Researchers at Michigan State University have identified a
test that can determine which children with malaria are likely to develop
cerebral malaria, a much more life-threatening form of the disease.
The screening tool could be a game-changer in
resource-limited rural health clinics where workers see hundreds of children
with malaria each day and must decide which patients can be sent home with oral
drugs and which need to be taken to hospitals for more comprehensive care.
“Rural health workers have to make these decisions with very
little objective data, and the consequences of an inappropriate decision are
huge,” said Karl Seydel, MSU assistant professor of osteopathic medical
specialties. “Children who progress to cerebral malaria have a 20 percent
mortality rate, or even higher if they don’t get the right treatment early in
the disease process.”
How the study was
In a new study in the
Journal of Infectious Diseases, Seydel and colleagues report that testing
patients’ blood for HRP2 – a protein produced by the malaria parasite – was an
accurate predictor of how the disease progressed among children at Queen
Elizabeth Central Hospital in Blantyre, Malawi.
“We found that if HRP2 levels are low, clinicians can be
more than 98 percent sure the child will not progress to cerebral malaria,”
Seydel said. “That would give them the confidence to merely prescribe oral
drugs and send the child home.”
Nowhere is the need for such a tool greater than in Africa,
where 90 percent of childhood malaria deaths occur. Only about 1 percent of
children with malaria develop the life-threatening form of the disease, yet an
estimated one million African children die from it each year.
“In most of Africa, where resources are still so limited,
using those available resources appropriately and intelligently is of great
importance,” Seydel said.
Cheaper option needed
The HRP2 test in its current form is costly and poorly
suited to use in rural clinics, Seydel noted. He and colleagues are in the
process of developing a less expensive, more portable version.
Seydel’s collaborators on the study include MSU researchers
Lindsay Fox, Terrie Taylor and Mathew Reeves, along with partners from the
University of Malawi College of Medicine.
The National Institutes of Health supported the research.