Prevalence Of Congenital Malaria Research Articles

Global prevalence of congenital malaria: A systematic review and meta-analysis

ObjectiveThe aim of this systematic review and meta-analysis is to pool the prevalence of congenital malaria. Study designThe guideline of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was strictly followed. The published studies were searched in international and national databases. Quality assessment for studied was performed using the modified Newcastle - Ottawa scale. Pooled Meta logistic regression was computed using OpenMeta Analyst software. The heterogeneity was explored by the subgroup and meta-regression method. ResultsTwenty-four studies enrolling 8148 newborns were conducted. All the studies were high-quality studies. The prevalence of congenital malaria ranged from 0.0 % in Colombia to 46.7 % in Nigeria. The overall prevalence of congenital malaria was 6.9 % (95 % CI: 4.8–7.9 %) (562/8148). There was large heterogeneity in prevalence of congenital malaria estimates among the different settings (I2 = 96.1 %). Hence the random effect model was used.In subgroup analyses, with respect to the type of malaria transmission, the prevalence of congenital malaria was significantly higher in areas characterized by unstable malaria transmission vs. the rate in areas with stable malaria transmission [16.8 % (95 % CI: 8.0–25.6 %) vs. 3.5 % (95 % CI: 2.3–4.6 %), Coefficient = 0.111; P = 0.035]. The results of additional sub- group (meta-regression) analyses showed a non-significant difference in prevalence of congenital malaria in study-sample sizes (Coefficient = −0.001, 95 % CI: −0.001 to 0.001), P-value = 0.534) and year of publication (C = −0.005; 95 % CI: −0.016 to 0.006), P-value = 0.369). ConclusionThis meta-analysis showed a varied prevalence of congenital malaria across endemic areas and it was higher in areas with unstable malaria transmissions.

Prevalence of Congenital Malaria in Kisangani, A Stable Malaria Transmission Area in Democratic Republic of the Congo.

Background Gestational malaria is a major public health problem. It produces fetal complications such as low birth weight, perinatal mortality, and congenital malaria. The present study is aimed at determining the prevalence of congenital malaria and its neonatal complications in the city of Kisangani. Methods We conducted a cross-sectional study in Kisangani from 1 January to 30 September 2018. Our study population was composed of 1248 newborns born in our study sites, during the period of our study. Just after their birth, we performed the thick drop smear in the placental print and in umbilical blood smear. Results The prevalence of congenital malaria was 13.98%; 69.23% of newborns who contracted congenital malaria were from 18- to 34-year-old mothers, 53.85% from primiparous mothers, 92.31% from mothers who took intermittent preventive treatment in pregnancy with Sulfadoxine-Pyrimethamine, all (100%) from mothers using the insecticide-treated mosquito nets and 7.69% from HIV-positive mothers. Low birth weight and perinatal mortality were recorded in 76.92% and 7.69% of congenital malaria cases, respectively. Intermittent preventive treatment in pregnancy with Sulfadoxine-Pyrimethamine had no effect on congenital malaria (FE = 0.5218; OR: 0.8, 95% CI: 0.1651-3.8769) and on low birth weight (FE = 0.3675; OR: 1.2308, 95% CI: 0.0037-0.1464); however, it seemed to have protective effect against perinatal mortality (FE = 0.0001; OR: 0.0233, 95% CI: 0.0037-0.1464). Conclusion Congenital malaria remains a major problem in stable malaria transmission area like Kisangani, and it is grafted by major perinatal complications, particularly low birth weight and perinatal mortality. We recommend an extended study to clarify the relationship between the outcome of pregnancy and the intermittent preventive treatment in pregnancy with Sulfadoxine-Pyrimethamine.

The Prevalence of Congenital Malaria : Nigerian Experience

This study was aimed at highlighting on the prevalence of malaria among pregnant women in Nigeria within the last ten years. The prevalence of congenital malaria in Nigeria varies and it affects every geopolitical zone in Nigeria. This is because Nigeria like other countries in the tropics and subtropics has factors which favour the survival of mosquito. Although the World Health Organization (WHO) recommends the use of insecticide treated nets and effective case management of uncomplicated malaria as a feasible and cost-effective control strategy, Nigeria remains one of the worst affected countries in the world with malaria among pregnant women and neonates. This paper recommends more programs to the menace of this infection among pregnant women and neonates in Nigeria.

Congenital Malaria in Newborns Presented at Tororo General Hospital in Uganda: A Cross-Sectional Study.

Despite recent large-scale investments, malaria remains a major public health concern. Few studies have examined congenital malaria, defined as the presence of malaria parasitemia within the first 7 days of life, in endemic areas. This study aimed to determine the prevalence, to describe the clinical presentation, and to examine factors associated with congenital malaria in newborns aged up to 7 days attending Tororo General Hospital in Uganda. A total of 261 mother/baby pairs were recruited in this cross-sectional study. Giemsa-stained thick blood smears for malaria parasites and rapid malaria diagnostic tests were performed on capillary blood samples from all newborns and mothers, as well as on placental and cord samples from newborns delivered in the hospital. The prevalence of congenital malaria in the newborns was 16/261 (6.1%). No single clinical feature was associated with congenital malaria. However, there were associations between congenital malaria and maternal parasitemia (P < 0.001), gravidity of one (P = 0.03), maternal age < 19 years (P = 0.01), cord blood parasitemia (P = 0.01), and placental malaria (P = 0.02). In conclusion, congenital malaria is not rare in Uganda and there are no obvious clinical features associated with it in the newborn. Based on these findings, we recommend strengthening malaria prevention during pregnancy to reduce the occurrence of congenital malaria in newborns.

Impact of placental malaria on adverse pregnancy outcomes in Sudanese women from Blue Nile state

Background: Sudan is one of the affected countries by malaria in sub-Saharan regions. Placental Malaria is a specific character of malaria infection during pregnancy. Sequestration of infected erythrocytes in the placental intervillous spaces is associated with adverse pregnancy outcomes, such as miscarriage, stillbirth, low birth weight (LBW) and congenital malaria. The aim of this study was to determine the impact of placental malaria on pregnancy outcomes in Blue Nile state, Sudan. Methods & Materials: A cross-sectional hospital based study was conducted during Jan. 2012- June 2014. Malaria infection was assessed at delivery time in peripheral maternal and neonatal blood, and in placental blood using microscopy and nested PCR. Finger prick blood was used for preparation of peripheral smears and dried spots. Smears were stained with Giemsa and examined microscopically for malaria parasites. DNA was extracted from the dried spots using chelex method and PCR was carried out using outer and nested primers. Results: A total of 336 mother–neonates pairs were enrolled in the study (mean maternal age 23.3 ± 6.3 yrs.). The mean (SD) haemoglobin was 10.1 (0.9) g/dl and the mean (SD) birth weight of the neonates was 2.4 (0.3) Kg. A high prevalence of P. falciparum infections was detected in maternal peripheral blood (30.5% and 42.7%) and placental blood (43.1% and 62.8%) using both microscopy and n-PCR respectively. The prevalence of congenital malaria was 2.0% by microscopy, while nested PCR identified positivity of 13.6%. Mothers of neonates with congenital malaria had at least one episode of clinical malaria in the index pregnancy. Placental malaria was significantly associated with low maternal haemoglobin level (P = 0.002), LBW (P = 0.011) and congenital malaria (P < 0.001). Conclusion: Infection with peripheral and/or placental malaria was associated with adverse pregnancy outcomes such as maternal anaemia and LBW. Materno- fetal transmission of P. falciparum is existence in Blue Nile state that may lead to intrautrine growth retardation, preterm birth and malaria illness mortality.

Prevalence of congenital malaria in newborns of mothers co-infected with HIV and malaria in Benin city

Background: HIV and Plasmodium falciparum malaria co-infection annually complicates about one million pregnancies in sub-Saharan Africa. Congenital malaria (CM) has deleterious effects on newborns. Little is known about the effect of co-infections on the prevalence of CM in infants born by these women. This study was carried out to determine the prevalence of CM in newborns of mothers co-infected with HIV and malaria compared to HIV-negative mothers with malaria in Benin-City.Methods: Subjects were 162 newborns of mothers co-infected with HIV and malaria. Controls were 162 newborns of HIV negative malaria infected mothers. Blood film for malaria parasites was done on cord blood and peripheral blood on days 1, 3 and 7 in the newborns. Maternal peripheral blood film for malaria parasite was done at delivery and placental tissue was obtained for confirmation of placental malaria by histology. Diagnosis of malaria in blood films was by light microscopy.Results: The prevalence of CM in subjects was significantly higher than in controls (34.6% and 22.2%, p=.014). Profound immunodepression (maternal CD4 cell count <200 cell/mm3) was significantly associated with CM (p=.006). The major predictors of CM in subjects were maternal CD4 cell count <200 cell/mm3 and placental malaria while in controls placental malaria was the only predictor.Conclusions: Babies born to mothers co-infected with HIV and malaria are at increased risk for CM. All babies born by HIV positive mothers should be screened for CM.

Epidemiological, Clinical, Biological, Therapeutic Features and Outcome of Congenital Malaria at the Borgou Regional University Teaching Hospital (CHUD-B) in Benin in 2015

Background: The prevalence of congenital malaria is getting more and more significant in Sub-Saharan Africa where is a malaria-endemic area. This study aimed to identify the clinical and therapeutic features as well as the outcome of congenital malaria in CHUD-B in 2015. Method: It was a cohort and descriptive study with analytical purpose, carried out in the Mother and Child Department which includes the Gynecology & Obstetrics and Pediatric Unit of CHUD-B. The study target population consisted of all the infants born in the CHUD-B as well as their mothers. The main variable was the presence of congenital malaria. The independent variables were those related to clinical, therapeutic features and outcome. Results: In the study, among the 300 newborns registered, 57 carried congenital malaria i.e. a prevalence of 19%. 171 (57.0%) of them were males versus 129 (43.0%) females. Among the 281 mothers involved, 48 presented with malaria in pregnancy i.e. a prevalence of 17.0%. At the end of this research work, the factors associated with congenital malaria were fever in the 3rd quarter and malaria in pregnancy in the mother. Conclusion: Nearly one out of five infants born in the CHUD-B was carrier of congenital malaria and approximately one out six mothers presented with malaria detection during pregnancy. A method based on Polymerase Chain Reaction (PCR) should be implemented during the diagnosis in order to confirm malaria cases among both newborns and mothers.

Prevalence of congenital malaria in Blue Nile state, Sudan

Prevalence of congenital malaria in Blue Nile state, Sudan

Retrospective study of congenital malaria in Calabar, South- Eastern Nigeria

Background: Perinatal infection heightens the risk of childhood malaria in endemic areas. In Nigeria, exhaustive case studies are necessary to document obviously unrecorded cases of infantile malaria to aid control efforts. Aim: The study aimed to determine the prevalence of congenital malaria among neonates delivered in the hospital. Methods: A retrospective analysis of a five-year medical record, 2009 to 2013 was conducted in General Hospital, Calabar. The study examined laboratory data of 9,398 pregnant women on antenatal admission and 5,730 children aged 0 -7 days; delivered in the hospital within the five-year period. Records of confirmed blood tests by microscopy for Plasmodium species were extracted for analysis. Data were analysed using descriptive and nonparametric statistics. Results: The study identified congenital malaria prevalence of 1.08% and maternal malaria prevalence of 9.17% within the period. The relationship between maternal malaria and congenital malaria was statistically significant (X 2 = 13.62; P = 0.05). The five-year prevalence profile indicated a rising trend of congenital malaria towards the current year; from 21% in 2009, 29% in 2010, 14.5% in both 2011 and 2012, to 21% in 2013. Conclusion: Findings suggest possible weakness in the mechanism of maternal malaria management in the city. There is a need to strengthen the existing malaria control capabilities, with ardent attention on vector control, intermittent preventive treatment for pregnant women and capacity for early diagnosis and case management.

Mother-to-Children Plasmodium falciparum Asymptomatic Malaria Transmission at Saint Camille Medical Centre in Ouagadougou, Burkina Faso.

Background. Malaria's prevalence during pregnancy varies widely in parts of sub-Saharan Africa, including Burkina Faso. The objective of this study was to evaluate the incidence of mother-to-child malaria transmission during childbirth at St. Camille Medical Centre in the city of Ouagadougou. Methods. Two hundred and thirty-eight (238) women and their newborns were included in the study. Women consenting to participate in this study responded to a questionnaire that identified their demographic characteristics. Asymptomatic malaria infection was assessed by rapid detection test Acon (Acon Malaria Pf, San Diego, USA) and by microscopic examination of Giemsa-stained thick and thin smears from peripheral, placental, and umbilical cord blood. Birth weights were recorded and the biological analyses of mothers and newborns' blood were also performed. Results. The utilization of long-lasting insecticidal nets (LLINs) and intermittent preventive treatment with sulfadoxine-pyrimethamine (SP) were 86.6% and 84.4%, respectively. The parasitic infection rates of 9.5%, 8.9%, and 2.8% were recorded, respectively, for the peripheral, placental, and umbilical cord blood. Placental infection was strongly associated with the presence of parasites in the maternal peripheral blood and a parasite density of >1000 parasites/µL. Conclusion. The prevalence of congenital malaria was reduced but was associated with a high rate of mother-to-child malaria transmission.

Prevalence of congenital malaria in high-risk Ghanaian newborns: a cross-sectional study

BackgroundCongenital malaria is defined as malaria parasitaemia in the first week of life. The reported prevalence of congenital malaria in sub-Saharan Africa is variable (0 - 46%). Even though the clinical significance of congenital malaria parasitaemia is uncertain, anti-malarial drugs are empirically prescribed for sick newborns by frontline health care workers. Data on prevalence of congenital malaria in high-risk newborns will inform appropriate drug use and timely referral of sick newborns.MethodsBlood samples of untreated newborns less than 1 week of age at the time of referral to Korle Bu Teaching hospital in Accra, Ghana during the peak malaria seasons (April to July) of 2008 and 2010 were examined for malaria parasites by, i) Giemsa-stained thick and thin blood smears for parasite count and species identification, ii) histidine-rich protein- and lactic dehydrogenase-based rapid diagnosis tests, or iii) polymerase chain reaction amplification of the merozoite surface protein 2 gene, for identification of sub-microscopic parasitaemia. Other investigations were also done as clinically indicated.ResultsIn 2008, nine cases of Plasmodium falciparum parasitaemia were diagnosed by microscopy in 405 (2.2%) newborns. All the nine newborns had low parasite densities (≤50 per microlitre). In 2010, there was no case of parasitaemia by either microscopy or rapid diagnosis tests in 522 newborns; however, 56/467 (12%) cases of P. falciparum were detected by polymerase chain reaction.ConclusionCongenital malaria is an uncommon cause of clinical illness in high-risk untreated newborns referred to a tertiary hospital in the first week of life. Empirical anti-malarial drug treatment for sick newborns without laboratory confirmation of parasitaemia is imprudent. Early referral of sick newborns to hospitals with resources and skills for appropriate care is recommended.

Congenital Transmission by Protozoan

Congenital transmission by protozoan parasites is a worldwide important public health problem. Congenital infections affects the mother and the fetus or newborn. It is still surprising that despite the abundant immunoepidemiological knowledge of congenital transmission of protozoan parasite, no definite etiology or predictive diagnostic tests have been identified. Understanding the mechanisms by which host/parasites infection and interaction occurs is one of the most important topics that will help find specific biomarkers of infection, prevent congenital transmission, maintain the health of the newborn, and develop safe and efficient treatments. In addition, understanding of the biological mechanisms of host/parasite interactions will facilitate protection of mothers and their families and reduce costs in health services. Moreover, this will lead to gain insight into epidemiological aspects and association with other pathologies and preserve the wellbeing of the newborn. In this special issue we have invited a few papers that address such issues. Congenital malaria is underestimated and usually associated with low-density cord parasitemia. However, it is increasingly recognized as a potentially serious complication of maternal malaria during pregnancy in Sub-Saharian Africa. Earliest epidemiological studies have reported prevalence varying widely in malaria-endemic areas from 0% to 33%. At birth, infections are usually asymptomatic with low parasitemia and the diagnosis by microscopy is often missed. Infection may occur by transplacental passage of parasites during disruption of the placental barrier at the time of delivery, with subsequent clinical illness in the newborn baby. A paper of this issue assessed the prevalence of congenital malaria during the dry season (period of low-mosquito density and low-malaria incidence) using peripheral and cord blood smears of new born babies in association with peripheral and placental blood smears of, respectively, near-term and term pregnant women. This study is interesting because the authors found that congenital malaria is not rare in their study area. Another paper is a literature review on the prevalence, burden, diagnosis, prevention, and control of congenital malaria in Sub-Saharian Africa. This review is of interest to individuals working in clinics and laboratory diagnostic of malaria but also to national governments and partners in Sub-Saharian Africa. The authors highlight the challenges in parasitological and clinical diagnosis, the challenges in prevention with the use of intermittent preventive treatment (IPT) and insecticide-treated nets (ITNs) and provides recommendation on how to strengthen the health system in Africa. Another paper reports the prevalence of transplacental malaria in Burkina Faso, a West African country, and determines the real burden of transplacental transmission. The authors show associations between levels of parasite in the maternal, placental, and umbilical cord blood. All papers about malaria published in this special issue show the interest of pursuing investigations for a better understanding of vertical transmission by malarial parasites. During congenital Chagas transmission, the parasite reaches the fetus by crossing the placental barrier. In the past few years congenital transmission of T. cruzi has increasingly become more important, and partly responsible for the “globalization of Chagas' disease,” constituting a public health problem of increasing relevance. The fact that only a percentage of the infected mothers transmit parasites to their fetuses raises the question of the ability of the placenta as well as the immunological status of mother and fetus/newborn to impair the parasite transmission. Therefore, it is thought that congenital Chagas disease is the product of a complex interaction between the parasite, the maternal, and fetus/newborn immune responses, and placental factors. Additionally, a paper of this special issue constitutes a morphological analysis by immunohistochemical and histochemical methods of placentas from women with chronic Chagas' disease. T. cruzi-infected placentas present destruction of the syncytiotrophoblast and villous stroma, selective disorganization of the basal lamina, and disorganization of collagen I in villous stroma. Changes in the extracellular matrix of placental tissues, together with the immunological status of mother and fetus, and parasite load may determine the probability of congenital transmission of T. cruzi. Another paper assayed the effect of T. cruzi on glucose transporter protein-1 (GLUT1), which is the main isoform involved in transplacental glucose transport. High glucose media as well as T. cruzi infection reduce GLUT1 expression. The effect of T. cruzi infection on GLUT1 expression may explain some of the clinical manifestation of congenital Chagas disease. Finally, a paper analyzing the congenital transmission of Chagas disease is a review about the role of possible local placental factors that contribute to the vertical transmission of the parasite. Additionally, in that review different available methods for studying the congenital transmission of T. cruzi are analyzed. In that context, the ex vivo infection of human placental chorionic villi by T. cruzi trypomastigotes constitutes an excellent tool for studying parasite infection strategies as well as possible local antiparasitic mechanisms. Ricardo E. Fretes Ulrike Kemmerling Demba Sarr

Prevention of Congenital Transmission of Malaria in Sub-Saharan African Countries: Challenges and Implications for Health System Strengthening

Objectives. Review of burden of congenital transmission of malaria, challenges of preventive measures, and implications for health system strengthening in sub-Saharan Africa. Methods. Literature from Pubmed (MEDLINE), Biomed central, Google Scholar, and Cochrane Database were reviewed. Results. The prevalence of congenital malaria in sub-Saharan Africa ranges from 0 to 23%. Diagnosis and existing preventive measures are constantly hindered by weak health systems and sociocultural issues. WHO strategic framework for prevention: intermittent preventive therapy (IPT), insecticide-treated nets (ITNs), and case management of malaria illness and anaemia remain highly promising; though, specific interventions are required to strengthen the health systems in order to improve the effectiveness of these measures. Conclusion. Congenital malaria remains a public health burden in sub-Saharan Africa. Overcoming the challenges of the preventive measures hinges on the ability of national governments and development partners in responding to the weak health systems.

Prevalence of Congenital Malaria in Minna, North Central Nigeria

The study was designed to determine the true prevalence of congenital, cord, and placental malaria in General Hospital Minna, North Central Nigeria. Peripheral blood smears of near-term pregnant women, as well as the placental, cord, and peripheral blood smears of their newborn babies, were examined for malaria parasites, using the Giemsa staining technique. Out of 152 pregnant women screened, 21 (13.82%) of them were infected with malaria parasites. Of the 152 new born babies, 4 (2.63%) showed positive peripheral parasitaemia. Placental parasitaemia was 7/152 (4.61%), while cord blood parasitaemia was 9/152 (5.92%). There were strong associations between peripheral and cord malaria parasitaemia and congenital malaria (P < 0.05). Plasmodium falciparum occurred in all, and none had mixed infection. The average birth weights of the babies delivered of nonmalarious pregnant women were higher than those delivered by malarious pregnant women, though not significant (P > 0.05). Malaria parasitaemia occurred more frequently in primigravidae than multigravidae.

Prevalence of congenital malaria among newborn babies at Morogoro Regional Hospital, Morogoro, Tanzania

Congenital malaria is increasingly reported among babies born to mothers living in malaria endemic areas. The aim of this study was to determine the prevalence of congenital malaria among newborn babies delivered at Morogoro Regional Hospital, Tanzania. A cross-sectional study was conducted among 200 pregnant women attending delivery services at the hospital. Socio-demographic and obstetric information of the mothers was also collected. Samples of the placental, cord and peripheral blood smears of mothers and babies were stained with Giemsa and examined for malaria parasites. Plasmodiun falciparum was the dominant malaria parasite species. The prevalence of congenital malaria among newly born babies was 4.0% (95% CI, 1.2-6.8%). Prevalence of placental parasitaemia was 7.0% (95% CI, 3.3-10.7%), while prevalence of cord parasitaemia was 0.5% (95% CI, 0.0-1.5%). The prevalence of malaria among the mothers at delivery was 11.5% (95% CI, 6.9-16.1%). There was a strong association between placental, cord, maternal and congenital parasitaemia. All babies with congenital malaria had infected mothers and placentas (P<0.01). In conclusion, congenital malaria is still common in Tanzania especially in malaria endemic areas. It is important that blood smear from neonates are taken and examined for malaria parasite soon after birth. Malaria prevention measures such as intermittent preventive treatment, prompt management of all malaria cases and use of insecticide treated bed nets should be emphasized for all pregnant women.

Some Biochemical and Haematological Studies on the Prevalence of Congenital Malaria in Ilorin, Nigeria

A seven month study (March-September 2006) on the prevalence of congenital malaria was carried out at the labour unit of three different hospitals within Ilorin metropolis: Eyitayo Hospital, Surulere MedicalHospital and Children Specialist Hospital Centre Gboro Ilorin. A total of 130 blood samples were collected from the mothers and their newborn babies and examined for malaria parasite using both thin and thick films. Maternal packed cell volume (PCV) and genotype was also determined using haematocrit method and cellulose acetate electrophoresis respectively. The prevalence rate of maternal, fetal, placental and cord parasitaemia were 37(28.46%), 29(22.31%), 33(25.38%) and 30(23.08%) respectively. Malaria infected maternal blood had a mild reduction in PCV level (p

Prevalence of Congenital Malaria in Ilorin, Nigeria

A Seven months (March-September 2006) study on the prevalence ofcongenital malaria was carried out at the labour unit of three differenthospitals within Ilorin metropolis: Eyitayo Hospital, Surulere MedicalHospital and Children Specialist Hospital Centre Gboro Ilorin. A total of130 blood samples were collected from the mothers and their newborn babiesand examined for malaria parasite using both thin and thick films. Maternalpacked cell volume (PCV), and genotype was also determined usinghaematocrit method and cellulose acetate electrophoresis respectively. Theprevalence rate of maternal, fetal, placental and cord parasitaemia were37(28.46%), 29(22.31%), 33(25.38%) and 30(23.08%) respectively. Malariainfected maternal blood had a mild reduction in PCV level (p