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Vietnam Vet's history of malaria may be clue to health problems
IOWA CITY, Iowa -- Cerebral malaria should be considered as seriously
as post-traumatic stress disorder (PTSD) or Agent Orange exposure as an
underlying cause of long-term medical and psychological problems faced
by some Vietnam War veterans, according to a study by a University of Iowa
and Veterans Affairs Medical Center (VAMC) psychologist.
In an article published in the November issue of the Journal of Nervous
and Mental Disease, Nils R. Varney, UI adjunct professor of psychology
and a staff neuropsychologist at the VAMC in Iowa City, and his colleagues
report that many cerebral malaria survivors from the Vietnam War have a
number of neuropsychiatric symptoms that can persist for years after the
acute illness has been treated.
It is estimated that as many as 250,000 Vietnam veterans suffered cerebral
malaria. Contracted from mosquitoes, the illness causes an encephalitis,
or inflammation of the brain. This can result in damage to cerebral nerve
tissue in the frontal-temporal areas of the neocortex.
"Cerebral malaria does a number of different things to a patient's
brain that cause a variety of neurological problems," Varney says.
"Clinical reports from 500 B.C. through the 20th century noted that
patients who survived the illness frequently developed depression, impaired
memory loss, personality change and proneness to violence as long-term
effects of the disease. These are symptoms that have been reported by many
Vietnam veterans for years and are often treated strictly as PTSD."
The researchers compared the neuropsychiatric status of 40 Vietnam combat
veterans who contracted cerebral malaria between 1966-1969 with 40 Vietnam
veterans with similar wartime experience who suffered gunshot or shrapnel
wounds during the same period. The participants underwent numerous tests
for sensory, cognitive and behavioral symptoms.
Findings indicated that, when compared to wounded combat veterans who
did not contract cerebral malaria during their service, the veterans who
had malaria reported more problems with depression, subjective distress,
auditory information processing, memory, emotional instability and seizure-like
Interestingly, Varney notes, the malaria-related health concerns among
Vietnam veterans are similar to what British troops faced in 19th century
India during the height of the British Empire. Nineteenth-century physicians
documented these cases and considered malaria a leading cause of mental
illness in British-occupied regions. "It's well-chronicled in the
medical literature from that period, but basically it's been forgotten,
since malaria has not been a major problem in industrialized western nations
for decades," Varney says.
The study results may offer new hope to many Vietnam veterans with neurological
and psychological problems that have not responded to previous treatments.
The findings suggest that doctors consider a history of malaria in any
medical, psychological or psychiatric workup of Vietnam veterans because
a positive response could change diagnosis and treatment. Anticonvulsant
medications can be beneficial in treating symptoms that affect cerebral
"I would suspect that doctors who treat Vietnam veterans with unexplained
and untreatable neurological or psychological problems would find a significant
number of them with a history of malaria," Varney says. "And
that means there's a different way to assess these cases. It's not solely
PTSD or Agent Orange exposure that's causing these problems, which are
the only explanations these veterans have had to hang their hats on. Now
we may be able to move these patients into a category where their problems
make sense, what is wrong with them is known and well-documented, and it's
The study was funded by the U.S. Department of Veterans Affairs.