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The 'hidden' burden of malaria: cognitive impairment following infection

DOI: 10.1186/1475-2875-9-366

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PUBMED and SCOPUS were searched for all articles with the key word 'Malaria' in the title field and 'cognitive impairment' in any field. Google Scholar was searched for the same keywords anywhere in the article. The search was restricted to articles published in English within the last 15 years (1995-2010). After filtering of abstracts from the initial search, 44 papers had research evidence on this topic.Cognitive abilities and school performance were shown to be impaired in sub-groups of patients (with either cerebral malaria or uncomplicated malaria) when compared with healthy controls. Studies comparing cognitive functions before and after treatment for acute malarial illness continued to show significantly impaired school performance and cognitive abilities even after recovery. Malaria prophylaxis was shown to improve cognitive function and school performance in clinical trials when compared to placebo groups. The implications of these findings are discussed.Mortality and morbidity due to malaria is still substantial in many tropical countries. In 2006, 247 million cases of malaria were estimated, resulting in 881,000 deaths [1]. Of the 109 endemic countries, 30 countries in sub-Saharan Africa and five in Asia accounted for 98% of malaria deaths globally [2]. The financial cost to tackle malaria is staggering. The global estimate of direct losses due to malaria (i.e., the personal and public expenditures to prevent and treat the disease) is USD 12 billion annually. Approximately 35.4 million disability adjusted life years (DALYs) are lost in sub-Saharan Africa alone due to the mortality and morbidity of malaria [2]. The estimates of expenditure to tackle malaria globally in 2009 and 2010 are USD 5.335 billion and 6.180 billion, respectively, and include direct costs for diagnosis, treatment and prevention [2].There exists an important hidden burden of malaria, namely, that of cognitive impairment and effects on school performance resulting from malaria infectio

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