MALARIA: State of the world's children

UNICEF’s 2013 State of the World’s Children focuses on “Children with Disabilities.”  Some attention is paid to the role of communicable or infectious disease in the cause of disabilities and the need for children with disabilities to benefit from disease control services, just like any other child. Of particular focus in the realm of infectious disease is recognition that, “… immunization is an important means of pre-empting diseases that lead to disabilities.” The Report goes on to explain for example, that, “More children than ever before are being reached. One consequence has been that the incidence of polio – which can lead to permanent muscle paralysis – fell from more than 350,000 cases in 1988 to 221 cases in 2012.” Malaria as an infectious disease continues to exert a disabling effect on children in endemic countries. The Report does present a case study of children who spent several years in a residential home for children with mental disabilities in the Republic of Moldova, but it is also important to recognize that malaria and other infectious diseases can lead to such problems. In reporting on neurological disease in Sub-Saharan Africa, Donald Silberberg and Elly Katabira explained that, “In addition to the hundreds of thousands of children who die each year from cerebral malaria, many more survive (often repeated attacks) and develop sequelae that have yet to be quantified. These include cognitive disorders and epilepsy.” Likewise Ngoungou and colleagues after studying children with cerebral malaria in Mali found persistent neurological sequelae including, “ headaches, mental retardation, speech delay, bucco-facial dyspraxia, diplegia and frontal syndrome (one case each), dystonia (two cases), epilepsy (five cases) and behavior and attention disorders (15 cases).” Immunization is of course a major tool in preventing disability, but we also need to examine the role other disease control efforts can play on preventing disability. Also as mentioned in the case of immunization above, we also need to ensure that all children with any kind of disability in a malaria endemic area promptly receive all necessary treatment and preventive interventions.