A family history - why does malaria lead to fits in some young children?

Why do some children infected with malaria have fits?  Is the predisposition passed from parent to child?  The Kenya Medical Research Institute together with the Institute of Child Health, University of London, carried out research amongst children with severe malaria and their parents in Kenya to see if there was a family history of fits. 

The families of 81 children, living in the Kilifi district of Kenya, were investigated for a history of seizures: febrile seizures (high temperatures leading to fits, or epilepsy).  35 of these children had been admitted to hospital with severe malaria at around the age of three. The remaining 46 acted as a control group.  Information was collected on:

• how frequently the fits occurred
• how long they lasted
• when they first began
• whether they were connected with fever
• what caused the fit. 

The study found:

• Children who have malaria with convulsions (falciparum malaria) are 1.4 times more likely to have relatives who also suffer from seizures.
• Relatives with epilepsy were more likely to die than those without epilepsy.
• There was no variation in the prevalence of fits between males and females.
• Some children may have a genetic predisposition to epilepsy or febrile seizures.  However it is not clear whether the link is genetic or due to other factors, e.g. other family members have also contracted malaria.
• There were problems using terms and definitions established by research conducted outside a tropical climate.
• Only four per cent of people with epilepsy were taking antiepileptic drugs.

The report recommends that:

• Death rates due to malaria can be reduced by treatment and education about the risks of malaria.
• Further investigation is required, perhaps using a long-term study, into seizures which occur in a tropical climate.   Research to date has taken place in settings outside a tropical climate.
• More detailed genetic studies should be carried out to determine whether convulsions are hereditary.

Children suffering from severe malaria are more likely to have fits if there is a history of convulsions in their family.  More research must be carried out to find out if the link is hereditary or due to other factors.

Source(s):
‘Seizure disorders among relatives of Kenyan children with severe falciparum malaria’, Tropical Medicine and International Health 8 (1): 12-16, by A. C. Versteeg et al., 2003
HINARI subscribers can access the full-text article here. Full document.

Funded by: The Dutch National Epilepsy Fund; the Spinoza Fund; and the Wellcome Trust

id21 Research Highlight: 2 June 2003

Further Information:
Charles R. J. C. Newton
Centre for Geographic Medicine Research (Coast)
Kenya Medical Research Institute
PO Box 230
Kilifi
Kenya

Tel: +254 125 25043
Fax: +254 125 22390
Contact the contributor: cnewton@kilifi.mimcom.net

Kenya Medical Research Institute

Institute of Child Health, University of London

Other related links:
'What mothers do: responses to childhood fever on the Kenyan Coast'

'Symptoms of change: malaria diagnosis in areas of low prevalence'

See id21's collection of links relevant to infectious diseases.

See id21's collection of links relevant to maternal and child health.