Malaria remains a significant cause of morbidity and mortality in Malawi, with an estimated 18-19% prevalence of Plasmodium falciparum in children 2-10 years in 2015-2016. While children report the highest rates of clinical disease, adults are thought to be an important reservoir to sustained transmission due to persistent asymptomatic infection.
The post-malaria neurological syndrome (PMNS) is an unusual and relatively underreported complication of malaria, which usually occurs after the resolution of acute febrile illness and the patient is free from parasitemia. The clinical spectrum of the PMNS varies from acute-onset cerebellar ataxia to significant encephalopathy with focal deficits resembling acute disseminated encephalomyelitis. Uncommon presentations of PMNS include Guillain–Barre syndrome, postural tremor, or even isolated neuropsychiatric features.