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Epicentre researchers are having children with cerebral
malaria inhale a gas, nitric oxide. Piped into the children’s noses and mouths
from large silver canisters marked “Experimental Study Drug,” nitric oxide is
thought to dilate blood vessels and reduce inflammation in the brain. The goal,
according to a 2012 article by the Epicentre team, is “buying time” for
medicines to kill the malaria parasites while protecting children’s brains from
the parasites’ devastating effects.
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Cerebral malaria is not tracked well, but the statistics
available suggest that it claims tens if not hundreds of thousands of lives
each year. The World Health Organization estimates that there were about 219
million new malaria cases and 660,000 malaria deaths in 2010. Ninety per cent
of malaria deaths occur in Africa, mostly among children under five. Cerebral
malaria occurs in about 10 per cent of child malaria cases in Africa, according
to a 2005 study in The Lancet Neurology, and they are the most likely cases to
be fatal.
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The Epicentre approach seeks to protect children from
cerebral malaria’s most dangerous effect: a build-up of malaria parasites that
causes inflammation and disrupts blood flow inside the brain. This build-up
prevents the flow of oxygen to brain centres that control basic neurological
function and even breathing, resulting in convulsions, coma, and eventually,
death. Even as anti-malaria drugs such as artemisinins attack the parasites,
the inflammation and blockage can still put the child in danger.
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The study’s principal investigator said the team is close to
completing clinical trials on 100 children with cerebral malaria. Another team
in Jinja, Uganda, affiliated with the University of Toronto and Uganda’s
Makarere University, is conducting similar trials. The researchers said they
are the first scientists to study nitric oxide as a treatment for malaria, and
Uganda is the only country where it is being tested.
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