Carme B, Bouquety J C, Plassart H
University Hospital of Brazzaville, Congo.
Am J Trop Med Hyg. 1993 Feb;48(2):216-21. doi: 10.4269/ajtmh.1993.48.216.
This study was carried out on 170 children admitted to the University Hospital of Brazzaville (Congo) for cerebral malaria between January 1, 1988 and June 30, 1989. The selection criteria were 1) unarousable coma, cerebrospinal fluid without microorganisms or a marked cellular reaction, and the absence of other causes, and 2) that the children lived in Brazzaville. The case fatality rate was 15%. In 75% of the cases, death occurred within the first 48 hr. The prognosis worsened with the stage of the coma and a younger age. At discharge from the hospital, 9% of the cases presented with sequelae. The postcerebral malaria mortality was high; indeed, death occurred in six (7%) of 90 children discharged from the hospital whose parents were contacted between nine and 27 months later. Two deaths were directly related to neurologic sequelae. Among the 58 children examined under satisfactory conditions between nine and 27 months (mean 16.9 months) after discharge, 50% (3 of 6) still presented with attenuated forms of the sequelae observed immediately after the episode of cerebral malaria (cortical blindness had regressed completely, unlike ataxia and loss of balance). Disorders that may have been related to the episode of cerebral malaria were observed in 31% of these 58 cases.
本研究对1988年1月1日至1989年6月30日期间因脑型疟疾入住布拉柴维尔大学医院（刚果）的170名儿童进行。入选标准为：1）不可唤醒的昏迷、脑脊液无微生物或明显的细胞反应且无其他病因；2）儿童居住在布拉柴维尔。病死率为15%。75%的病例在最初48小时内死亡。预后随着昏迷程度加重和年龄较小而恶化。出院时，9%的病例出现后遗症。脑型疟疾后的死亡率很高；事实上，在出院的90名儿童中，有6名（7%）在9至27个月后与家长取得联系时死亡。两例死亡与神经后遗症直接相关。在出院后9至27个月（平均16.9个月）条件良好的58名儿童中，50%（6例中的3例）仍有脑型疟疾发作后立即观察到的后遗症的减轻形式（与共济失调和平衡丧失不同，皮质盲已完全消退）。在这58例中的31%观察到可能与脑型疟疾发作有关的病症。
