Brain Swelling and Death in Children with Cerebral Malaria

Malaria causes substantial morbidity and mortality in sub-Saharan Africa. In this report from Malawi, the pathogenesis of cerebral malaria in children is evaluated. Despite recent advances in treatment, prevention, and control, malaria remains a major scourge. 1 Quinine, the mainstay of treatment for cerebral malaria for 300 years, has been supplanted by artesunate, 2 , 3 but despite more rapid parasite clearance with artesunate, the case fatality rate among African children with cerebral malaria treated with artesunate remains high at 18%. 3 Improvements in community-based care will help to prevent cerebral malaria, but additional advances in the treatment of hospitalized patients will probably require adjunctive therapies targeting key pathogenetic mechanisms. The pathogenesis of cerebral malaria is incompletely understood, and although there is considerable evidence to suggest that . . .