Neonatal malaria in Nigeria -a 2 year review

Abstract

BackgroundIn view of the fact that a significant proportion of neonates with malaria may be missed on our wards on the assumption that the disease condition is rare, this study aims at documenting the prevalence of malaria in neonates admitted into our neonatal ward. Specifically, we hope to describe its clinical features and outcome of this illness. Knowledge of these may ensure early diagnosis and institution of prompt management.MethodsMethods Hospital records of all patients (two hundred and thirty) admitted into the Neonatal ward of Olabisi Onabanjo University Teaching Hospital, Sagamu between 1st January 1998 and 31st December 1999 were reviewed. All neonates (fifty-seven) who had a positive blood smear for the malaria parasite were included in the study. Socio-demographic data as well as clinical correlates of each of the patients were reviewed. The Epi-Info 6 statistical software was used for data entry, validation and analysis. A frequency distribution was generated for categorical variables. To test for an association between categorical variables, the chi-square test was used. The level of significance was put at values less than 5%.ResultsPrevalence of neonatal malaria in this study was 24.8% and 17.4% for congenital malaria.While the mean duration of illness was 3.60 days, it varied from 5.14 days in those that died and and 3.55 in those that survived respectively. The duration of illness significantly affected the outcome (p value = 0.03). Fever alone was the clinical presentation in 44 (77.4%) of the patients. Maturity of the baby, sex and age did not significantly affect infestation. However, history of malaria/febrile illness within the 2 weeks preceding the delivery was present in 61.2% of the mothers. Maternal age, concurrent infection and duration of illness all significantly affected the outcome of illness. Forty-two (73.7%) of the babies were discharged home in satisfactory condition.ConclusionIt was concluded that taking a blood smear to check for the presence of the malaria parasite should be included as part of routine workup for all neonates with fever or those whose mothers have history of fever two weeks prior to delivery. In addition, health education of pregnant mothers in the antenatal clinic should include early care-seeking for newborns.

Reporte de cinco casos de malaria neonatal grave por Plasmodium vivax en Urabá, Colombia

“…La malaria neonatal se define como aquella enfermedad que aparece en los primeros 28 días de vida posnatal (6). Esta definición no especifica si se toma a partir del inicio de los síntomas o al momento del diagnóstico.…”

“…El paludismo en este período de la vida incluye la posibilidad de un mecanismo de transmisión del parásito al neonato, tanto en forma vectorial como vertical (transplacentaria) (6). Esta diferenciación comienza con la verificación del cumplimiento de ciertos criterios, tomados de Henry (12), que puntualizan la transmisión vertical, así: antecedente materno de malaria gestacional por la misma especie de Plasmodium que se encontró en el neonato; obtención de aquél en sangre de cordón umbilical; antecedente materno de estancia en zona endémica o transfusión durante el embarazo; y demostrar en la zona endémica la presencia del parásito en los primeros siete días de vida postnatal para los casos de P. falciparum y hasta los 21 días para las demás especies.…”

“…Dos estudios realizados en Nigeria destacan la mayor frecuencia de la enfermedad en hijos de primigrávidas con antecedentes de fiebre (5,6). En nuestro reporte todas las maternas refirieron fiebre durante el embarazo y en dos de ellas se hizo diagnóstico de malaria durante la gestación.…”

“…(4). Asimismo, en el 2004, Orogade encontró una prevalencia de 8,3% (17/206) de malaria neonatal en el Hospital Universitario de Abu en Nigeria y Runsewe-Abiodun, en el 2006, reportó una prevalencia de 24,8% (5,6).…”

Clinical Presentation and Management of Neonatal Malaria: A Review

“…Despite these well-documented indirect effects of malaria to the fetus and newborn, the direct burden of neonatal malaria infection in terms of prevalence and outcome is not well described in malaria endemic areas. Studies published so far have documented contradictory levels of this burden [4][5][6][7]. Most of these studies were conducted in large referral or teaching hospitals, and the results are difficult to generalize [4][5][6]8,9].…”