Abstract
The burden of neonatal malaria was thought rare in the past because of presence of protective factors such as maternal antimalarial antibodies, lactoferrin, secretary IgA in human milk and HbF. In endemic areas for malaria, this group (neonates) needs to be more focused for such infection, as due to difficulty in diagnosis it may be representing only the tip of iceberg. In addition there is little information on the use of artimisinin-based combination therapy in neonates. This review aims to discuss all these aspects, focusing mainly on diagnosis and management of neonatal malaria. The final objective is to emphasize the need to establish management guideline of malaria in this neglected age group.
Highlights
This review analyzes the issues regarding diagnosis and management of neonatal malaria with an aim to provide physicians, clear and concise information about the diagnosis and to emphasize the need to establish management guideline of neonatal malaria in the clinical practice
Congenital malaria, defined as asexual parasites detected in cord blood or peripheral blood during the first week of life [5], is due to transmission from the mother through placenta just before or during delivery [28]
A study from Nigeria had identified a prevalence of 24.8% of acquired neonatal malaria and 17.4% of congenital malaria [37]
Summary
This review analyzes the issues regarding diagnosis and management of neonatal malaria with an aim to provide physicians, clear and concise information about the diagnosis and to emphasize the need to establish management guideline of neonatal malaria in the clinical practice. Malaria contributes significantly to perinatal disease burden in terms of pregnancy loss, prematurity and intra-uterine growth retardation (IUGR) [1,2,3]. 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. Fetal hemoglobin (Hb F), present in high concentration at birth [17] can inhibit parasite development [21] and can protect infant in the first few months of life. Some reduction in malaria risks in neonates can probably be achieved by improving malaria control in late pregnancy and reduction in morbidity and mortality may be achieved by effective management of malaria in neonates
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