April 25th is World Malaria Day. People the world over are driving awareness for this disease that threatens 3.3 billion people in 106 countries, and the global efforts to research and treat it. In 2013, there were 198 million cases and 584,000 deaths. The most startling statistic: malaria still kills one child every minute.
In 2013, 90 percent of people who died of malaria were in Africa1. Dr. Terrie Taylor, a professor at Michigan State University, describes it as “the Voldemort of parasites.”
Decades of research have led to several effective treatments for the malaria parasite itself, like quinidine. But the damage malaria leaves in its wake is still little understood, and death rates remain unacceptably high2.
Dr. Taylor has been studying how malaria affects the brain since 1986. Together with her research team, she established the Blantyre Malaria Project at the Queen Elizabeth Central Hospital in Malawi, where she spends six months of every year treating patients and carrying out research.
A groundbreaking new study carried out by Dr. Taylor and her team has finally shed light on the likely mechanism by which the disease kills children.
Malaria is caused by a parasite called Plasmodium, which is transmitted via the bites of infected mosquitoes. In the body, the parasites multiply in the liver, and then infect and destroy red blood cells. Symptoms include severe headache, fever, chills, vomiting, anemia and jaundice3.
Using Magnetic Resonance Imaging (MRI), they imaged the brains of hundreds of infected children. They compared the scans of those who died and those who survived, and saw that over 80 percent of the children who died suffered severe brain swelling.
“We discovered that some children with cerebral malaria develop massively swollen brains and those are the children who die,” Taylor said.
In effect, they found that the brain became so swollen it was forced through the bottom of the skull. This compresses the brain stem, causing the child to stop breathing and die.
“It’s gut-wrenching when children die, but what keeps us going is that we are making progress against this Voldemort of parasites,” Taylor added. “It’s been an elusive quarry, but I think we have it cornered.”
In 2008, the nearest MRI machine was a thousand miles away from Blantyre. That’s when GE Healthcare provided one to Queen Elizabeth Hospital, and this groundbreaking research was made possible.
“Because we know now that the brain swelling is what causes death, we can work to find new treatments,” Taylor said. “The next step is to identify what’s causing the swelling and then develop treatments targeting those causes. It’s also possible that using ventilators to keep the children breathing until the swelling subsides might save lives, but ventilators are few and far between in Africa at the moment.”