Epidemiology of congenital malaria in Nigeria: a multi-centre study.
OBJECTIVE
To determine the burden of congenital malaria in newborns in Nigeria.


METHODS
In a prospective multi-centre study, 1875 consecutive mother-baby pairs were enrolled over a continuous 12-month period. Blood smears were prepared from mothers, neonates, placental aspirates and cord blood within 4 h of delivery. Outcome variables were patent parasitaemia in the mother, placenta, cord and neonate in addition to maternal and neonatal haematocrit.


RESULTS
Patent parasitaemia was detected in 95 neonates (5.1%). The occurrence varied between study centres, but was found year round in all sites. The mean parasite density among infected neonates was low (48 asexual forms per microl, range 8-200/microl). Maternal and placental parasitaemia were the most important risk factors for patent neonatal parasitaemia (P < 0.0001). Spontaneous clearance of parasitaemia occurred in 62.1% of neonates before day 2. 33.7% were symptomatic within 3 days of birth.


CONCLUSIONS
Congenital malaria is often asymptomatic, clears spontaneously and may not warrant treatment. However, newborns with unexplained fever and refusal to feed in malaria endemic areas should be tested for malaria.
Falade
Catherine
C
Department of Clinical Pharmacology, University College Hospital, Ibadan, Nigeria. fallady@skannet.com
Mokuolu
Olugbenga
O
Okafor
Henrietta
H
Orogade
Adeola
A
Falade
Adegoke
A
Adedoyin
Olanrewaju
O
Oguonu
Tagbo
T
Aisha
Maman
M
Hamer
Davidson H
DH
Callahan
Michael V
MV
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn / Q000097:blood; D016778:Malaria, Falciparum / Q000151:congenital* / Q000453:epidemiology*; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies