Central nervous system virus infection in African children with cerebral malaria

Authors

Douglas Postels, Washington University, USA
Lawrence Osei-Tutu, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Karl Seydel, Michigan State University, USA
Qian Xu, Washington University, USA
Chenxi Li, Washington University, USA
Terrie Taylor, Washington University, USA
Chandy John, Indiana University, USA
Macpherson Mallewa, University of Malawi, Malawi
Tom Solomon, University of Liverpool, UK
Robert Opoka, Aga Khan UniversityFollow

Document Type

Article

Department

Paediatrics and Child Health (East Africa)

Abstract

We aimed to identify the contribution of central nervous system (CNS) viral coinfection to illness in African children with retinopathy-negative or retinopathy-positive cerebral malaria (CM). We collected cerebrospinal fluid (CSF) from 272 children with retinopathy-negative or retinopathy-positive CM and selected CSF from 111 of these children (38 retinopathy positive, 71 retinopathy negative, 2 retinopathy unknown) for analysis by metagenomic next-generation sequencing. We found CSF viral coinfections in 7/38 (18.4%) retinopathy-positive children and in 18/71 (25.4%) retinopathy-negative children. Excluding HIV-1, human herpesviruses (HHV) represented 61% of viruses identified. Excluding HIV-1, CNS viral coinfection was equally likely in children who were retinopathy positive and retinopathy negative (P = 0.1431). Neither mortality nor neurological morbidity was associated with the presence of virus (odds ratio [OR] = 0.276, 95% CI: 0.056–1.363). Retinopathy-negative children with a higher temperature, lower white blood cell count, or being dehydrated were more likely to have viral coinfection. Level of consciousness at admission was not associated with CNS viral coinfection in retinopathy-negative children. Viral CNS coinfection is unlikely to contribute to coma in children with CM. The herpesviruses other than herpes simplex virus may represent incidental bystanders in CM, reactivating during acute malaria infection.

Comments

This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

The American journal of tropical medicine and hygiene

DOI

https://doi.org/10.4269/ajtmh.19-0962

Recommended Citation

Postels, D., Osei-Tutu, L., Seydel, K., Xu, Q., Li, C., Taylor, T., John, C., Mallewa, M., Solomon, T., Opoka, R. (2020). Central nervous system virus infection in African children with cerebral malaria. The American journal of tropical medicine and hygiene, 103(1), 200-205.
Available at: https://ecommons.aku.edu/eastafrica_fhs_mc_paediatr_child_health/490

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.