User:Csidhu3/sandbox

Cerebral Malaria or CM is a neurological complication that arises due to infection of Plasmodium falciparum, the most common and dangerous vector of malaria. CM is the deadliest of all complications associated with malaria and most of the incidences of cerebral malaria found are within children under the age of five. Children who survive a bout with CM often develop long term cognitive issues such as memory impairment, language and verbal deficiencies, and motor defecits. The majority of the cases that occur are located in developing nations especially in Sub-Saharan Africa where the medical infrastructure and education about health are not as developed.

Signs and Symptoms
Symptoms of malaria and cerebral malaria are often the same and are flu-like such as sweats, fever, headache, and shivers. Also enlarged spleen so talk about conversation with Dr. Roman about the children in third world countries with spleens often 10 times larger than those of children from the developed world. Cerebral malaria can only occur with infection by P. falciparum and it just so happens that this causes severe malaria with cerebral malaria being one of the most severe instances of this. Then talk about hypoglycemia again from talks with Dr. Roman resulting often in many children in hospitals with comas. Last talk about pregnant women and children being more susceptible.

Cause
Mosquitoes carrying the P. falciparum virus infects a human host. It then travels through blood vessels into liver cells where it is proliferated and then infects red blood cells. The virus continues replicating until the red blood cells burst causing the virus to infect other areas. If the invading red blood cells burst in the brain, the epithelial cells of the brain are the first infected causing the gap junctions to break and thus there is little to no blood brain barrier specificity.

Pathogenesis
Infection by mosquito carrying P. falciparum leads to proliferation of virus in the liver where it is relatively shielded from the immune system and immune response. After replicating many times in the liver, the virus then infects red blood cells where they again begin to replicate. The virus replicates until the red blood cell bursts and if the cell bursts in the brain, the virus infects the epithelial cells of the brain and lead to destruction of blood brain barrier specificity.

Diagnosis
Right now the most effective way to diagnose cerebral malaria is the same as the way to diagnose regular malaria, with a blood test. Cerebral malaria requires a greater amount of care and treatment than regular malaria but it can essentially be seen as an extreme form of malaria where the virus infects the brain causing adverse effects within the brain. But another way to classify if cerebral malaria is present is to do PCR testing to see if the virus is actually P. falciparum not any other vector since only P. falciparum causes cerebral malaria.

Prevention
Ecotourism and the nature of the world today where it is so easy to travel to remote locations is responsible for the reemergence of cerebral malaria in the developed world. It is still a large problem in the developing world especially in tropical areas since it is difficult to control mosquitoes in areas like these. If one is visiting a nation which still has malaria present, it is recommended to take certain antibiotics and antimalarials that are given on the CDC website which are often quite effective. The problem with these is that overuse of these antibiotics and antimalarials have made the presence of antibiotic resistant viruses.

Treatment
There is currently no vaccine present for the cure of malaria. This is partly because malaria is a problem mainly controlled to very poor, third world areas thus there is not much of a research incentive to create a cure. Right now the treatment of malaria is to use oral antimalarials in all cases, but in specific with severe malaria which is commonly what occurs in the case of cerebral malaria sometimes hemodialysis is necessary to replenish the red blood cells and platelets. Also respiratory machines or other aid to help with the many other complications that occur with malaria may be necessary. These are often not readily present or available in third world countries so it is not uncommon for hospitals to have 5+ beds with children in a coma from cerebral malaria.

Epidemiology
Need to look up specific numbers but Sub-Saharan Africa, Southeast Asia, and Central and South America. In tropical areas that are not very well developed with low quality of living and low sanitation. Was present in areas such as Sweeden, Washington D.C., and Italy even up to the Civil War time. In fact malaria comes from an Italian word meaning bad air. Now it is pretty much eradicated from the developed world except in cases where someone has visited a tropical area and a little more than a week later begins to experience flu-like symptoms that are commonly associated with malaria.

History
Need to look this up. May be hard to find so may delete this later but for now I will keep it.

Society and Culture
Same as history, I need to look this up more to see if it would be enough for its own section. May later delete.

Research
There is a tough time doing clinical trials and finding experimental groups to test certain medications on that have been proposed to help out in animal models. Talk about the different types of treatment that Bienvenu talks about in my Wiki topic related book Neuroprotection and Cerebral Malaria where she talks about statins and other brain blood vessel dilators which help to save the epithelial cells from being damaged and eventually ruptured. Dr. Roman was asked about these and said that he has heard some about it and there has been some research about it but some of the more recent trials have shown that these treatments that deal with changing the elasticity of the blood vessels sometimes prove worse than regular antimalarial treatment.