{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T17:48:53Z","timestamp":1773337733082,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Icelandic company Hananja ehf."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Cerebral malaria (CM) is a life-threatening disease that affects mainly children in sub-Saharan Africa. Studies have shown that children who survive CM are often left with neurological disabilities after recovery, such as behavioral changes similar to attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). However, diagnosis and treatments for ADHD are limited in many places in Africa. The purpose of this study was to assess behavioral changes following CM infection in Children in Malawi and parents\u2019 acceptability of behavioral treatments. Twenty-one parents of children who had survived CM were compared to forty parents from the general population. Assessment instruments included the Disruptive Behavior Rating Scale (DBRS), Treatment Evaluation Inventory-Short Form (TEI-SF), and ADHD symptom checklist. The results showed that the most acceptable treatments among parents in Malawi were interrupt\/redirect, discussion, and medication. Parents of CM-surviving children were significantly more accepting of medication (F(1,59) = 7.92, p &lt; 0.007). The majority of the children who survived CM were rated above the clinical cut-off for ADHD and ODD symptoms.<\/jats:p>","DOI":"10.3390\/ijerph22060928","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T07:44:23Z","timestamp":1749714263000},"page":"928","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Behavioral Consequences Among Survivors of Cerebral Malaria and Acceptability to Different Disciplinary Methods"],"prefix":"10.3390","volume":"22","author":[{"given":"Gudlaug Maria","family":"Sveinbjornsdottir","sequence":"first","affiliation":[{"name":"Department of Psychology, School of Health Sciences, University of Iceland, S\u00e6mundargata 2, 102 Reykjav\u00edk, Iceland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sam","family":"Kabota","sequence":"additional","affiliation":[{"name":"Pediatric Department, Nkhoma Mission Hospital, Christian Health Association in Malawi, Nkhoma P.O. Box 48, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7824-9752","authenticated-orcid":false,"given":"Sveinbjorn","family":"Gizurarson","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, School of Health Sciences, University of Iceland, Hofsvallagata 53, 107 Reykjavik, Iceland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2993-9359","authenticated-orcid":false,"given":"Urdur","family":"Njardvik","sequence":"additional","affiliation":[{"name":"Department of Psychology, School of Health Sciences, University of Iceland, S\u00e6mundargata 2, 102 Reykjav\u00edk, Iceland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,12]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2023). World Malaria Report 2023, World Health Organization."},{"key":"ref_2","unstructured":"World Health Organization (2021). World Malaria Report 2021, An In-Depth Update on Global and Regional Malaria Data and Trends, World Health Organization."},{"key":"ref_3","unstructured":"(2020, May 03). Centers for Disease Control and Prevention, Available online: https:\/\/www.cdc.gov\/malaria\/about\/index.html."},{"key":"ref_4","unstructured":"Luo, E.K. (2020, May 03). Malaria. Available online: https:\/\/www.healthline.com\/health\/malaria."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Kay, H.H., Nelson, M., and Wang, Y. (2011). Infections in the Placenta. The Placenta: From Development to Disease, Blackwell Publishing Company. Chapter 34.","DOI":"10.1002\/9781444393927"},{"key":"ref_6","unstructured":"Hotez, P.J. (2010). The Neglected Tropical Diseases and their Impact on Global Health and Development. Forgotten Diseases in Forgotten People, ASM Press."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Idro, R., Kakooza-Mwesige, A., Balyejjussa, S., Mirembe, G., Mugasha, C., Tugumisirize, J., and Byarugaba, J. (2010). Severe neurological sequelae and behaviour problems after cerebral malaria in Ugandan children. BMC Res. Notes, 3.","DOI":"10.1186\/1756-0500-3-104"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"291","DOI":"10.2217\/fmb.11.155","article-title":"Cerebral malaria pathogenesis: Revisiting parasite and host contributions","volume":"7","author":"Grau","year":"2012","journal-title":"Future Microbiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/S1474-4422(05)70247-7","article-title":"Pathogenesis, clinical features, and neurological outcome of cerebral malaria","volume":"4","author":"Idro","year":"2005","journal-title":"Lancet Neurol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1111\/j.1365-3156.2010.02704.x","article-title":"Developmental outcomes in Malawian children with retinopathy-positive cerebral malaria","volume":"16","author":"Boivin","year":"2011","journal-title":"Trop. Med. Int. Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e360","DOI":"10.1542\/peds.2006-2027","article-title":"Cognitive impairment after cerebral malaria in children: A prospective study","volume":"119","author":"Boivin","year":"2007","journal-title":"Pediatrics"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1186\/s12936-016-1233-6","article-title":"Cerebral malaria is associated with long-term mental health disorders: A cross-sectional survey of a long-term cohort","volume":"15","author":"Idro","year":"2016","journal-title":"Malar. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e92","DOI":"10.1542\/peds.2007-3709","article-title":"Cerebral malaria in children is associated with long-term cognitive impairment","volume":"122","author":"John","year":"2008","journal-title":"Pediatrics"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1186\/s12936-020-03336-z","article-title":"Pathophysiology and neurologic sequelae of cerebral malaria","volume":"19","author":"Schiess","year":"2020","journal-title":"Malar. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1016\/S1474-4422(10)70270-2","article-title":"Blantyre Malaria Project Epilepsy Study (BMPES) of neurological outcomes in retinopathy-positive paediatric cerebral malaria survivors: A prospective cohort study","volume":"9","author":"Birbeck","year":"2010","journal-title":"Lancet Neurol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s40475-022-00270-9","article-title":"The Silent Pandemic: The impact of COVID-19 on the Mental Health of adolescents living with HIV","volume":"9","author":"Swanson","year":"2022","journal-title":"Curr. Trop. Med. Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"105","DOI":"10.4314\/mmj.v34i2.5","article-title":"Prevalence and correlates of common mental disorders among children and adolescents in Blantyre-Urban Malawi","volume":"34","author":"Matandika","year":"2022","journal-title":"Malawi Med. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1176\/ajp.2007.164.6.942","article-title":"The worldwide prevalence of ADHD: A systematic review and metaregression analysis","volume":"164","author":"Polanczyk","year":"2007","journal-title":"Am. J. Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12991-020-00271-w","article-title":"Epidemiology of attention-deficit\/hyperactivity disorder (ADHD) in children and adolescents in Africa: A systematic review and meta-anaysis","volume":"19","author":"Ayano","year":"2020","journal-title":"Ann. Gen. Psychiatry"},{"key":"ref_20","first-page":"74","article-title":"Attention Deficit and Hyperactivity Disorder (ADHD) in Southren Africa: Management Perspecives","volume":"12","author":"Kasu","year":"2023","journal-title":"EC Paediatr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1300\/J019v20n04_02","article-title":"Treatment acceptability of behavioral interventions for children: An assessment by mothers of children with disruptive behavior disorders","volume":"20","author":"Jones","year":"1998","journal-title":"Child Fam. Behav. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1300\/J019v14n01_02","article-title":"Treatment acceptability: The effects of parent gender, marital adjustment, and child behavior","volume":"14","author":"Miller","year":"1992","journal-title":"Child Fam. Behav. Ther."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1027\/1901-2276.60.4.283","article-title":"Cultural Effects on Treatment Acceptability","volume":"60","author":"Njardvik","year":"2008","journal-title":"Nord. Psychol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Dorsey, S., Akiba, C.F., Triplett, N.S., Lucid, L., Carroll, H.A., Benjamin, K.S., Itemba, D.K., Wasonga, A.I., Manongi, R., and Martin, P. (2022). Consumer perspectives on acceptability of trauma-focused cognitive behavioral therapy in Tanzania and Kenya: A mixed methods study. Implement. Res. Pract., 3.","DOI":"10.1177\/26334895221109963"},{"key":"ref_25","first-page":"107","article-title":"Feasibility and acceptability of an online response inhibition cognitive training program for youth with Williams syndrome","volume":"59","author":"Brei","year":"2020","journal-title":"Int. Rev. Res. Dev. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/0734282905285235","article-title":"Assessment of disruptive behaviors in preschoolers: Psychometric properties of the disruptive behavior disorders rating scale and school situations questionnaire","volume":"24","author":"Pelletier","year":"2006","journal-title":"J. Psychoeduc. Assess."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1007\/BF00960495","article-title":"Development of a modified treatment evaluation inventory","volume":"11","author":"Kelley","year":"1989","journal-title":"J. Psychopathol. Behav. Assess."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1023\/B:CCFP.0000020190.60808.a4","article-title":"Enhancements to the behavioral parent training paradigm for families of children with ADHD: Review and future directions","volume":"7","author":"Chronis","year":"2004","journal-title":"Clin. Child Fam. Pychol. Rev."},{"key":"ref_29","unstructured":"International Test Commission (2025, June 03). The ITC Guidelines for Translating and AdaptingTests (Second edition). Available online: www.InTestCom.org."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/6\/928\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:50:44Z","timestamp":1760032244000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/6\/928"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,12]]},"references-count":29,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["ijerph22060928"],"URL":"https:\/\/doi.org\/10.3390\/ijerph22060928","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,12]]}}}