Congenital malaria: Frequency and epidemiology in Colombia, 2009-2020

Abstract

Congenital Malaria (CM) is an underestimated and under-researched problem in Colombia, despite its severe clinical, epidemiological, economic, and public health consequences. The objective was to determine the general frequency of CM, the specific frequency of CM by diagnostic test and plasmodial species, and identify its associated factors. A retrospective study was carried out using the records of 567 newborns. qPCR and Thick Blood Smear (TBS) were performed. The frequency of infection was determined with a 95% confidence interval. Associated factors were identified by non-parametric tests and odds ratios; the confusion was controlled with a logistic regression model. All cases corresponded to submicroscopic CM (negative with TBS and positive with PCR), and the frequency was 12.2% (95%CI = 9.4–14.9). The detection was statistically higher in the umbilical cord with 16,2% (95%CI = 12.4–19.9) versus peripheral blood of the newborn with 2.2% (95%CI = 0.7–4.9). CM was statistically higher in newborn whose mothers had malaria in the last year, gestational and placental malaria. The median birth weight in newborn infected with CM was lower compared to the one of healthy neonates. Because the control program in Colombia is based on TBS, it must be improved with the inclusion of other tests that allow the detection of submicroscopic CM. In addition, the program has other limitations such as do not have specific actions for pregnant women and have a passive surveillance system. These difficulties do not allow to show the magnitude of CM, its consequences on neonatal and infant health, constituting a serious problem of health injustice.

Malaria in newborn: A missed entity for primary care physician

“…In a recent study, done in Colombia, all CM cases were found to be submicroscopic with a frequency of 12.2% infections. [ 32 ] Here, submicroscopic refers to negative with Thick Blood Smear and positive with PCR. The same study showed better yield with umbilical cord blood as compared to peripheral blood (16.2% vs 2.2%.…”

Systematic Review: Prevalensi dan Dampak Infeksi Malaria pada Wanita Hamil dan Neonatal

“…24 Manajemen malaria pada wanita hamil signifikan dapat mengurangi risiko maternal anemia diantaranya dengan melakukan pemeriksaan ANC secara rutin untuk memantau kondisi ibu dan janin, penggunaan kelambu berinsektisida untuk mencegah gigitan nyamuk, 27 pemeriksaan Hb secara rutin sebulan sekali dan pemberian tablet zat besi selama kehamilan, 28 asam folat, pemberian chloroquine pada kunjungan pertama ANC sampai dengan masa nifas, efektivitas pemberian tiga dosis sulfadoxine pyrimethamine yang direkomendasikan WHO terbukti efektif untuk mencegah malaria selama kehamilan. 29,30,31…”

“…7 Parasit malaria yang ditemukan dalam darah pada tali pusat signifikan lebih tinggi dibandingkan darah tepi bayi baru lahir. 31 Terdeteksinya malaria dalam plasenta dan infeksi malaria dalam setahun terakhir menunjukkan hubungan yang signifikan dengan malaria kongenital. Insiden kongenital malaria yang dilaporkan sangat bervariasi antara 7% sampai dengan 33% pada daerah endemis malaria.…”

Clinical and Parasitological Profiles of Gestational, Placental and Congenital Malaria in Northwestern Colombia

“…In Colombia, there are few clinical studies on PAM. Some epidemiological antecedents reported a high frequency of GM (35.8%), PM (27.7%), and CM (12.2%), associated with a higher risk of maternal anemia and lower birth weight [ 8 , 9 , 10 ]. In clinical practice guidelines for malaria, the clinical aspects of PAM are cited from WHO and CDC reports [ 11 ].…”