Article

Magnetic resonance imaging may help with the treatment of cerebral malaria

World Malaria Day is April 25th, helps to raise awareness for a disease that affects roughly 210,000,000 people around the world each year.1 Of those 210 million people, about 440,000 people die from malaria.1 Young children in Africa make up the majority of the cases that end in death. A person's location can have an exceptional impact on their likelihood of contracting malaria. Because of the high rate of contraction, travelers to and citizens of certain countries, such as those in tropical or subtropical climates, should be wary.

What is malaria?

Malaria is a parasitic disease, or a disease caused by a parasite.1,2 This parasite is typically transmitted to humans from infected mosquitoes, though it may also be transmitted from a mother to their unborn child, blood transfusions, or sharing needles. The whole process is a bit cyclic, as it starts and ends with an uninfected mosquito biting a person with malaria. Once the infected mosquito has bitten a person, the parasite has been transmitted and will mature in the liver, where it may be dormant for up to a year. The parasite then matures and travels into the bloodstream, infecting a person's red blood cells. At this stage, the patient may begin to develop malaria symptoms.

The most common symptoms of malaria are:

  • fever
  • chills
  • headache
  • nausea and vomiting
  • muscle pain and fatigue.1,2

Some of the less common symptoms may include:

  • sweating
  • chest or abdominal pain
  • cough.1,2

In most cases, these symptoms begin within a few weeks of a bite. Since some types of parasites lie dormant for up to a year, symptoms may begin at that time.

If a patient has traveled to certain locations and reports having these symptoms, they may have been infected.1,2 The riskiest areas for travelers and residents are African countries that are south of the Sahara desert, areas of the Asian subcontinent, New Guinea, the Dominican Republic and Haiti. It is uncommon for patients to contract malaria in temperate climates, but it is still common in tropical and subtropical areas. The most common way to learn more about the disease is through blood tests that may check for the presence of the parasite, which type of parasite is present or if the infection is caused by a drug-resistant parasite.

Some world health organizations are attempting to protect people from being bit while they sleep by encouraging the use of bed nets with the hope of reducing the incidence rate.2 Additionally, people in high-risk areas are urged to take precautionary steps. These tips include wearing protective clothing, using insect repellents and sleeping under the treated mosquito nets previously mentioned. Some travelers may take preventative medicine before, during and after their trip. In some cases, people in highly affected areas may build up a resistance to the disease, which may lessen the severity of their symptoms. This resistance may wane if they leave the area for an extended period of time.

There are a few different complications that may be fatal.1,2 These may often be a result of a certain variety of parasite that is common in tropical parts of Africa. These complications occur in cases of severe malaria and may include breathing problems, organ failure, anemia, low blood sugar or cerebral malaria.

  • Breathing problems due to malaria may be due to accumulated fluid in the lungs, also referred to as a pulmonary edema, and can make it difficult to breath.1,2
  • Organ failure may occur in the kidney or liver. Malaria may sometimes result in a rupture of the spleen.1,2
  • Anemia results from having too few healthy red blood cells in the blood. This may be attributed to the parasite infecting the red blood cells.1,2
  • Low blood sugar may be seen in cases of severe malaria. Quinine, a common medicine used to combat malaria, may also reduce a patient's blood sugar.1,2
  • Cerebral malaria may occur when infected blood cells block other small blood vessels from getting to your brain. As a result, malaria may result in swelling of brain or brain damage. It may also cause seizures and coma.1,2

Buyers Guide_950x250.jpg

How can magnetic resonance imaging help with cerebral malaria?

Magnetic resonance imaging (MRI) may produce detailed images of different tissue structures and organs in the body. It may be used to monitor the progression of various diseases and check for lesions, tumors or abnormalities. In the case of malaria, MRI might be particularly helpful for investigating the effects of cerebral malaria, rather than imaging its progression.

Because cerebral malaria causes swelling of or damage to the brain, brain MR scans may be necessary to determine the best course of action. A professor at Michigan State University, Dr. Terrie Taylor, and her team conducted a study of the MR scans of the brains of infected children.3 In this study, Dr. Taylor imaged the brains of hundreds of infected children. Her team then compared the scans of those children who died with those who had survived. They noted that over 80% of the children who died suffered from severe brain swelling. The swelling caused the brain to be forced through the bottom of the skull, which compressed the brain stem and led to difficulty breathing. Dr. Taylor believes that her research may help others direct their research.3

Researchers like Dr. Taylor may continue to provide information about the causes of death due to malaria and the causes of the patient's symptoms. It is not clear at this point how much of an impact this will have, especially in lower-income areas. However, if this research can reduce the number of deaths due to malaria by even a few, the medical community may be taking a step in the right direction.

For more information, please read The Pulse "World Malaria Day: MRI Shows How 'Voldemort of Parasites' Kills Children."

References

1. Global Health, Division of Parasitic Diseases and Malaria. "About Malaria." CDC.gov. 29 March 2018. Web. 15 April 2019.

2. Mayo Clinic Staff. "Malaria." MayoClinic.org. 13 December 2018. Web. 15 April 2019. <https://www.mayoclinic.org/diseases-conditions/malaria/symptoms-causes/syc-20351184>.

3. "World Malaria Day: MRI Shows How "Voldemort of Parasites" Kills Children." The Pulse. 19 March 2015. Web. 15 April 2019. <http://newsroom.gehealthcare.com/mri-shows-how-voldemort-of-parasites-kills-children/>.

a. WHO. "10 facts on malaria." WHO.int. December 2016. Web. 15 April 2019. <https://www.who.int/features/factfiles/malaria/en/>.

b. Richard Idro, et al. "Cerebral Malaria; Mechanisms of Brain Injury and Strategies For Improved Neuro-Cognitive Outcome." Pediatr Res. October 2010. Web. 15 April 2019. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056312/>.

c. WHO. "World Malaria Report 2014." WHO.int. December 2014. Web. 15 April 2019. <https://www.who.int/malaria/publications/world_malaria_report_2014/report/en/>.