{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:41:52Z","timestamp":1789864912429,"version":"4.0.1"},"reference-count":56,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:p>\n                    Malaria continues to pose a significant public health challenge in Africa, where 95% of global malaria cases and deaths occur in Sub-Saharan Africa (SSA). Cerebral malaria (CM) is a fatal type of severe malaria primarily caused by\n                    <jats:italic>Plasmodium falciparum<\/jats:italic>\n                    species and disproportionately affects children under five years. Despite ongoing control efforts, CM persists as one of the most prevalent presentations of severe malaria with surprisingly high prevalences even in regions with lower endemicity and transmission rates. This commentary presents an updated compilation of key CM-related public health challenges, including delayed presentation of cases and a lack of diagnostic tools in resource-limited African communities, leading to misdiagnosis. Further challenges include insufficient provision of anti-malarial drugs and inaccessibility in rural and remote areas, coupled with emerging resistance to the gold-standard therapy (artemisinin combination therapy). CM carries a high risk of long-term neurological complications and is seen in almost half of the survivors. These complications severely impair their daily quality of life and extend to social and financial challenges. CM survivors also suffer from the lack of appropriate health services such as continuous rehabilitation, medical care, and psychological support. Despite its burden, interventional research in CM management remains insufficient, particularly regarding short- and long-term neurological complications. Local African governments have occupied the backseat for the length of this continental health crisis. It is crucial for them to occupy a proactive role in supporting healthcare infrastructure and delivering high-quality health services. Intragovernmental collaborations and establishing a regional health network within Africa can ensure realistic and accurate surveillance data tracking. From this, strategic healthcare planning, control measures, and source allocation could be better observed and tailored to the needs of different African subpopulations.\n                  <\/jats:p>","DOI":"10.5339\/qmj.2024.55","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T03:50:43Z","timestamp":1736394643000},"source":"Crossref","is-referenced-by-count":4,"title":["Africa\u2019s public health battle with cerebral malaria: What are we up against?"],"prefix":"10.5339","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9616-0815","authenticated-orcid":true,"given":"Abubaker","family":"Abdelmalik","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Misurata University, Misurata, Libya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muataz","family":"Kashbour","sequence":"additional","affiliation":[{"name":"Department of Radiology, National Cancer Institute, Misrata, Libya*Correspondence: Abubaker Abdelmalik a.abdelmalik@med.misuratau.edu.ly"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3277","reference":[{"key":"CIT0001","article-title":"World malaria report 2022","year":"2022"},{"issue":"(18):","key":"CIT0002","series-title":"FEBS J","first-page":"4670\u20139","article-title":"Malaria\u2014An overview","volume":"274","author":"Tuteja\n \nR","year":"2007;"},{"issue":"(1):","key":"CIT0003","series-title":"PLoS One","first-page":"e0211205","article-title":"Improving socioeconomic status may reduce the burden of malaria in sub Saharan Africa: A systematic review and meta-analysis","volume":"14","author":"Degarege\n \nA","year":"2019;"},{"key":"CIT0004","series-title":"J Trop Med","first-page":"1\u201310","article-title":"Factors contributing to urban malaria transmission in sub-Saharan Africa: A systematic review","volume":"2012","author":"De Silva\n \nPM","year":"2012;"},{"issue":"(Suppl 1):","key":"CIT0005","series-title":"Trop Med Int Health","first-page":"7\u2013131","article-title":"Severe malaria","volume":"19","year":"2014;"},{"issue":"(12):","key":"CIT0006","series-title":"JAMA","first-page":"1461","article-title":"Association of transmission intensity and age with clinical manifestations and case fatality of severe Plasmodium falciparum malaria","volume":"293","author":"Reyburn\n \nH","year":"2005;"},{"issue":"(9649):","key":"CIT0007","series-title":"Lancet","first-page":"1555\u201362","article-title":"Effect of a fall in malaria transmission on morbidity and mortality in Kilifi, Kenya","volume":"372","author":"O\u2019Meara\n \nWP","year":"2008;"},{"issue":"(6):","key":"CIT0008","series-title":"Lancet Glob Health","first-page":"e873\u201381","article-title":"The epidemiology of severe malaria at Manhi\u00e7a District Hospital, Mozambique: A retrospective analysis of 20 years of malaria admissions surveillance data","volume":"10","author":"Guinovart\n \nC","year":"2022;"},{"issue":"(2):","key":"CIT0009","series-title":"PLoS Oone","first-page":"e8988","article-title":"Age-patterns of malaria vary with severity, transmission intensity and seasonality in sub-Saharan Africa: A systematic review and pooled analysis","volume":"5","author":"Carneiro\n \nI","year":"2010;"},{"issue":"(1):","key":"CIT0010","series-title":"Malar J","first-page":"282","article-title":"The age patterns of severe malaria syndromes in sub-Saharan Africa across a range of transmission intensities and seasonality settings","volume":"9","author":"Roca-Feltrer\n \nA","year":"2010;"},{"issue":"(5):","key":"CIT0011","series-title":"Br J Haematol","first-page":"573\u201380","article-title":"General Haematology Task Force of the British Committee for Standards in Haematology. Guideline: The laboratory diagnosis of malaria. General Haematology Task Force of the British Committee for Standards in Haematology","volume":"163","author":"Bailey\n \nJW","year":"2013;"},{"issue":"(1):","key":"CIT0012","series-title":"Malar J","first-page":"60","article-title":"Delayed presentation to hospital care is associated with sequelae but not mortality in children with cerebral malaria in Malawi","volume":"21","author":"Borgstein\n \nA","year":"2022;"},{"issue":"(6):","key":"CIT0013","series-title":"J Community Health","first-page":"1171\u20138","article-title":"Determinants of delay in seeking malaria treatment for children under-five years in parts of South Eastern Nigeria","volume":"39","author":"Chukwuocha\n \nUM","year":"2014;"},{"issue":"(6):","key":"CIT0014","series-title":"Cochrane Database Syst Rev","first-page":"CD005967","article-title":"Artesunate versus quinine for treating severe malaria","volume":"2012","author":"Sinclair\n \nD","year":"2012"},{"key":"CIT0015","first-page":"14","article-title":"WHO guidelines for malaria","year":"2023"},{"issue":"(13):","key":"CIT0016","series-title":"N Engl J Med","first-page":"1163\u201371","article-title":"Evidence of artemisinin-resistant malaria in Africa","volume":"385","author":"Balikagala\n \nB","year":"2021;"},{"issue":"(3):","key":"CIT0017","series-title":"Acta Trop","first-page":"305\u201315","article-title":"Artemisinin-based combination therapies (ACTs): Best hope for malaria treatment but inaccessible to the needy!","volume":"95","author":"Mutabingwa\n \nTK","year":"2005;"},{"issue":"(6):","key":"CIT0018","series-title":"Lancet Infect Dis","first-page":"488\u201396","article-title":"Poor-quality antimalarial drugs in southeast Asia and sub-Saharan Africa [published correction appears in Lancet Infect Dis. 2012 Jul;12(7):506]","volume":"12","author":"Nayyar\n \nGM","year":"2012;"},{"key":"CIT0019","series-title":"classic.clinicaltrials.gov","article-title":"Search of cerebral malaria - 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Guideline: The laboratory diagnosis of malaria. General Haematology Task Force of the British Committee for Standards in Haematology","volume":"163","author":"Bailey\n \nJW","year":"2013;"},{"issue":"(1):","key":"CIT0012","series-title":"Malar J","first-page":"60","article-title":"Delayed presentation to hospital care is associated with sequelae but not mortality in children with cerebral malaria in Malawi","volume":"21","author":"Borgstein\n \nA","year":"2022;"},{"issue":"(6):","key":"CIT0013","series-title":"J Community Health","first-page":"1171\u20138","article-title":"Determinants of delay in seeking malaria treatment for children under-five years in parts of South Eastern Nigeria","volume":"39","author":"Chukwuocha\n \nUM","year":"2014;"},{"issue":"(6):","key":"CIT0014","series-title":"Cochrane Database Syst Rev","first-page":"CD005967","article-title":"Artesunate versus quinine for treating severe malaria","volume":"2012","author":"Sinclair\n \nD","year":"2012"},{"key":"CIT0015","first-page":"14","article-title":"WHO guidelines for malaria","year":"2023"},{"issue":"(13):","key":"CIT0016","series-title":"N Engl J Med","first-page":"1163\u201371","article-title":"Evidence of artemisinin-resistant malaria in Africa","volume":"385","author":"Balikagala\n \nB","year":"2021;"},{"issue":"(3):","key":"CIT0017","series-title":"Acta Trop","first-page":"305\u201315","article-title":"Artemisinin-based combination therapies (ACTs): Best hope for malaria treatment but inaccessible to the needy!","volume":"95","author":"Mutabingwa\n \nTK","year":"2005;"},{"issue":"(6):","key":"CIT0018","series-title":"Lancet Infect Dis","first-page":"488\u201396","article-title":"Poor-quality antimalarial drugs in southeast Asia and sub-Saharan Africa [published correction appears in Lancet Infect Dis. 2012 Jul;12(7):506]","volume":"12","author":"Nayyar\n \nGM","year":"2012;"},{"key":"CIT0019","series-title":"classic.clinicaltrials.gov","article-title":"Search of cerebral malaria - 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