Malaria was responsible for approximately 584,000 deaths in 2013, the majority of which were among children in Africa. Now, researchers from Michigan State University claim to have made a groundbreaking discovery about cerebral malaria, a deadly form of the disease: it is brain swelling that causes children to die from it - a finding that may pave the way for new treatments.
Malaria is caused by Plasmodium parasites transmitted by a bite from infected Anopheles mosquitoes. Though a curable disease if treated quickly and correctly, it remains responsible for hundreds of thousands of deaths each year.
In Africa - where more than 90% of malaria deaths occur - a child dies from the disease every minute. It is estimated that in 2013, 437,000 African children died from the disease before they reached their fifth birthday.
Cerebral malaria is one of the most common causes of death from the disease. It occurs when blood cells containing the Plasmodium parasite block blood vessels to the brain. This can cause brain inflammation and brain damage.
Scientists have seen much success in finding treatments that can kill the Plasmodium parasite, tackling malaria at its root. In December 2014, for example, Medical News Today reported on a study published in the Proceedings of the National Academy of Sciences, in which researchers identified an antimalaria compound that destroyed all traces of the parasite in mice within 48 hours.
The Michigan State researchers - led by Dr. Terrie Taylor - say progress in finding ways to treat the effects of malaria, however, has moved at a much slower pace. But with the help of magnetic resonance imaging (MRI), Dr. Taylor and her team believe they may be closer to identifying such treatments.
Death in cerebral malaria 'caused by brain stem compression'
Dr. Taylor spends 6 months a year at the Queen Elizabeth Hospital in Malawi, treating and studying children with malaria. In 2008, the hospital received an MRI scanner - a tool that, though common in developed countries, is very rare in Africa.
The research team used MRI to analyze the brain images of hundreds of children with cerebral malaria, some of whom had survived the disease and some of whom had died from it.
The results of the analysis, which are published in The New England Journal of Medicine, revealed that children who had survived the disease never experienced brain swelling, while the majority of those who died experienced severe brain inflammation. "This was a triumphant moment," says Dr. Taylor. "I wanted to say to the parasite 'Ha! You never thought we'd get an MRI, did you?'"
In detail, the researchers found that the brain of some children with cerebral malaria becomes so inflamed that the organ is pushed out through the bottom of the skull, compressing the brain stem. This can cause a child to stop breathing, leading to their death.
Commenting on the team's discovery, Dr. Taylor says:
"Because we know now that the brain swelling is what causes death, we can work to find new treatments.
The next step is to identify what's causing the swelling and then develop treatments targeting those causes. It's also possible that using ventilators to keep the children breathing until the swelling subsides might save lives, but ventilators are few and far between in Africa at the moment."
Last month, Medical News Today reported on a study published in the International Journal of Systematic and Evolutionary Microbiology, in which researchers claim genetically modifying a newly discovered strain of bacteria in mosquitoes could prevent malaria transmission.