title: Severe falciparum malaria and acquired childhood language disorder.
abstract: Language disorders have been reported after severe falciparum malaria but the deficits have not been described in detail. We assessed language outcome in three groups of children aged 6 to 9 years (n=487): those previously admitted to Kilifi District Hospital, Kenya, with cerebral malaria (CM; n=152; mean age 7y 4 mo [SD 1y 1mo]; 77 males, 75 females); or those with malaria and complicated seizures (M/S; n=156; mean age 7y 4mo [SD 1y 2mo]; 72 males, 84 females); and those unexposed to either condition (n=179; mean age 7y 6mo [SD 1y 1mo]; 93 males, 86 females). Median age at hospital admission was 28 months (interquartile range [IQR] 19 to 44 mo) among children with a history of CM and 23 months (IQR 12 to 35mo) among children with a history of M/S. A battery of eight assessments covering the major facets of speech and language was used to measure language performance. Cognitive performance, neurological/motor skills, behaviour, hearing, and vision were also measured. Eighteen (11.8%) of the CM group, 14 (9%) of the M/S group, and four (2.2%) of the unexposed group were found to have a language impairment. CM (odds ratio 3.68, 95% confidence interval 1.09 to 12.4, p=0.04) was associated with significantly increased odds of an impairment-level score relative to the unexposed group. The results suggest that falciparum malaria is one of the most common causes of acquired language disorders in the tropics.
authors.affiliation: Neurosciences Unit, Institute of Child Health, The Wolfson Centre, London, UK. j.carter@ich.ucl.ac.uk
authors.forename: Julie A
authors.initials: JA
authors.lastname: Carter
authors.forename: Janet A
authors.initials: JA
authors.lastname: Lees
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Gona
authors.forename: Gladys
authors.initials: G
authors.lastname: Murira
authors.forename: Kenneth
authors.initials: K
authors.lastname: Rimba
authors.forename: Brian G R
authors.initials: BG
authors.lastname: Neville
authors.forename: Charles R J C
authors.initials: CR
authors.lastname: Newton
mesh_terms: D002648:Child; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D007806:Language Disorders / Q000453:epidemiology* / Q000469:parasitology* / Q000503:physiopathology; D016778:Malaria, Falciparum / Q000150:complications* / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D009483:Neuropsychological Tests; D012307:Risk Factors; D012720:Severity of Illness Index