Abstract
Cerebral malaria (CM) can be classified as retinopathy-positive or retinopathy-negative, based on the presence or absence of characteristic retinal features. While malaria parasites are considered central to the pathogenesis of retinopathy-positive CM, their contribution to retinopathy-negative CM is largely unknown. One theory is that malaria parasites are innocent bystanders in retinopathy-negative CM and the etiology of the coma is entirely non-malarial. Because hospitals in malaria-endemic areas often lack diagnostic facilities to identify non-malarial causes of coma, it has not been possible to evaluate the contribution of malaria infection to retinopathy-negative CM. To overcome this barrier, we studied a natural experiment involving genetically inherited traits, and find evidence that malaria parasitemia does contribute to the pathogenesis of retinopathy-negative CM. A lower bound for the fraction of retinopathy-negative CM that would be prevented if malaria parasitemia were to be eliminated is estimated to be 0.93 (95% confidence interval: 0.68, 1).
Original language | English |
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Article number | 23699 |
Journal | eLIFE |
Volume | 6 |
DOIs | |
Publication status | Published - 7 Jun 2017 |
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Ian Maccormick
- Deanery of Clinical Sciences - Senior Clinical Research Fellow in Ophthalmology
- Centre for Clinical Brain Sciences
- Institute for Adaptive and Neural Computation
- Edinburgh Neuroscience
Person: Academic: Research Active