New malaria tool shows which kids at greatest risk

Researchers at Michigan State University have identified a test that can determine which children with malaria are likely to develop cerebral malaria, a much more life-threatening form of the disease.

The screening tool could be a game-changer in resource-limited rural health clinics where workers see hundreds of children with malaria each day and must decide which patients can be sent home with oral drugs and which need to be taken to hospitals for more comprehensive care.

“Rural health workers have to make these decisions with very little objective data, and the consequences of an inappropriate decision are huge,” said Karl Seydel, MSU assistant professor of osteopathic medical specialties. “Children who progress to cerebral malaria have a 20 percent mortality rate, or even higher if they don’t get the right treatment early in the disease process.”

In a new study in the Journal of Infectious Diseases, Seydel and colleagues report that testing patients’ blood for HRP2 – a protein produced by the malaria parasite – was an accurate predictor of how the disease progressed among children at Queen Elizabeth Central Hospital in Blantyre, Malawi.

“We found that if HRP2 levels are low, clinicians can be more than 98 percent sure the child will not progress to cerebral malaria,” Seydel said. “That would give them the confidence to merely prescribe oral drugs and send the child home.”

Nowhere is the need for such a tool greater than in Africa, where 90 percent of childhood malaria deaths occur. Only about 1 percent of children with malaria develop the life-threatening form of the disease, yet an estimated one million African children die from it each year.

What are the symptoms of malaria? Your baby is unlikely to get malaria in the first two months of her life. This is because of the immunity you gave her during your pregnancy. As she grows older, she loses that immunity, and her risk of catching malaria increases.

Malaria tends to be more severe in children under five years old. Symptoms start showing about 10 days to four weeks after being bitten.

If your little one is younger than five, you should look out for these symptoms:

fever
shivering
cold
irritability and drowsiness
poor appetite
sleeplessness
vomiting
stomach pain
hypothermia (instead of a fever)
rapid breathing

If your child is older than five, she will have the same symptoms as adults do. They are similar to flu-like symptoms and include: