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Year : 2006  |  Volume : 9  |  Issue : 4  |  Page : 109-112

Neurological sequelae complicating childhood cerebral malaria in Nigeria

Department of Paediatrics, Usmanu Danfodiyo Universit y Teaching Hospital, P.M.B. 2370, Sokoto, Nigeria

Correspondence Address:
N M Jiya
Department of Paediatrics, Usmanu Danfodiyo University Department of Paediatrics, Usmanu Danfodiyo University
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Background: Malaria remains a major cause of high morbidity and mortality in sub­ Saharan African children especially those aged between 1 and 5 years. Amongst the survivors of those with cerebral malaria, 10% to 35% may exhibit residual neurological sequelae. Objective: To determine the pattern of neurological sequelae complicating cerebral malaria in children aged 6 months to 12 years that were admitted consecutively into Emergency Paediatric Unit (EPU), Usmanu Danfodiyo University Teaching Hospital Sokoto a one-year period. Methods: This was a prospective study that was conducted between 1"1 June 1999 and 181 May 2000. All the children with confirmed diagnosis of cerebral malaria formed the stud y cohort. Intravenous (I .V .) quinine dlhydrochlorlde was the antimalarial drug of choice. Neurological sequelae were documented among the survivors of cerebral malaria. Results: A total of 78 children with cerebral malaria were admitted Into EPU over the study period. Twenty (26%) patients died while 11 (14%) developed residual neurological . Four (36%) had generalized spasticity of the limbs, 3 (27%) generalized hypotonia with inability to walk, 2 (18%) hemiparesis, and 2 (18%) partial seizure disorder with secondary generalization. Others include 2 (18%) cortical blindness, 2 (18%) aphasia , 1 ( 9%) and 1(9%) cerebellar ataxia. Hemiplegia and cranial nerve palsy were , however, not seen. Six (67%) of the 9 patients who came for follow-up had completely recovered b y the sixth week of outpatient follow-up. Conclusion: The neurological disability following cerebral malaria in children ma y therefore, constitute a larger public health problem than gener·ally recognized ; hence there Is a need for longer follow0-up of such children.

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