Abstract
Malaria continues to be a public health problem that particularly affects the tropical regions and developing countries, whereas Latin America is an endemic region for the disease. Despite the fact that a decrease in malaria cases has been shown, in general, cases of complicated malaria remain stable and within the severe complications of this parasitic infection is cerebral malaria, which, although considered uncommon, is associated with a mortality of up to 20 %, especially in children and also produces high disability rates: about 11 % of children and 25 % of adults who suffer from it. Of hence the relevance of knowing it and making early detection of this complication. We present the definition of cerebral malaria, the pathophysiological mechanisms from the microvascular obstruction, cytokine storm to endothelial alteration. We call the attention to the picture of signs and symptoms, the importance of maintaining this clinical suspicion and the need to consider the main differential diagnoses; we mention the usefulness of each of the diagnostic aids and the limitation due to the limited availability of them in many geographic areas. We leave a message for the entire health team to be attentive to detect timely systemic complications. The bases of the current treatment and where is vaccine research going. This review is also an invitation to reflect on the approach to this pathology and the necessary inclusion of other factors to consider such as cultural conditions, socioeconomic and educational conditions that affect the behavior of the disease in affected communities.
References
Schiess N, ViUabona-Rueda A, Cottier KE, Huether K, Chipeta J, Stins MF. Pathophysiology and neurologic sequelae of cerebral malaria. Malar J. 2020;19(1):1-12. doi: 10.1186/s12936-020-03336-z.
Global Malaria Programme: WHO Global. World malaria report 2019. WHO Regional Office for Africa. 2019. Disponible en: https://www.who.int/news-room/fact-sheets/detail/malaria
Organización Panamericana de la Salud (OPS), Organización Mundial de la Salud (OMS). Situación de la malaria en la región de las Américas, 2000-2016. OPS; 2013.
Chaparro Narváez PEC, Perez ML, Rengifo LM, Padilla J, Herrera S, Herrera MA. Clinical and epidemiological aspects of complicated malaria in Colombia, 2007-2013. Malar J. 2016; 15(1):269. doi: 4. 10.1186/s12936-016-1323-5.
World Health Organization (WHO). WHO severe malaria 2014. Trop Med Int Heal 2014;19(Suppl 7-131).
Idro R, Kakooza-Mwesige A, Asea B, Ssebyala K, Bangirana P, Opoka RO, et al. Cerebral malaria is associated with longterm mental health disorders: A cross sectional survey of a long-term cohort. Malar J. 2016;15(1):1-11. doi: 10.1186/s12936-016-1233-6.
Crawley J, Chu C, Nosten F, Mtove G. Malaria in children. Lancet. 2010;375(9724):1468-81. doi: 10.1016/S0140-6736(10)60447-3.
Hermansyah B, Fitri LE, Sardjono TW, Endharti AT, Ari S. Clinical features of severe malaria: Protective effect of mixed plasmodial malaria. Asian Pac J Trop Biomed. 2017;7(1):4-9. 8. doi: 10.1016/j.apjtb.2016.11.001.
Luzolo AL, Ngoyi DM. Cerebral malaria. Brain Res Bull. 2019;145:53-8. doi: 10.1016/j.brainresbull.2019.01.010.
Tobón Castaño Al, Piñeros Jiménez J, Blair Trujillo S, Carmona-Fonseca. Clínica de la malaria complicada debida a P. falciparum: Estudio de casos y controles en Tumaco y Turbo (Colombia). Iatreia. 2006;19(4):339-55.
Thakur K, Zunt J. Tropical neuroinfectious diseases. Continuum (Minneap Minn). 2015;21(6):1639-61. doi: 10.1212/CON.0000000000000248. PMID: 26633780.
Bruneel F. Human cerebral malaria : 2019 mini review. Rev Neurol. 2019;175(7-8):445-50. doi: 10.1016/j.neurol.2019.07.008.
Taylor TE, Molyneux ME. The pathogenesis of pediatric cerebral malaria: eye exams, autopsies, and neuroimaging. Ann N Y Acad Sci. 2015;1342(1):44-52. doi: 10.1111/nyas.12690.
Wassmer SC, Taylor TE, Rathod PK, Mishra SK, Mohanty S, Arevalo-Herrera M, Duraisingh MT, Smith JD. Investigating the pathogenesis of severe malaria: a multidisciplinary and cross-geographical approach. Am J Trop Med Hyg. 2015;93(3 Suppl):42-56. doi: 10.4269/ajtmh.14-0841.
Sahu PK, Satpathi S, Behera PK, Mishra SK, Mohanty S, Wassmer SC. Pathogenesis of cerebral malaria: new diagnostic tools, biomarkers, and therapeutic approaches. Front Cell Infect Microbiol. 2015;5:75. doi: 10.3389/fcimb.2015.00075.
Ghazanfari N, Mueller SN, Heath WR. Cerebral malaria in mouse and man. Front Immunol. 2018;9:2016. doi: 10.3389/fimmu.2018.02016.
Storm J, Craig AG. Pathogenesis of cerebral malaria--inflammation and cytoadherence. Front Cell Infect Microbiol. 2014;4:100. doi: 10.3389/fcimb.2014.00100.
Hora R, Kapoor P, Thind KK, Mishra PC. Cerebral malaria-clinical manifestations and pathogenesis. Metab Brain Dis. 2016;31(2):225-37. doi: 10.1007/s11011-015-9787-5.
Román GC. The neurology of parasitic diseases and malaria. Continuum (Minneap Minn). 2011;17(1):113-33. doi: 10.1212/01.CON.0000394678.13115.ad.
MacCormick IJ, Beare NA, Taylor TE, Barrera V, White VA, Hiscott P, Molyneux ME, Dhillon B, Harding SP. Cerebral malaria in children: using the retina to study the brain. Brain. 2014;137(Pt 8):2119-42. doi: 10.1093/brain/awu001.
Carmona-Fonseca J, Lucía Sánchez Y, Yasnot MF. Malaria por Plasmodium vivax o P. falciparum en hospital de tercer nivel en la región más endémica de Colombia TT - Malaria due to Plasmodium vivax or P. falciparum in a tertiary hospital in the most endemic region of Colombia. Acta Médica Colomb. 2015;40(4):294-304.
Abba K, Kirkham AJ, Olliaro PL, Deeks JJ, Donegan S, Garner P, Takwoingi Y. Rapid diagnostic tests for diagnosing uncomplicated non-falciparum or Plasmodium vivax malaria in endemic countries. Cochrane Database Syst Rev. 2014;12:CD011431. doi: 10.1002/14651858.CD011431.
Dondorp A, Nosten F, Stepniewska K, Day N, White N; South East Asian Quinine Artesunate Malaria Trial (SEAQUAMAT) Group. Artesunate versus quinine for treatment of severe falciparum malaria: a randomised trial. Lancet. 2005;366(9487):717-25. doi: 10.1016/S0140-6736(05)67176-0.
Varo R, Crowley VM, Sitoe A, Madrid L, Serghides L, Kain KC, Bassat Q. Adjunctive therapy for severe malaria: a review and critical appraisal. Malar J. 2018;17(1):47. doi: 10.1186/s12936-018-2195-7.
Prasad K, Garner P. Steroids for treating cerebral malaria. Cochrane Database Syst Rev. 2000;1999(2):CD000972. doi: 10.1002/14651858.CD000972.
Taylor TE, Molyneux ME, Wirima JJ, Borgstein A, Goldring JD, Hommel M. Intravenous immunoglobulin in the treatment of paediatric cerebral malaria. Clin Exp Immunol. 1992;90(3):357-62. doi: 10.1111/j.1365-2249.1992.tb05851.x.
van Hensbroek MB, Palmer A, Onyiorah E, Schneider G, Jaffar S, Dolan G, et al. The effect of a monoclonal antibody to tumor necrosis factor on survival from childhood cerebral malaria. J Infect Dis. 1996;174(5):1091-7. doi: 10.1093/infdis/174.5.1091.
Havlik I, Looareesuwan S, Vannaphan S, Wilairatana P, Krudsood S, Thuma PE, et al. Curdlan sulphate in human severe/cerebral Plasmodium falciparum malaria. Trans R Soc Trop Med Hyg. 2005;99(5):333-40. doi: 10.1016/j.trst-mh.2004.05.005.
Das BK, Mishra S, Padhi PK, Manish R, Tripathy R, Sahoo PK, Ravindran B. Pentoxifylline adjunct improves prognosis of human cerebral malaria in adults. Trop Med Int Health. 2003;8(8):680-4. doi: 10.1046/j.1365-3156.2003.01087.x.
Palacpac NMQ, Horii T. Malaria vaccines: facing unknowns. F1000Res. 2020;9:F1000 Faculty Rev-296. doi: 10.12688/f1000research.22143.1.
Zapata Zapata CH, Blair Trujillo S. Malaria cerebral. Iatreia [Internet]. 2003;16(3): 202-16. Disponible en: https://revistas.udea.edu.co/index.php/iatreia/article/view/4003.

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