Target Malaria: Sierra Leone Telegraph: 27 October 2026:
When nine-year-old James Ssemambo developed severe malaria in Kitosi, a village located in Koome Sub County in Mukono district in Uganda, the illness affected far more than his physical health. His mother, Sarah Nankya, spent three days with him at a health centre, leaving work and her other children while the family absorbed the additional costs of transport, treatment, and food.
Even after James returned home, recovery took time.
“My child missed school for over a week because of the illness. Even after returning, he was still weak and sometimes had difficulty concentrating on his schoolwork,” Nankya recalls.
Her experience shows a part of the malaria burden that is less often discussed: the potential challenges a child faces after surviving malaria.
The latest World Health Organisation (WHO) figures estimate that Africa accounted for 94% of malaria cases and 95% of deaths globally in 20241 , with children under five accounting for three-quarters of malaria deaths in the region. Yet mortality is not the only measure of malaria’s impact.
Research led by African scientists is providing evidence that some forms of severe malaria can have consequences extending years beyond the initial illness.
Dr. Paul Bangirana of Makerere University (Photo) has studied the neuropsychological consequences of childhood malaria for more than two decades. His earlier prospective research found impaired cognition in one in four survivors of childhood cerebral malaria 24 months after illness.
More recently, a 2026 study published in JAMA2 , co-authored by Bangirana, followed 889 participants and found that survivors of childhood cerebral malaria or severe malarial anaemia had lower overall cognitive ability and maths achievement scores than unaffected community children when assessed 4 to 15 years later. The study did not find significant differences in reading or attention scores.
“Survival of malaria is paramount. However, the secondary effects of a severe episode can be debilitating,” says Bangirana. His team’s broader research has associated severe malaria, particularly cerebral malaria and severe malarial anaemia, with problems including cognition, behaviour, mental health, educational attainment and health-related quality of life.
Bangirana and collaborators have also expanded their research examining how effects may emerge from childhood into early adulthood.
Photo: Kitosi landing site in Koome Sub county in Mukono district. Credit: Uganda Virus Research Institute.
The practical and emotional effects on families
Research is also beginning to reveal what these consequences can mean for families. Interviews conducted by one of Bangirana’s doctoral students3 with caregivers of children who experienced severe malaria and subsequent repeated malaria attacks, found behavioural changes and poorer academic achievement, alongside family disruption, disagreements about where to seek help, feelings of helplessness and difficulties balancing work and family responsibilities.
“Repeated malaria brings a lot of worry because as a parent, you are always afraid your child may become seriously ill again,” says Nankya. “Sometimes I must leave work or other responsibilities to care for my child, which affects the entire family’s income.”
These experiences reinforce why preventing malaria remains critical, and why Africa continues to need multiple, complementary tools.
Existing interventions including insecticide-treated nets, medicines and vaccines are saving lives. But challenges including drug and insecticide resistance continue to threaten progress. Research into new approaches therefore remains an important part of the malaria response.
Target Malaria, a not-for-profit research consortium, is among the African-led research programmes investigating whether genetic technologies could one day complement existing interventions. Its research is exploring gene drive technology designed to reduce populations of specific malaria-transmitting mosquitoes, with research progressing through phased scientific assessment, regulatory oversight and community engagement.
The technology remains under development and is currently being studied in contained laboratory settings, but its ambition speaks to a larger vision – malaria prevention is more than surviving it.
“When the fever goes down, it does not mean the child is fully okay,” says Nankya.
For Bangirana, this strengthens the case for looking at the value of malaria prevention beyond avoiding acute illness and death. Preventing severe malaria may also help avert some of the longer-term cognitive, behavioural, educational and quality-of-life consequences associated with it.
As Africa works towards ending malaria, understanding the disease’s full burden means looking beyond the infection itself to the children returning to classrooms, the parents returning to work, and the futures that prevention can help protect.
About Target Malaria
Target Malaria is a not-for-profit research consortium that aims to develop and share new, cost-effective and sustainable genetic technologies to modify mosquitoes and reduce malaria transmission. Our vision is to contribute to a world free of malaria. We aim to achieve excellence in all areas of our work, creating a path for responsible research and development of genetic technologies, such as gene drive. www.targetmalaria.org.
Target Malaria receives core funding by the Gates Foundation and Coefficient Giving (formerly Open Philanthropy). The lead grantee organisation is Imperial College London with partners in Africa, Europe and North America.