OBJECTIVE. This study was conducted to assess prospectively the frequency of cognitive deficits in children with cerebral malaria.METHODS. Cognitive testing in the areas of working memory, attention, and learning was performed for Ugandan children 5 to 12 years of age with cerebral malaria ( n = 44), children with uncomplicated malaria ( n = 54), and healthy community children ( n = 89) at admission and 3 and 6 months later.RESULTS. Six months after discharge, 21.4% of children with cerebral malaria had cognitive deficits, compared with 5.8% of community children. Deficits were seen in the areas of working memory (11.9% vs 2.3%) and attention (16.7% vs 2.3%). Children with cerebral malaria had a 3.7-fold increased risk of a cognitive deficit, compared with community children, after adjustment for age, gender, nutritional status, school level, and home environment. Among children with cerebral malaria, those with a cognitive deficit had more seizures before admission (mean: 4.1 vs 2.2) and a longer duration of coma (43.6 vs 30.5 hours), compared with those without a deficit. Children with uncomplicated malaria did not have an increased frequency of cognitive deficits.CONCLUSIONS. Cerebral malaria may be a major cause of cognitive impairment in children in sub-Saharan Africa. Cognitive deficits in children with cerebral malaria are more likely for those who have multiple seizures before effective treatment for cerebral malaria.
展开▼
机译：目的。这项研究旨在前瞻性评估脑疟疾患儿认知功能障碍的发生率。对工作记忆，注意力和学习领域的认知测试对乌干达5至12岁患有脑疟疾的儿童（n = 44），无并发症疟疾的儿童（n = 54）和健康的社区儿童（n = 89）在入院时以及3和6个月后。结果。出院后六个月，有21.4％的脑疟疾儿童有认知缺陷，而社区儿童为5.8％。在工作记忆（11.9％vs 2.3％）和注意力（16.7％vs 2.3％）方面出现不足。在调整了年龄，性别，营养状况，学校水平和家庭环境之后，与社区儿童相比，脑疟疾儿童的认知缺陷风险增加了3.7倍。在患有脑疟疾的儿童中，与没有赤字的儿童相比，认知缺陷的儿童入院前癫痫发作多（平均：4.1 vs 2.2），昏迷时间更长（43.6 vs 30.5小时）。疟疾未患儿的认知缺陷发生率没有增加。结论。脑疟疾可能是撒哈拉以南非洲地区儿童认知障碍的主要原因。对于在有效治疗脑疟疾之前多次发作的人来说，脑疟疾患儿的认知功能障碍可能性更高。
展开▼
