Cerebral malaria

Cerebral malaria is a severe form of malaria whereby malaria-causing parasites enter the brain and cause damage. This condition is life-threatening and you should see a healthcare provider immediately when you experience any of the symptoms. Symptoms of cerebral malaria include loss of consciousness, seizures and problems breathing. Quick treatment with appropriate antimalaria medicines is necessary.

In addition to common malaria symptoms, such as headaches, fever and vomiting, you are likely to have:

• Seizures.
• Lose awareness of your surrounding and become confused.
• Problems breathing.
• Low blood sugar levels.
• Low levels of red blood cells (anaemia). 

Cerebral malaria is caused by malaria parasites crossing the barrier which protects the brain and keeps it from being exposed to infections. When the protective part of the barrier becomes weak, the parasite can enter the brain. This causes swelling of the brain , which affects the nervous system.

• If you live in Nigeria, your risk for developing malaria or its more severe form, cerebral malaria, is high. Three-quarters of Nigerians live in areas that are high risk for malaria transmission.
• Children younger than five years old have a higher risk of developing severe forms of malaria.
• Most people who live in places with frequent malaria infections develop some immunity. When this immunity reduces due to ill-health (e.g. HIV infection) or poor diet, the risk of severe malaria infection increases.

• If you have severe headaches and high fever, you should immediately go to the health centre for care.
• If you experience seizures, do not drive yourself. Call for help or request an ambulance (if that service is available to you) to move you to a health centre immediately.

If you see someone who loses consciousness (faints), is confused or is shaking uncontrollably, do not move them or wipe away spit or other body fluids.

• Call for an ambulance immediately. If this is not available, arrange for their immediate transport to a health centre.
• Do not put any objects in their mouth, as this can lead to choking.
• If they are struggling to breathe, place them on their side.
• Reassure them when they come around, and allow them to continue laying there until the ambulance (or other transport) is available to transport them to a health centre.

The most effective way to prevent cerebral malaria is to prevent being bitten by mosquitos. This can be done by:

• Sleeping under a long-lasting insecticide-treated bed net.
• Using mosquito repellant cream and spray.
• Preventing breeding sites for mosquitoes around your home by draining pools of stagnant water.
• Wearing long clothing that reduces exposure to a mosquito bites.

If you are at risk for cerebral malaria (e.g. due to poor immune defences), your healthcare provider will advise you to take preventive steps. This may include using an antimalaria medicine taken by mouth regularly (weekly or monthly).

You cannot manage cerebral malaria at home since it is a life-threatening condition. You must go to a health centre immediately.

When your healthcare provider confirms the diagnosis of cerebral malaria, they will start treatment with antimalarial medicines. They may also provide treatment for affected organs.

If you have high blood sugar or high blood pressure they may, for the time being,  change how you use the medication for these conditions.

Most people infected with cerebral malaria recover without any long-term effects as long as they get treated quickly. It is essential to remain well hydrated and complete your malaria treatment as advised by your healthcare provider, even after you begin to feel well.