![]() ![]() Children under five are disproportionately affected, accounting for approximately 77% of deaths worldwide in 2020 ( WHO, 2021). Some studies showed long-term sequelae/poor outcomes in 25-50% of survivors ( WHO, 2014 Bruneel, 2019 Langfitt et al., 2019). CM is an often-fatal form of SM: it requires immediate intervention, has a mortality rate up to 30%, and long-term residual neurological complications. This results in a range of complications, organ dysfunction, and systemic inflammation, which include cerebral malaria (CM), severe anaemia, acute respiratory distress syndrome (ARDS), intestinal injury (gut leak) and acute kidney injury (AKI) ( Wassmer et al., 2015 Ouma et al., 2020 Namazzi et al., 2022 Ngai et al., 2022). SM is a broad-spectrum sepsis-like syndrome defined by organ dysfunctions caused by the excessive production of inflammatory mediators and sequestration of infected erythrocytes within the host’s microvasculature ( White et al., 2013 WHO, 2014). However, in non-exposed populations this immunity fails to build up and individuals are more likely to develop severe malaria (SM). Symptoms are often mild (e.g., fever, headaches, and vomiting) in endemic areas where populations develop a degree of immunity to the parasite, leading to uncomplicated malaria (UM) and asymptomatic malaria (AM, who harbour malarial parasites, but manifest minimal clinical symptoms) ( Mace et al., 2018 Gupta and Wassmer, 2021). ![]() Caused by apicomplexan parasites of the Plasmodium genus, the greatest burden is found in tropical and subtropical parts of the world approximately fifty percent of the world’s population is at risk of infection ( Mace et al., 2018). Malaria, a blood-borne parasitic disease, is a devastating illness that caused 247 million cases globally in 2021, increasing from the 227 million reported in 2019, and still predominantly affecting African paediatric populations ( WHO, 2022). Here, we provide an updated review on promising CM biomarker candidates and evaluate their applicability as point-of-care tools in malaria-endemic areas. Several host and parasite factor-based biomarkers have been suggested as rapid diagnostic tools with potential for early CM diagnosis, however, no specific biomarker signature has been validated. However, current diagnostic tools remain inadequate to assess the degree of brain dysfunction associated with CM before the window for effective treatment closes. Prompt diagnosis and treatment are key to a positive outcome in CM. 2Department of Biotechnology, Institute of Applied Sciences & Humanities, GLA University, Mathura, UP, IndiaĬerebral malaria (CM) is a major cause of mortality in Plasmodium falciparum (Pf) infection and is associated with the sequestration of parasitised erythrocytes in the microvasculature of the host’s vital organs.1Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom.Pranavi Muppidi 1, Emily Wright 1, Samuel C. ![]()
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