Impairment of executive function in Kenyan children exposed to severe falciparum malaria with neurological involvement

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dc.contributor.author Kihara, Michael
dc.contributor.author Kariuki, Symon M
dc.contributor.author Abubakar, Amina
dc.contributor.author Newton, Charles
dc.date.accessioned 2015-07-08T09:50:07Z
dc.date.available 2015-07-08T09:50:07Z
dc.date.issued 2014
dc.identifier.issn 1475-2875
dc.identifier.uri http://erepo.usiu.ac.ke/11732/483
dc.description A journal article by Dr. Michael Kihara, an Associate Professor of Psychology, at United States International University -Africa en_US
dc.description.abstract Background: Persistent neurocognitive impairments occur in a fifth of children hospitalized with severe falciparum malaria. There is little data on the association between different neurological phenotypes of severe malaria (seizures, impaired consciousness and prostration) and impairments in executive function. Methods: Executive functioning of children exposed to severe malaria with different neurological phenotypes (N = 58) and in those unexposed (N = 56) was examined using neuropsychological tests such as vigilance test, test for everyday attention test for children (TEA-Ch), contingency naming test (CNT) and self-ordered pointing test (SOPT). Linear regression was used to determine the association between neurological phenotypes of severe malaria and executive function performance scores, accounting for potential confounders. Results: Children with complex seizures in severe malaria performed more poorly than unexposed controls in the vigilance (median efficiency scores (interquartile range) = 4.84 (1.28-5.68) vs. 5.84 (4.71-6.42), P = 0.030) and SOPT (mean errors (standard deviation) = 29.50 (8.82) vs. 24.80 (6.50), P = 0.029) tests, but no differences were observed in TEA-Ch and CNT tests. Performance scores for other neurological phenotypes of severe malaria were similar with those of unexposed controls. After accounting for potential confounders, such as child’s age, sex, schooling; maternal age, schooling and economic activity; perinatal factors and history of seizures, complex seizures remained associated with efficiency scores in the vigilance test (beta coefficient (β) (95% confidence interval (CI)) = −0.40 (−0.67, −0.13), P = 0.006) and everyday attention scores of the TEA-Ch test (β (95% CI) = −0.57 (−1.04, −0.10), P = 0.019); the association with SOPT error scores was weak (β (95% CI) = 4.57 (−0.73-9.89), P = 0.089). Combined neurological phenotypes were not significantly associated with executive function performance scores. Conclusion: Executive function impairment in children with severe malaria is associated with specific neurological phenotypes, particularly complex seizures. Effective prophylaxis and management of malaria-associated acute seizures may improve executive functioning performance scores of children. en_US
dc.publisher Malaria Journal en_US
dc.subject Children en_US
dc.subject Executive functioning en_US
dc.subject Falciparum malaria en_US
dc.subject Kenya en_US
dc.subject Acute seizures en_US
dc.title Impairment of executive function in Kenyan children exposed to severe falciparum malaria with neurological involvement en_US
dc.type Article en_US

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