Congenital malaria: Prevalence, Risk Factors and Clinical Correlates in a Tertiary Hospital in Zaria, Nigeria.

Abstract

Background – Malaria is undoubtedly the world’s^, most important and devastating parasitic disease which has remained a serious public health issue especially in Tropical countries since ancient times. The spectrum of congenital malaria has been poorly elucidated in our locale.

Objectives- To document the prevalence, maternal risk factors and clinical correlates of congenital malaria.

Methodology- A prospective descriptive study was carried out over a 12-month period. Neonates aged ≤ 7 days of age delivered at or presenting to the Neonatal Unit that had not been transfused with blood, along with their mothers, were studied. Blood specimens obtained from these subjects were analysed for malaria parasite, packed cell volume and maternal Human Immunodeficiency Virus (HIV) sero status.

Results- A total of 338 mothers and 342 neonates were studied prospectively. Congenital malaria was found in 13.5% of the neonates. The prevalence of congenital malaria was highest (63%) in neonates seen within the first 24 hours of birth. Maternal malaria peripheral parasitaemia was 12.7%. The significant maternal risk factors for congenital malaria were: peripheral parasitaemia (p<0.05), lack of antimalarial chemoprophylaxis (p=0.001), positive HIV serostatus (p < 0.05), premature rupture of membranes (p=0.001), prolonged rupture of membranes (p < 0.05), fever in the week preceding delivery (p=0.039). Season of the year at birth was significant to the occurrence of congenital malaria. The significant clinical correlates of congenital malaria were fever (p = 0.008), anaemia (p=0.001), clinical jaundice (p < 0.05), hepatomegaly (p< 0.05) and splenomegaly (p=0.008). Plasmodium falciparum was the only species of malaria parasite identified and symptomatic babies responded satisfactorily to oral quinine.

Conclusion - Congenital malarial is prevalent in our environment. Neonates of mothers with the identified risk factors should be evaluated for congenital malaria, especially, if they have anaemia, clinical jaundice, hepatomegaly and/or splenomegaly. Although the study is limited greatly by being over a decade old, findings are still pertinent as the endemicity pattern and demographics are still relatively similar