{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T19:34:58Z","timestamp":1794339298665,"version":"4.9.0"},"reference-count":21,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,5,3]]},"abstract":"<jats:p>\n                    Cerebral malaria (CM) is a severe and often lethal complication of falciparum malaria. A classic malaria retinopathy is seen in some (retinopathy-positive [RP]) children but not others (retinopathy-negative [RN]), and is associated with increased parasite sequestration. It is unclear whether RN CM is a severe nonmalarial illness with incidental parasitemia or a less severe form of the same malarial illness as RP CM. Understanding the clinical differences between RP and RN CM may help shed light on the pathophysiology of malarial retinopathy. We compared clinical history, physical examination, laboratory findings, and outcomes of RP (\n                    <jats:italic>N<\/jats:italic>\n                    = 167) and RN (\n                    <jats:italic>N<\/jats:italic>\n                    = 87) children admitted to Mulago Hospital, Kampala, Uganda. Compared with RN children, RP children presented with a longer history of illness, as well as physical examination and laboratory findings indicative of more severe disease and organ damage. The hospital course of RP children was complicated by longer coma duration and a greater transfusion burden than RN children. Mortality did not differ significantly between RP and RN children (14.4% versus 8.0%,\n                    <jats:italic>P<\/jats:italic>\n                    = 0.14). Further, severity of retinal hemorrhage correlated with the majority of variables that differed between RP and RN children. The data suggest that RP and RN CM may reflect the spectrum of illness in CM, and that RN CM could be an earlier, less severe form of disease.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.16-0315","type":"journal-article","created":{"date-parts":[[2017,1,30]],"date-time":"2017-01-30T22:00:48Z","timestamp":1485813648000},"page":"1176-1184","source":"Crossref","is-referenced-by-count":24,"title":["Clinical Comparison of Retinopathy-Positive and Retinopathy-Negative Cerebral Malaria"],"prefix":"10.4269","volume":"96","author":[{"given":"Chandler","family":"Villaverde","sequence":"first","affiliation":[{"name":"The Warren Alpert Medical School, Brown University, Providence, Rhode Island."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Namazzi","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estela","family":"Shabani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota."},{"name":"Department of Pediatrics, Indiana University, Indianapolis, Indiana."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert O.","family":"Opoka","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandy C.","family":"John","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota."},{"name":"Department of Pediatrics, Indiana University, Indianapolis, Indiana."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"World Malaria Report 2015","author":"World Health Organization","year":"2015"},{"key":"ref2","series-title":"J Neurol Neurosurg Psychiatry","first-page":"433","article-title":"Cerebral malaria","volume":"69","author":"Newton","year":"2000"},{"key":"ref3","series-title":"Pediatrics","first-page":"e92","article-title":"Cerebral malaria in children is associated with long-term cognitive impairment","volume":"122","author":"John","year":"2008"},{"key":"ref4","series-title":"J Infect Dis","first-page":"663","article-title":"Sequestration and microvascular congestion are associated with coma in human cerebral malaria","volume":"205","author":"Ponsford","year":"2012"},{"key":"ref5","series-title":"Brain","first-page":"2119","article-title":"Cerebral malaria in children: using the retina to study the brain","volume":"137","author":"MacCormick","year":"2014"},{"key":"ref6","series-title":"Nat Med","first-page":"143","article-title":"Differentiating the pathologies of cerebral malaria by postmortem parasite counts","volume":"10","author":"Taylor","year":"2004"},{"key":"ref7","series-title":"Arch Ophthalmol","first-page":"1141","article-title":"Prognostic significance and course of retinopathy in children with severe malaria","volume":"122","author":"Beare","year":"2004"},{"key":"ref8","series-title":"Trans R Soc Trop Med Hyg","first-page":"618","article-title":"Correlation of retinal haemorrhages with brain haemorrhages in children dying of cerebral malaria in Malawi","volume":"95","author":"White","year":"2001"},{"key":"ref9","series-title":"Arch Ophthalmol","first-page":"924","article-title":"Clinical-histopathological correlation of the abnormal retinal vessels in cerebral malaria","volume":"118","author":"Lewallen","year":"2000"},{"key":"ref10","series-title":"J Infect Dis","first-page":"263","article-title":"Perfusion abnormalities in children with cerebral malaria and malarial retinopathy","volume":"199","author":"Beare","year":"2009"},{"key":"ref11","series-title":"J Infect Dis","first-page":"1977","article-title":"Severity of retinopathy parallels the degree of parasite sequestration in the eyes and brains of Malawian children with fatal cerebral malaria","volume":"211","author":"Barrera","year":"2015"},{"key":"ref12","series-title":"Trans R Soc Trop Med Hyg","first-page":"1089","article-title":"Using malarial retinopathy to improve the classification of children with cerebral malaria","volume":"102","author":"Lewallen","year":"2008"},{"key":"ref13","series-title":"Pediatr Infect Dis J","first-page":"953","article-title":"Children with retinopathy-negative cerebral malaria: a pathophysiological puzzle","volume":"30","author":"Postels","year":"2011"},{"key":"ref14","series-title":"Malar J","first-page":"232","article-title":"Retinopathy in severe malaria in Ghanaian children: overlap between fundus changes in cerebral and non-cerebral malaria","volume":"9","author":"Essuman","year":"2010"},{"key":"ref15","series-title":"PLOS One","first-page":"e0163728","article-title":"Differing causes of lactic acidosis in cerebral malaria and severe malarial anemia may explain differences in acidosis-related mortality","volume":"11","author":"Brand","year":"2016"},{"key":"ref16","series-title":"Clin Infect Dis","first-page":"874","article-title":"Acute renal failure in patients with severe falciparum malaria","volume":"15","author":"Trang","year":"1992"},{"key":"ref17","series-title":"Clin Infect Dis","first-page":"1080","article-title":"Predicting the clinical outcome of severe falciparum malaria in African children: findings from a large randomized trial","volume":"54","author":"von Seidlein","year":"2012"},{"key":"ref18","series-title":"J Infect Dis","first-page":"309","article-title":"Plasma concentrations of parasite histidine-rich protein 2 distinguish between retinopathy-positive and retinopathy-negative cerebral malaria in Malawian children","volume":"206","author":"Seydel","year":"2012"},{"key":"ref19","series-title":"J Infect Dis","first-page":"1522","article-title":"Relationship of cell-free hemoglobin to imparied endothelial nitric oxide bioavailability and perfusion in severe falciparum malaria","volume":"200","author":"Yeo","year":"2009"},{"key":"ref20","series-title":"J Infect Dis","first-page":"1627","article-title":"Decreased endothelial nitric oxide bioavailability, impaired microvascular function, and increased tissue oxygen consumption in children with falciparum malaria","volume":"210","author":"Yeo","year":"2014"},{"key":"ref21","series-title":"J Neurol Sci","first-page":"35","article-title":"Morphological characteristics of intracerebral arterioles in clinical (Plasmodium falciparum) and experimental (Plasmodium berghei) cerebral malaria","volume":"101","author":"Polder","year":"1991"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/96\/5\/article-p1176.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/96\/5\/article-p1176.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/96\/5\/article-p1176.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T18:30:26Z","timestamp":1723055426000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/96\/5\/article-p1176.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,3]]},"references-count":21,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.16-0315","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.727253345.793538764","asserted-by":"object"}]},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5,3]]}}}