Protocol for a Magnetic Resonance Imaging (MRI) Study of Participants in the Fever Randomized Controlled Trial: Does fever control prevent brain injury in malaria?

• DOI: 10.1101/2023.11.10.23298374
• Publication Date: 2023-11-11T09:15:16Z
• Authors: Moses B. Chilombe; Karl B. Seydel; Colleen Hammond; Suzanna Mwanza; Archana A. Patel; Frank Lungu; Somwe wa Somwe; Sam Kampondeni; Michael J. Potchen; Michael P. McDermott; Gretchen L. Birbeck
• Keywords: Antipyretic; Acute disseminated encephalomyelitis

Despite eradication efforts, ~135,000 African children sustained brain injuries as a result of central nervous system (CNS) malaria in 2021. Newer antimalarial medications rapidly clear peripheral parasitemia and improve survival, but mortality remains high with no associated decline post-malaria neurologic injury. A randomized controlled trial aggressive antipyretic therapy acetaminophen ibuprofen (Fever RCT) for malarial fevers being conducted Malawi Zambia began enrollment 2019. We propose to use neuroimaging the context RCT further evaluate neuroprotective effects therapy.This observational magnetic resonance imaging (MRI) ancillary study will obtain neurodevelopmental behavioral outcomes previously enrolled Fever at 1- 12-months post discharge. Analysis compare odds any injury between usual care groups based upon MRI structural abnormalities. For unable undergo without deep sedation, be used identify injury.Neuroimaging is well-established, valid proxy neurological after pediatric CNS malaria. This add value by determining if treatment It may also help elucidate underlying mechanism(s) neuroprotection expand FEVER safety assessments.