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Severe falciparum malaria and acquired childhood language disorder

Published online by Cambridge University Press:  19 December 2005

Julie A Carter
Affiliation:
Neurosciences Unit, Institute of Child Health, The Wolfson Centre, London, UK. The Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi, Kenya.
Janet A Lees
Affiliation:
Neurosciences Unit, Institute of Child Health, The Wolfson Centre, London, UK.
Joseph K Gona
Affiliation:
The Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi, Kenya.
Gladys Murira
Affiliation:
The Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi, Kenya.
Kenneth Rimba
Affiliation:
The Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi, Kenya.
Brian GR Neville
Affiliation:
Neurosciences Unit, Institute of Child Health, The Wolfson Centre, London, UK.
Charles RJC Newton
Affiliation:
Neurosciences Unit, Institute of Child Health, The Wolfson Centre, London, UK. The Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute, Kilifi, Kenya.
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Abstract

Language disorders have been reported after severe falciparum malaria but the deficits have not been described in detail. We assessed language outcome in three groups of children aged 6 to 9 years (n=487): those previously admitted to Kilifi District Hospital, Kenya, with cerebral malaria (CM; n=152; mean age 7y 4 mo [SD 1y 1mo]; 77 males, 75 females); or those with malaria and complicated seizures (M/S; n=156; mean age 7y 4mo [SD 1y 2mo]; 72 males, 84 females); and those unexposed to either condition (n=179; mean age 7y 6mo [SD 1y 1mo]; 93 males, 86 females). Median age at hospital admission was 28 months (interquartile range [IQR] 19 to 44 mo) among children with a history of CM and 23 months (IQR 12 to 35mo) among children with a history of M/S. A battery of eight assessments covering the major facets of speech and language was used to measure language performance. Cognitive performance, neurological/motor skills, behaviour, hearing, and vision were also measured. Eighteen (11.8%) of the CM group, 14 (9%) of the M/S group, and four (2.2%) of the unexposed group were found to have a language impairment. CM (odds ratio 3.68, 95% confidence interval 1.09 to 12.4, p=0.04) was associated with significantly increased odds of an impairment-level score relative to the unexposed group. The results suggest that falciparum malaria is one of the most common causes of acquired language disorders in the tropics.

Type
Original Articles
Copyright
© 2006 Mac Keith Press

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