Abstract
Introduction: The occurrence of malaria is classically described as uncommon or exceptional in the neonatal period. This work aims to describe the epidemiological, diagnostic, therapeutic, clinical features and outcomes of congenital malaria in the Borgou/Alibori Regional University Teaching Hospital (CHUD B/A) located in Parakou. Patients and Methods: This research is a cross-sectional and descriptive study that was conducted in the neonatal intensive care unit of the CHUD B/A from January to December 2017. It included and involved all newborns less than eight (08) days old with positive thick smears. Comorbidities were taken into account to establish the diagnosis of congenital malaria with accuracy. Findings: A total of 170 newborns out of 892 newborns admitted tested positive with Plasmodium falciparum thick smears, i.e., a hospital-based frequency of 19%. The sex ratio was 1.1. The mean age was 22.44 ± 2.72 hours. There was malaria-bacterial infection comorbidity in 39.3% of cases. Among the 91 cases of thick smears testing positive without stigma of bacterial infection, G6PD deficiency and fetal-maternal Rhesus incompatibility, the main reasons for admission were prematurity (51.6%), low birth weight (44%), neonatal distress (31.8%) and respiratory distress (15.3%). In addition, the main signs found during the physical examination were neurological disorders or impairments (43.9%), respiratory distress (30%), hyperthermia (12.1%) and jaundice (4.4%). The mean or median parasitemia was 490 parasites/μl, with extremes ranging from 100 to 6500 parasites/μl. Treatment was based on artemisinin derivatives. The patient condition improved in 88.7% of cases. Overall mortality was estimated at 11.9%, and the specific mortality was 13.2%. Conclusion: Congenital malaria is a reality that actually prevails in the CHUDB/A. It has become vital and urgent to explore innovative, effective and efficient strategies to ensure its management and prevention. A study using PCR as the gold standard should be conducted to better assess the extent and magnitude of the disease.
Highlights
The occurrence of malaria is classically described as uncommon or exceptional in the neonatal period
1) Hospital-based frequency of congenital malaria Among the 892 newborns admitted to the neonatal care unit during the study period, 170 were infected with malaria, i.e., a hospital-based frequency of 19%. 2) Sociodemographic characteristics of mothers and gestational anamnesis data The mothers’ mean age was 27.3 ± 6 years with extremes ranging from 15 to 42 years
3) Characteristics of newborns infected with malaria Concerning all 170 newborns infested by Plasmodium, the sex ratio was 1.1
Summary
The occurrence of malaria is classically described as uncommon or exceptional in the neonatal period. Patients and Methods: This research is a cross-sectional and descriptive study that was conducted in the neonatal intensive care unit of the CHUD B/A from January to December 2017. It included and involved all newborns less than eight (08) days old with positive thick smears. Among the 91 cases of thick smears testing positive without stigma of bacterial infection, G6PD deficiency and fetal-maternal Rhesus incompatibility, the main reasons for admission were prematurity (51.6%), low birth weight (44%), neonatal distress (31.8%) and respiratory distress (15.3%). Malaria is a major public health issue It mainly affects the tropical region of Africa, which is the focus of 80% to 90% of cases [1]. Those with a direct impact on the fetus and newborn are stillbirths, prematurity, intrauterine growth restrictions (IUGR) and congenital malaria [4] [5]
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