Cover image for 𝐖𝐡𝐞𝐧 𝐌𝐚𝐥𝐚𝐫𝐢𝐚 𝐀𝐟𝐟𝐞𝐜𝐭𝐬 𝐭𝐡𝐞 𝐁𝐫𝐚𝐢𝐧:

𝐖𝐡𝐞𝐧 𝐌𝐚𝐥𝐚𝐫𝐢𝐚 𝐀𝐟𝐟𝐞𝐜𝐭𝐬 𝐭𝐡𝐞 𝐁𝐫𝐚𝐢𝐧: 𝐖𝐡𝐲 𝐂𝐞𝐫𝐞𝐛𝐫𝐚𝐥 𝐌𝐚𝐥𝐚𝐫𝐢𝐚 𝐂𝐚𝐧 𝐋𝐨𝐨𝐤 𝐋𝐢𝐤𝐞 ‘𝐌𝐚𝐝𝐧𝐞𝐬𝐬’ A public health article explaining how cerebral malaria attacks the brain and why it can turn life-threatening. I broke down the science behind the condition, from how it develops to symptoms like confusion, seizures, and loss of consciousness, and explained it in plain language that a general reader could follow without losing what makes it credible. This piece shows my ability to translate complex medical research into clear language without losing the science. Link to the article. (https://drive.google.com/file/d/1JpqugZqCngM6AIbQH9Oh-YhrupnthcbZ/view?usp=drivesdk) 𝐖𝐡𝐞𝐧 𝐌𝐚𝐥𝐚𝐫𝐢𝐚 𝐈𝐬 𝐌𝐨𝐫𝐞 𝐓𝐡𝐚𝐧 𝐚 𝐅𝐞𝐯𝐞𝐫 Is it malaria, typhoid, or something else? Confusion can be a medical emergency. When malaria is severe, it can go beyond fever and chills and affect the brain. This can cause dramatic changes in behaviour, consciousness, and thinking that may look frightening or confusing to an untrained observer, and could be mistaken for madness. This condition is called cerebral malaria. 𝐖𝐡𝐚𝐭 𝐈𝐬 𝐂𝐞𝐫𝐞𝐛𝐫𝐚𝐥 𝐌𝐚𝐥𝐚𝐫𝐢𝐚? Cerebral malaria is a very serious form of malaria that affects the brain. It is caused by 𝑃𝑙𝑎𝑠𝑚𝑜𝑑𝑖𝑢𝑚 𝑓𝑎𝑙𝑐𝑖𝑝𝑎𝑟𝑢𝑚, the deadliest malaria parasite. This parasite is responsible for most severe malaria and malaria deaths. And yes, it is caused by the same parasite that causes malaria. But this isn't just a case of someone having a high fever and feeling weak. Cerebral malaria can cause a person to become confused, act very differently from normal, have seizures, or even lose consciousness and fall into a coma. The WHO defines cerebral malaria as an unarousable coma that persists even after other temporary causes, such as low blood sugar or the temporary effects of a recent seizure, have been corrected. In simpler terms, the person's brain has been affected so severely that they become completely unresponsive. They cannot be woken up by normal stimulation, such as loud sounds or shaking. That is what makes cerebral malaria so dangerous. 𝐖𝐡𝐲 𝐂𝐚𝐧 𝐈𝐭 𝐂𝐡𝐚𝐧𝐠𝐞 𝐇𝐨𝐰 𝐒𝐨𝐦𝐞𝐨𝐧𝐞 𝐁𝐞𝐡𝐚𝐯𝐞𝐬? So, how can malaria make someone confused, behave strangely, or even become unconscious? Remember, 𝑃𝑙𝑎𝑠𝑚𝑜𝑑𝑖𝑢𝑚 𝑓𝑎𝑙𝑐𝑖𝑝𝑎𝑟𝑢𝑚 is a parasite that lives in red blood cells. The parasites do not go directly into the brain tissue. Instead, as the infection becomes severe, these infected cells stick to the walls of the tiny blood vessels in the brain and get trapped there. This blocks blood flow and reduces oxygen to the brain. It causes inflammation, swelling, and changes that can damage brain function. Chemicals in the brain get out of balance. All this causes the brain to function poorly. And when the brain is not functioning well, the effects can be dramatic. 𝐀 𝐩𝐞𝐫𝐬𝐨𝐧 𝐦𝐚𝐲: • Become confused or disoriented. • See or hear things that are not there (hallucinations). • Act aggressively, violently, or very strangely. • Have seizures and then be very drowsy or agitated. • Talk in a way that does not make sense. So, what may look like a sudden change in someone's personality or behaviour may actually be a sign that their brain is in serious trouble. 𝐖𝐡𝐲 𝐈𝐭 𝐂𝐚𝐧 𝐁𝐞 𝐌𝐢𝐬𝐭𝐚𝐤𝐞𝐧 𝐟𝐨𝐫 ‘𝐌𝐚𝐝𝐧𝐞𝐬𝐬’ In many communities, especially where mental health literacy is limited, these sudden changes can look like the person is having a mental health crisis. Others may think it is typhoid or even that the person is possessed by spirits. But cerebral malaria can cause some of these same outward signs. The important difference is that these changes can be caused by a severe infection affecting the brain. They do not automatically mean that the person has a mental illness. This is why it is dangerous to make assumptions based only on what you can see. Many people may not recognise that these symptoms require urgent medical attention. If the behaviour is mistaken for a mental health problem, typhoid, or something supernatural, the person may not receive the medical treatment they urgently need. Don't dismiss the behaviour as ‘madness’. It could be the brain signalling that something is seriously wrong. 𝐖𝐡𝐚𝐭 𝐒𝐡𝐨𝐮𝐥𝐝 𝐘𝐨𝐮 𝐃𝐨? If a person with suspected or confirmed malaria becomes confused, unusually sleepy, very weak, unconscious, has seizures, or has trouble breathing, treat it as an emergency. 𝐖𝐡𝐚𝐭 𝐭𝐨 𝐝𝐨: • Don't wait to see if they get better. • Take them to the nearest hospital immediately for urgent medical assessment and treatment. • Don't assume it is only a mental health problem, typhoid, or something supernatural. • Don't try to manage severe symptoms at home. • Don't restrain the person unless it is necessary to prevent immediate injury. A sudden change in behaviour should not be assumed to be purely psychiatric without urgent medical assessment. • If a seizure happens, move nearby objects away to prevent injury. Do not put anything in the person's mouth, and do not force food or drink. Most importantly, get medical help quickly. 𝐖𝐡𝐲 𝐅𝐚𝐬𝐭 𝐓𝐫𝐞𝐚𝐭𝐦𝐞𝐧𝐭 𝐌𝐚𝐭𝐭𝐞𝐫𝐬 Cerebral malaria is an important public health problem because it can be life-threatening and can leave lasting effects, especially in children. Surviving is not always the end of the story. Even when a person survives cerebral malaria, some may have long-term problems, such as: • Trouble concentrating, learning, or remembering. • Behavioural changes, mood problems, or lasting mental health effects. • Difficulty at school or at work. Children who survive cerebral malaria may be particularly affected, and some may need follow-up care for learning and behaviour problems. This is why recognising the warning signs early and getting medical care quickly can save lives and help reduce the risk of long-term brain damage. 𝐓𝐡𝐞 𝐓𝐚𝐤𝐞𝐚𝐰𝐚𝐲 Malaria is more than a fever. When it becomes severe, it can be life-threatening. And while children are particularly affected by severe malaria, adults can also become seriously ill, including travellers visiting malaria-endemic regions and pregnant women. When we recognise sudden changes in behaviour, we shouldn't delay urgent medical care. Cerebral malaria needs immediate antimalarial treatment and supportive care in the hospital. This is also why continued investment in malaria prevention, including treated mosquito nets, indoor spraying, and malaria vaccines, matters, alongside early diagnosis and rapid treatment. Sometimes, what looks like a change in behaviour is actually a medical emergency. 𝐒𝐨𝐮𝐫𝐜𝐞𝐬 [World Health Organization (WHO) – Malaria] (https://www.who.int/news-room/fact-sheets/detail/malaria) [WHO Guidelines for Malaria] (https://www.who.int/publications/i/item/guidelines-for-malaria) [Neuropsychiatric Profile in Malaria: An Overview] (https://pmc.ncbi.nlm.nih.gov/articles/PMC5020222/) [Cerebral Malaria and Neuronal Implications of Plasmodium falciparum Infection: From Mechanisms to Advanced Models](https://pmc.ncbi.nlm.nih.gov/articles/PMC9798991/) [Human cerebral malaria and the blood-brain barrier](https://pubmed.ncbi.nlm.nih.gov/16616145/)

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Cover image for 𝐖𝐡𝐲 𝐀𝐫𝐞 𝐌𝐨𝐫𝐞 𝐘𝐨𝐮𝐧𝐠 𝐏𝐞𝐨𝐩𝐥𝐞

𝐖𝐡𝐲 𝐀𝐫𝐞 𝐌𝐨𝐫𝐞 𝐘𝐨𝐮𝐧𝐠 𝐏𝐞𝐨𝐩𝐥𝐞 𝐃𝐞𝐯𝐞𝐥𝐨𝐩𝐢𝐧𝐠 𝐓𝐲𝐩𝐞 𝟐 𝐃𝐢𝐚𝐛𝐞𝐭𝐞𝐬? 𝐖𝐡𝐚𝐭 𝐭𝐡𝐞 𝐑𝐞𝐬𝐞𝐚𝐫𝐜𝐡 𝐑𝐞𝐚𝐥𝐥𝐲 𝐓𝐞𝐥𝐥𝐬 𝐔𝐬 I wrote this research-based article to explain why more young people are developing type 2 diabetes. The article covers what the research says about the causes, who is most affected, why the condition is a growing concern, and what can be done about it. I turned complex health research into clear, easy-to-understand information for a general audience. Link to the article. (https://drive.google.com/file/d/1bQRRsU4y4YovvNHfiGeCs6j3JxcmrbH2/view?usp=drivesdk) 𝐈𝐭 𝐔𝐬𝐞𝐝 𝐭𝐨 𝐁𝐞 𝐂𝐚𝐥𝐥𝐞𝐝 𝐚𝐧 ‘𝐎𝐥𝐝𝐞𝐫 𝐏𝐞𝐫𝐬𝐨𝐧’𝐬 𝐃𝐢𝐬𝐞𝐚𝐬𝐞’ Type 2 diabetes was once considered mainly a disease of adulthood. That narrative is changing. More children, teenagers, and young adults are being diagnosed with type 2 diabetes, a condition that was once much less common in these age groups. In the United States, the SEARCH for Diabetes in Youth Study found that the incidence of type 2 diabetes among 10-to-19-year-olds nearly doubled between 2002–2003 and 2017–2018, rising from 9.0 to 17.9 cases per 100,000 young people. So, what is changing? The answer isn't as simple as saying young people are eating too much sugar or not exercising enough. Type 2 diabetes develops through a combination of factors, including insulin resistance, obesity, genetics, sleep, stress, physical activity, and the environments in which people live and make health choices. To understand why more young people are getting this condition, we first need to understand what happens inside the body. 𝐅𝐢𝐫𝐬𝐭, 𝐖𝐡𝐚𝐭 𝐀𝐜𝐭𝐮𝐚𝐥𝐥𝐲 𝐇𝐚𝐩𝐩𝐞𝐧𝐬 𝐢𝐧 𝐓𝐲𝐩𝐞 𝟐 𝐃𝐢𝐚𝐛𝐞𝐭𝐞𝐬? When you eat, your body breaks down much of the food into sugar (glucose) and releases it into your bloodstream. Your pancreas then releases insulin, a hormone that helps move the sugar in your blood into your cells, where it can be used for energy. In type 2 diabetes, that system starts to struggle. Your body develops insulin resistance, meaning your cells don't respond to insulin as well as they should. At first, your pancreas tries to make more insulin to keep your blood sugar under control. But over time, it may not be able to make enough to keep up, causing sugar to build up in your bloodstream. For young people, there is another piece to the story: puberty. During puberty, hormonal changes make the body temporarily more resistant to insulin. In most young people, the pancreas can make more insulin to compensate and keep blood sugar under control. But in those who already have risk factors such as obesity or a family history of diabetes, the pancreas may not be able to keep up with the body's increased need for insulin. This can contribute to prediabetes or type 2 diabetes, or make existing diabetes harder to control. That is one reason youth-onset type 2 diabetes is more complicated than simply saying, ‘Someone ate too much sugar.’ 𝐒𝐨, 𝐖𝐡𝐲 𝐀𝐫𝐞 𝐌𝐨𝐫𝐞 𝐘𝐨𝐮𝐧𝐠 𝐏𝐞𝐨𝐩𝐥𝐞 𝐃𝐞𝐯𝐞𝐥𝐨𝐩𝐢𝐧𝐠 𝐈𝐭? 𝟏. 𝐎𝐛𝐞𝐬𝐢𝐭𝐲 𝐢𝐬 𝐚 𝐌𝐚𝐣𝐨𝐫 𝐏𝐢𝐞𝐜𝐞 𝐨𝐟 𝐭𝐡𝐞 𝐏𝐮𝐳𝐳𝐥𝐞 Obesity is one of the strongest risk factors for insulin resistance, especially in young people. When a young person has obesity, their body has excess fat, particularly around the abdomen and in organs such as the liver and pancreas. These fat cells can become stressed and release substances, including excess fatty acids, that interfere with how insulin works. This makes it harder for the body to move sugar from the blood into cells. As a result, young people with obesity can have much higher fasting insulin levels than their peers without obesity, showing that their bodies may need to produce more insulin just to keep blood sugar within a normal range. Research also shows that young people with obesity tend to be more insulin-resistant throughout puberty. Not everyone with obesity will develop the condition. 𝟐. 𝐆𝐞𝐧𝐞𝐭𝐢𝐜𝐬 𝐚𝐧𝐝 𝐅𝐚𝐦𝐢𝐥𝐲 𝐇𝐢𝐬𝐭𝐨𝐫𝐲 𝐌𝐚𝐭𝐭𝐞𝐫 Genetics also influences who develops type 2 diabetes. Some people inherit genetic changes that affect how much insulin their body produces or how well it uses insulin. This can make them more likely to develop the disease, and at a younger age. Family history matters too. A young person's risk of developing type 2 diabetes is about 2–3 times higher if a parent or sibling has the condition. The risk is even higher when both parents have it. 𝟑. 𝐎𝐮𝐫 𝐄𝐧𝐯𝐢𝐫𝐨𝐧𝐦𝐞𝐧𝐭 𝐒𝐡𝐚𝐩𝐞𝐬 𝐎𝐮𝐫 𝐂𝐡𝐨𝐢𝐜𝐞𝐬 What people eat or how active they are isn't always about personal choice. Sometimes, the environment around us shapes our decisions. Cheap, heavily marketed processed foods and sugary drinks are everywhere, while healthier foods can be more expensive or harder to access. This can make healthy living more difficult. Many teens are also getting less physical activity, walking less and spending more time on screens. They may also get too little sleep and face high levels of stress, anxiety, or depression, which can affect eating patterns and metabolic health. Sadly, the COVID-19 pandemic made many of these challenges worse. So we shouldn't look only at individual choices. We also need to look at the conditions that influence those choices. 𝟒. 𝐓𝐡𝐞 𝐒𝐭𝐨𝐫𝐲 𝐂𝐚𝐧 𝐁𝐞𝐠𝐢𝐧 𝐁𝐞𝐟𝐨𝐫𝐞 𝐁𝐢𝐫𝐭𝐡: 𝐌𝐚𝐭𝐞𝐫𝐧𝐚𝐥 𝐃𝐢𝐚𝐛𝐞𝐭𝐞𝐬 If a mother has diabetes or obesity during pregnancy, her child has a higher risk of developing type 2 diabetes at a young age. High blood sugar in the womb can affect the baby's developing metabolism and increase their risk of insulin resistance and obesity later in life. As more women enter pregnancy with obesity or diabetes, more children may be born with factors that put them at higher risk. 𝐖𝐡𝐨 𝐢𝐬 𝐌𝐨𝐬𝐭 𝐀𝐟𝐟𝐞𝐜𝐭𝐞𝐝? Some groups are more likely to develop type 2 diabetes, sometimes at lower body weights. This includes some racial and ethnic groups. Poverty, food insecurity, unsafe neighbourhoods, limited access to healthcare, and discrimination can also increase risk. They affect what people eat, how active they are, their stress levels, and whether they can get the care they need. In the United States, SEARCH data found that youth type 2 diabetes increased particularly quickly among non-Hispanic Black, Asian/Pacific Islander, and American Indian youth. So this isn't just about individual choices. Where people live, what they can afford, and the care they can access can also affect their risk. 𝐖𝐡𝐲 𝐘𝐨𝐮𝐭𝐡-𝐨𝐧𝐬𝐞𝐭 𝐓𝐲𝐩𝐞 𝟐 𝐃𝐢𝐚𝐛𝐞𝐭𝐞𝐬 𝐌𝐚𝐭𝐭𝐞𝐫𝐬 When young people get type 2 diabetes, their bodies may lose the ability to produce enough insulin more quickly. The disease can also be more aggressive in young people than in older adults, with complications affecting the eyes, kidneys, nerves and heart appearing earlier and progressing faster. And because these young people have more years ahead of them, they may spend much longer living with the disease and its complications. That makes the rise in youth-onset type 2 diabetes more than a concern about blood sugar. It is a long-term public health problem. 𝐖𝐡𝐚𝐭 𝐂𝐚𝐧 𝐖𝐞 𝐃𝐨 𝐀𝐛𝐨𝐮𝐭 𝐈𝐭? A healthy diet also plays an important role in preventing and managing type 2 diabetes. But preventing the disease in young people isn't just about telling them to eat better or exercise more. Effective prevention needs both personal support and stronger policies. Families can support healthy food, physical activity, good sleep and stress management, while healthcare providers can identify young people at higher risk and offer support early. At a wider level, we need healthier food systems, safe places to be active, protection from harmful food marketing and equitable access to healthcare. Prevention can start even before a child is born and continue through pregnancy, infancy, childhood and adolescence, with particular attention to those at higher risk. The goal isn't to blame young people for developing type 2 diabetes. It is to create conditions that make it easier for them to stay healthy. 𝐓𝐡𝐞 𝐓𝐚𝐤𝐞𝐚𝐰𝐚𝐲 Type 2 diabetes isn't just for adults anymore. More young people are developing it, and it's not only about personal choices. Family history, obesity, health before birth, and the environments young people grow up in all matter. If we want fewer young people to develop type 2 diabetes, we can't just tell them to ‘eat better’ or ‘exercise more.’ We need to make healthy food and physical activity easier, identify those at risk early, and create healthier environments for young people to grow up in. Preventing type 2 diabetes isn't just about helping people live longer. It's about helping young people be healthier from the start. 𝐒𝐨𝐮𝐫𝐜𝐞𝐬 1. CDC/SEARCH: Trends in Incidence of Youth-Onset Type 1 and Type 2 Diabetes, 2002–2018 https://pmc.ncbi.nlm.nih.gov/articles/PMC10091237/ 2. American Diabetes Association: Evaluation and Management of Youth-Onset Type 2 Diabetes https://diabetesjournals.org/care/article/41/12/2648/36602/Evaluation-and-Management-of-Youth-Onset-Type-2 3. Youth-Onset Type 2 Diabetes: Burden of Complications and Socioeconomic Cost https://pmc.ncbi.nlm.nih.gov/articles/PMC10037371/ 4. Rising Tide: The Global Surge of Type 2 Diabetes in Children and Adolescents Demands Action Now https://pmc.ncbi.nlm.nih.gov/articles/PMC11099374/ 5. Association Between Intrauterine Exposure to Maternal Diabetes and Obesity With Type 2 Diabetes in Youth https://pmc.ncbi.nlm.nih.gov/articles/PMC2453655/ 6. CDC MMWR: Trends in Incidence of Type 1 and Type 2 Diabetes Among Youths, 2002–2015 https://www.cdc.gov/mmwr/volumes/69/wr/mm6906a3.htm 7. Youth Physical Activity and the COVID-19 Pandemic: A Systematic Review https://pmc.ncbi.nlm.nih.gov/articles/PMC9394097/ 8. NIDDK: Study Shows That Diabetes in Young People Under the Age of 20 Continues to Rise https://www.niddk.nih.gov/news/archive/2023/study-shows-that-diabetes-young-people-under-age-20-continues-rise

Uduak Eti

I help health brands make complex health ideas easy to grasp