Evidence map›Paper›PMID 39962580›Full record

ArticleMalaria journal2025

Cytomegalovirus reactivation and acute and chronic complications in children with cerebral malaria: a prospective cohort study.

Jonathan A Mayhew, Andrew J Witten, Caitlin A Bond, Robert O Opoka, Paul Bangirana, Andrea L Conroy, Nelmary Hernandez-Alvarado, Mark R Schleiss, Chandy C John

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Malaria journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jonathan A MayhewRyan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, 705 Riley Hospital Dr, Indianapolis, IN, 46202, USA.
Andrew J WittenRyan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, 705 Riley Hospital Dr, Indianapolis, IN, 46202, USA.
Caitlin A BondRyan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, 705 Riley Hospital Dr, Indianapolis, IN, 46202, USA.
Robert O OpokaAga Khan University, Nairobi, Kenya.
Paul BangiranaGlobal Health Uganda, Kampala, Uganda.
Andrea L ConroyRyan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, 705 Riley Hospital Dr, Indianapolis, IN, 46202, USA.
Nelmary Hernandez-AlvaradoDepartment of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
Mark R SchleissDepartment of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
Chandy C JohnRyan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, 705 Riley Hospital Dr, Indianapolis, IN, 46202, USA. chjohn@iu.edu.

Funding

Severe Malaria And Risk to The Brain (SMART Brain)R01NS055349 · NINDS · UNIVERSITY OF MINNESOTA · PI Chandy C. John, Ruth Namazzi · 2008 to 2026
$11.2M
Immunology and Infectious Diseases Training ProgramT32AI060519 · NIAID · INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS · PI MARK H KAPLAN · 2004 to 2026
$6.0M
Research training in infection, nutrition and neurodevelopment in UgandaD43TW010928 · FIC · INDIANA UNIVERSITY INDIANAPOLIS · PI Chandy C. John · 2018 to 2026
$1.9M
FIC NIH HHS D43 TW010928NIAID NIH HHS T32 AI060519NIH HHS AI060519NIH HHS R01NS055349NINDS NIH HHS R01 NS055349
6 · The paper itself

Abstract

backgroundVirus co-infection or reactivation may modify the host response during cerebral malaria. Cytomegalovirus (CMV) DNAemia has been associated with increased morbidity and mortality in adults with sepsis; however, the impact of CMV DNAemia on adverse outcomes in children with cerebral malaria is unknown.

methodsClinical, physiological, and neurocognitive outcomes were compared in children aged 18 months to 12 years with cerebral malaria (N = 242) based on the presence or absence of CMV DNAemia 24 h after admission. The primary study outcome was subsequent in-hospital mortality. Secondary outcomes included the presence of acute kidney injury, neurocognitive impairment over a 2-year follow-up, and chronic kidney disease at the 1-year follow-up. Markers of platelet and endothelial cell activation and oxidative and nitrosative stress were measured to characterize the mechanisms by which CMV DNAemia might contribute to pathogenesis.

resultsCMV DNAemia was present in 33 children with cerebral malaria (13.6%) 24 h after admission. CMV DNAemia was not significantly associated with mortality in this study. Children with CMV-DNAemia had a higher prevalence of acute kidney injury than those without CMV-DNAemia (59.4% vs. 38.6%, p = 0.03). There was no difference in the prevalence of chronic kidney disease or long-term neurocognitive impairment based on the presence of DNAemia. CMV DNAemia was associated with elevated plasma levels of P-selectin, angiopoietin-1, asymmetric dimethylarginine, and platelet counts.

conclusionsIn children with cerebral malaria, CMV DNAemia is associated with acute kidney injury but not in-hospital mortality, chronic kidney disease, or long-term neurocognitive impairment.

Indexed as

CytomegalovirusCytomegalovirus InfectionsMalaria, CerebralVirus ActivationAcute Kidney InjuryChildChild, PreschoolFemaleHumansInfantMaleProspective StudiesAcute kidney injuryAngiopoietin-1Asymmetric dimethylarginineCerebral malariaCytomegalovirusPlatelet activationP-selectin

Identifiers

PMID39962580
PMCPMC11834542

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.