Affiliations: Atlanta Research and Education Foundation, Decatur,
GA, USA | Malaria Branch, Division of Parasitic Diseases and
Malaria, Center for Global Health, Centers for Disease Control and Prevention,
Atlanta, GA, USA | National Institute of Malaria Research, Regional
Medical Research Center for Tribals, Jabalpur, India | Morehouse School of Medicine, Atlanta, GA, USA
Note: [] Corresponding author: Jonathan K. Stiles, Morehouse School of
Medicine, Department of Microbiology, Biochemistry and Immunology, BMSB Room
349D, 720 Westview Dr. SW, Atlanta, GA 30310, USA. Tel.: +1 404 742 1586; Fax:
+1 404 752 1179; E-mail: jstiles@msm.edu
Abstract: Biomarkers have been used to diagnose and prognosticate the progress
and outcome of many chronic diseases such as neoplastic and non communicable
diseases. However, only recently did the field of malaria research move in the
direction of actively identifying biomarkers that can accurately discriminate
the severe forms of malaria. Malaria continues to be a deadly disease, killing
close to a million people (mostly children) every year. One life-threatening
complication of malaria is cerebral malaria (CM). Studies carried out in Africa
have demonstrated that even with the best treatment, as high as 15–30% of
CM patients die and about 10–24% of CM survivors suffer short-or long-term
neurological impairment. The transition from mild malaria to CM can be sudden
and requires immediate intervention. Currently, there is no biological test
available to confirm the diagnosis of CM and its complications. It is hoped
that development of biomarkers to identify CM patients and potential risk for
adverse outcomes would greatly enhance better intervention and clinical
management to improve the outcomes. We review here what is currently known
regarding biomarkers for CM outcomes. A Pub Med literature search was performed
using the following search terms: "malaria," "cerebral malaria,"
"biomarkers," "mortality" and "neurological sequelae." This search
revealed a paucity of usable biomarkers for CM management. We propose three
main areas in which researchers can attempt to identify CM biomarkers: 1) early
biomarkers, 2) diagnostic biomarkers and 3) prognostic biomarkers.
Keywords: Biomarkers, cerebral malaria, severe malaria, malaria
