Clinical comparison of retinopathy-positive and retinopathy-negative cerebral Malaria

Chandler Villaverde, Ruth Namazzi, Estela Shabani, Robert O. Opoka, Chandy John

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Cerebral malaria (CM) is a severe and often lethal complication of falciparum malaria. A classic malaria retinopathy is seen in some (retinopathy-positive [RP]) children but not others (retinopathy-negative [RN]), and is associated with increased parasite sequestration. It is unclear whether RN CM is a severe nonmalarial illness with incidental parasitemia or a less severe form of the same malarial illness as RP CM. Understanding the clinical differences between RP and RN CM may help shed light on the pathophysiology of malarial retinopathy. We compared clinical history, physical examination, laboratory findings, and outcomes of RP (N = 167) and RN (N = 87) children admitted to Mulago Hospital, Kampala, Uganda. Compared with RN children, RP children presented with a longer history of illness, as well as physical examination and laboratory findings indicative of more severe disease and organ damage. The hospital course of RP children was complicated by longer coma duration and a greater transfusion burden than RN children. Mortality did not differ significantly between RP and RN children (14.4% versus 8.0%, P = 0.14). Further, severity of retinal hemorrhage correlated with the majority of variables that differed between RP and RN children. The data suggest that RP and RN CM may reflect the spectrum of illness in CM, and that RN CM could be an earlier, less severe form of disease.

Original languageEnglish (US)
Pages (from-to)1176-1184
Number of pages9
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume96
Issue number5
DOIs
StatePublished - 2017

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Cerebral Malaria
Physical Examination
Retinal Hemorrhage
Uganda
Parasitemia
Falciparum Malaria
Coma
Malaria
Parasites
Mortality

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases
  • Virology

Cite this

Clinical comparison of retinopathy-positive and retinopathy-negative cerebral Malaria. / Villaverde, Chandler; Namazzi, Ruth; Shabani, Estela; Opoka, Robert O.; John, Chandy.

In: American Journal of Tropical Medicine and Hygiene, Vol. 96, No. 5, 2017, p. 1176-1184.

Research output: Contribution to journalArticle

Villaverde, Chandler ; Namazzi, Ruth ; Shabani, Estela ; Opoka, Robert O. ; John, Chandy. / Clinical comparison of retinopathy-positive and retinopathy-negative cerebral Malaria. In: American Journal of Tropical Medicine and Hygiene. 2017 ; Vol. 96, No. 5. pp. 1176-1184.
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