical blindness and epilepsy occur in 3-31%. Plasmodium falciparum is responsible for almost all the mortality from malaria and is the only species that appear to directly affect the central nervous system causing neurological deficits and cognitive sequelae. The World Health Organization estimated that more than 83% of P. falciparum malaria occurs in sub- Saharan Africa where children bear the brunt of the disease with over one million children dying annually. The aim of this review is to provide an update on cerebral malaria.