Congenital Malaria in Calabar, Nigeria: The Molecular Perspective

Oduwole, Olabisi; Gc, Ejezie; Odey, Friday; Oringanje, Chioma; Nwakanma, Davis; Bello, Segun; Oriero, Eniyou; Okebe, Joseph; Alaribe, Anyawu A.; Etuk, Saturday; Meremikwu, Martin

doi:10.4269/ajtmh.2011.10-0253

Cited by 20 publications

(12 citation statements)

References 21 publications

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“…Only two newborns had mothers with neither peripheral malaria infection nor placental malaria infection. Earlier studies of transplacental malaria reported these associations [11, 18, 24, 30]. A strong association between placental malaria and umbilical cord blood parasitemia has been reported, and this was suggested to be responsible for congenital malaria.…”

Section: Discussionmentioning

confidence: 93%

Transplacental Transmission ofPlasmodium falciparumin a Highly Malaria Endemic Area of Burkina Faso

Ouédraogo

Tiono

Diarra

et al. 2012

Journal of Tropical Medicine

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Malaria congenital infection constitutes a major risk in malaria endemic areas. In this study, we report the prevalence of transplacental malaria in Burkina Faso. In labour and delivery units, thick and thin blood films were made from maternal, placental, and umbilical cord blood to determine malaria infection. A total of 1,309 mother/baby pairs were recruited. Eighteen cord blood samples (1.4%) contained malaria parasites (Plasmodium falciparum). Out of the 369 (28.2%) women with peripheral positive parasitemia, 211 (57.2%) had placental malaria and 14 (3.8%) had malaria parasites in their umbilical cord blood. The umbilical cord parasitemia levels were statistically associated with the presence of maternal peripheral parasitemia (OR = 9.24, P ≪ 0.001), placental parasitemia (OR = 10.74, P ≪ 0.001), high-density peripheral parasitemia (OR = 9.62, P ≪ 0.001), and high-density placental parasitemia (OR = 4.91, P = 0.03). In Burkina Faso, the mother-to-child transmission rate of malaria appears to be low.

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Section: Discussionmentioning

confidence: 93%

Transplacental Transmission ofPlasmodium falciparumin a Highly Malaria Endemic Area of Burkina Faso

Ouédraogo

Tiono

Diarra

et al. 2012

Journal of Tropical Medicine

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“…Possible explanations could be differences in malaria prevention coverage during pregnancy or laboratory operational factors. Traditional microscopy in routine service laboratories may over-diagnose malaria, and has been shown to have a poor positive predictive value when compared with microscopy from research laboratories [25,26]. …”

Section: Discussionmentioning

confidence: 99%

Prevalence of congenital malaria in high-risk Ghanaian newborns: a cross-sectional study

Enweronu‐Laryea

Adjei

Mensah

et al. 2013

Malar J

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BackgroundCongenital malaria is defined as malaria parasitaemia in the first week of life. The reported prevalence of congenital malaria in sub-Saharan Africa is variable (0 - 46%). Even though the clinical significance of congenital malaria parasitaemia is uncertain, anti-malarial drugs are empirically prescribed for sick newborns by frontline health care workers. Data on prevalence of congenital malaria in high-risk newborns will inform appropriate drug use and timely referral of sick newborns.MethodsBlood samples of untreated newborns less than 1 week of age at the time of referral to Korle Bu Teaching hospital in Accra, Ghana during the peak malaria seasons (April to July) of 2008 and 2010 were examined for malaria parasites by, i) Giemsa-stained thick and thin blood smears for parasite count and species identification, ii) histidine-rich protein- and lactic dehydrogenase-based rapid diagnosis tests, or iii) polymerase chain reaction amplification of the merozoite surface protein 2 gene, for identification of sub-microscopic parasitaemia. Other investigations were also done as clinically indicated.ResultsIn 2008, nine cases of Plasmodium falciparum parasitaemia were diagnosed by microscopy in 405 (2.2%) newborns. All the nine newborns had low parasite densities (≤50 per microlitre). In 2010, there was no case of parasitaemia by either microscopy or rapid diagnosis tests in 522 newborns; however, 56/467 (12%) cases of P. falciparum were detected by polymerase chain reaction.ConclusionCongenital malaria is an uncommon cause of clinical illness in high-risk untreated newborns referred to a tertiary hospital in the first week of life. Empirical anti-malarial drug treatment for sick newborns without laboratory confirmation of parasitaemia is imprudent. Early referral of sick newborns to hospitals with resources and skills for appropriate care is recommended.

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“…A strong correlation between placental and congenital parasitaemia has been reported from previous studies in Calabar. [25] This study has provided a current profile of congenital malaria in Calabar, and would rekindle research focus on maternal and infantile malaria in the study area and other locations. Although the finding in this study compares with the low, 2.0%, prevalence from studies in the University of Calabar Teaching Hospital, reported within the same period; [25] the five-year prevalence profile indicates that congenital malaria was rising from 14.5% in 2011 and 2012 to 21% in 2013, suggesting possible weakness in the mechanism of maternal malaria management in the city.…”

Section: Discussionmentioning

confidence: 99%

“…[23] 5.1% in the University College Hospital, Ibadan, western Nigeria; [24] 2.0% in the University of Calabar Teaching Hospital; [25] 14% in the General Hospital, Minna, North-central Nigeria; [26] and 9.6% in the University of Port Harcourt Teaching Hospital. [27] However, comparatively lower rates have been reported in neighbouring West African countries such as 2.2% in Ghana and 4.7% in Cote d'Ivore.…”

Section: Discussionmentioning

confidence: 99%

“…[ 28] Reports of such variable prevalence of congenital malaria in these countries with similar endemicity as Nigeria have been explained in terms of differences in malaria prevention coverage during pregnancy or laboratory operational factors. [25,29] Obviously, the use of Polymerase Chain reaction (PCR), a rapid and efficient method of malaria parasite detection, that can diagnose congenital malaria more frequently because of its ability to detect parasite macromolecules and not necessarily live parasites, would record higher prevalence than microscopy. [27,30] This study was based on positive parasitaemia by microscopy.…”

Section: Discussionmentioning

confidence: 99%

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Retrospective study of congenital malaria in Calabar, South- Eastern Nigeria

Ukpong

Etim

Ogbeche

et al. 2016

Int J Infect Trop Dis

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Background: Perinatal infection heightens the risk of childhood malaria in endemic areas. In Nigeria, exhaustive case studies are necessary to document obviously unrecorded cases of infantile malaria to aid control efforts. Aim: The study aimed to determine the prevalence of congenital malaria among neonates delivered in the hospital. Methods: A retrospective analysis of a five-year medical record, 2009 to 2013 was conducted in General Hospital, Calabar. The study examined laboratory data of 9,398 pregnant women on antenatal admission and 5,730 children aged 0-7 days; delivered in the hospital within the five-year period. Records of confirmed blood tests by microscopy for Plasmodium species were extracted for analysis. Data were analysed using descriptive and nonparametric statistics. Results: The study identified congenital malaria prevalence of 1.08% and maternal malaria prevalence of 9.17% within the period. The relationship between maternal malaria and congenital malaria was statistically significant (X 2 = 13.62; P = 0.05). The five-year prevalence profile indicated a rising trend of congenital malaria towards the current year; from 21% in 2009, 29% in 2010, 14.5% in both 2011 and 2012, to 21% in 2013. Conclusion: Findings suggest possible weakness in the mechanism of maternal malaria management in the city. There is a need to strengthen the existing malaria control capabilities, with ardent attention on vector control, intermittent preventive treatment for pregnant women and capacity for early diagnosis and case management.

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Congenital Malaria in Calabar, Nigeria: The Molecular Perspective

Cited by 20 publications

References 21 publications

Transplacental Transmission ofPlasmodium falciparumin a Highly Malaria Endemic Area of Burkina Faso

Transplacental Transmission ofPlasmodium falciparumin a Highly Malaria Endemic Area of Burkina Faso

Prevalence of congenital malaria in high-risk Ghanaian newborns: a cross-sectional study

Retrospective study of congenital malaria in Calabar, South- Eastern Nigeria

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