[Congenital malarial disease due to Plasmodium falciparum in high-infection-risk newborn].
The aim of this work was to differentiate in an endemic area congenital malaria diseases (CMD) from congenital malaria infestations (CMI) or other maternal-fetal infections.


METHODS
Four hundred and seventy-five newborn (0-7 d) suspected of infection were prospectively studied. CMD was diagnosed when clinical manifestations were associated with positive thick and thin blood films in a mother and her newborn. The diagnosis of CMI was retained when despite positive parasitemia, no clinical manifestations were observed.


RESULTS
Forty newborns (1.7% of the cases of maternal malaria) were diagnosed as CMD and ninety-one (19% of live births) were considered as CMI. The main clinical manifestations were related to cerebral (100%), respiratory (95%) and hemodynamic (90%) systems. Hematologic signs were present in 95% of cases. The level of parasitemia varied from 700 to 3,000 parasites/mL in CMD and from 360 to 870 parasites/mL in CMI. Death occurred in ten cases (25%) of CMD.


CONCLUSIONS
In this malaria-endemic area, neither clinical manifestions nor parasitemia allow one to distinguish CMD from CMI associated with bacterial materno-fetal infections. Studying placental or systemic immunity and antimalaria IgM in the newborn could be of interest to clarify this problem.
Balaka
B
B
Service de néonatologie, Centre hospitalier universitaire, Lomé, Togo.
Agbere
A D
AD
Bonkoungou
P
P
Kessie
K
K
Assimadi
K
K
Agbo
K
K
D000328:Adult; D000818:Animals; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008288:Malaria / Q000151:congenital* / Q000175:diagnosis / Q000635:transmission; D010963:Plasmodium falciparum / Q000472:pathogenicity*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology*; D012307:Risk Factors
D007075:Immunoglobulin M