Prevalence, Clinical Features and Outcome of Neonatal Malaria in Two Major Hospitals in Jos, North-Central Nigeria

Udochukwu M Diala,Stephen Oguche,Akinyemi O D Ofakunrin,Olubunmi O Diala,Kenneth I Onyedibe,B Toma ,Dz Egah

doi:10.4236/aid.2017.73007

Udochukwu M Diala, Stephen Oguche + Show 5 more

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https://doi.org/10.4236/aid.2017.73007

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Abstract

Malaria was thought to be rare in neonates. However, recent studies report increasing prevalence in neonates. Clinical features of neonatal malaria have also not been adequately reported. This study was undertaken to assess the prevalence, clinical features and outcome of malaria in neonates admitted into two tertiary hospitals in Jos, Plateau State. All consecutive neonates aged 0 - 28 days admitted into the neonatal units of Jos University Teaching Hospital and Bingham University Teaching Hospital, Jos were recruited into the study. Giemsa stained blood films of the neonates were examined by trained microscopists. Neonates with malaria had presenting clinical features recorded and treated with amodiaquine (1st line) and quinine (2nd line). Clinical features and parasitaemia were monitored for 14 days for outcome. Of the 301 neonates enrolled, 16 had malaria parasitaemia giving a prevalence of 5.3%. Congenital malaria accounted for 87.5% of cases of neonatal malaria. Plasmodium falciparum mono-infection was responsible for all the cases of malaria. ITN use in pregnancy offered some protection against neonatal malaria (CI=0.2 - 0.7). The median parasite density was 255 (72, 385) parasites/μl. Fever was significantly present in 10 (66.7%) of the cases (p=0.03). Fifteen of the 16 neonates had clinical and parasitological cure on treatment with amodiaquine. One treatment failure had cure after retreatment with quinine. There was no mortality in all 16 neonates treated for malaria. Malaria is not rare in neonates on admission in Jos. Fever is the commonest clinical feature of neonatal malaria. Amodiaquine provided effective treatment of malaria in neonates in Jos.

Highlights

Malaria remains a major health problem with forty one percent of the world’s population living in malaria endemic areas [1]
All consecutive neonates aged 0 28 days admitted into the neonatal units of Jos University Teaching Hospital and Bingham University Teaching Hospital, Jos were recruited into the study
This increase in the prevalence of neonatal malaria is believed to be associated with drug-resistance of Plasmodium falciparum and increased virulence of malaria parasite resulting from altered antigenic determinants [7]

Summary

Introduction

Malaria remains a major health problem with forty one percent of the world’s population living in malaria endemic areas [1]. Several studies over the past two decades, especially in Nigeria have shown that the prevalence of malaria in neonates appears to be increasing with values as high as 25% [6] [7]. This increase in the prevalence of neonatal malaria is believed to be associated with drug-resistance of Plasmodium falciparum and increased virulence of malaria parasite resulting from altered antigenic determinants [7]. Other factors that contribute to the higher prevalence of malaria in neonates include: increased reporting, poor attitude towards sleeping under insecticide treated net (ITN), poor uptake of intermittent malaria prophylaxis (IT-SP), change in climatic conditions in favour of mosquito breeding and high prevalence of HIV infection in pregnancy [7] [8] [9] [10]

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