Cerebral malaria — a severe, brain-targeting form of malaria — remains one of Uganda’s deadliest health threats, striking children with alarming speed and leaving survivors at risk of lifelong complications.
Uganda records between 12 and 16 million malaria cases each year, placing it among the most affected countries globally, according to Richard Idro, associate professor of paediatrics and child health at Makerere University College of Health Sciences.
The disease is transmitted by the bite of the female Anopheles mosquito. Symptoms, which typically appear 9-16 days after infection, include fever, weakness, vomiting, and diarrhea, particularly in young children.
“Malaria develops rapidly from the time you get a fever,” Idro warns. “Within the next 24 to 48 hours, especially in children and pregnant women, severe forms of the disease can start to develop.”
Once in the body, the parasite destroys red blood cells, often causing anemia and the need for transfusions. In children, it may clog the lungs and cause breathing difficulties.
In its most dangerous form, the parasite binds to blood vessels in the brain or kidneys, triggering convulsions that can lead to coma.
Even with treatment, cerebral malaria has a 20% fatality rate.
Doctors diagnose cerebral malaria when a patient — most often a child — falls into a coma and tests positive for malaria parasites.
The onset can be alarmingly fast, sometimes within just 48 hours of the first fever.
“No parent with a child who has a fever should let the sun set twice before getting a correct diagnosis and treatment,” Idro cautions.
Survival is not always the end of the battle. About 10% of children who recover develop epilepsy, while 10-15% face long-term effects such as psychological disorders, motor impairment, behavioral changes, and learning difficulties.
