MALARIA: Congenital malaria in calabar, Nigeria: the molecular perspective.

Am J Trop Med Hyg. 2011 Mar;84(3):386-9.

Oduwole OA, Ejezie GC, Odey FA, Oringanje CM, Nwakanma D, Bello S, Oriero E, Okebe J, Alaribe AA, Etuk S, Meremikwu M.
Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria; United Kingdom Medical Research Council Laboratories, Fajara, The Gambia.

Abstract.
Polymerase chain reaction (PCR) has been shown to be more sensitive in detecting low-level parasitemia than conventional blood film microscopy. We estimated the prevalence of congenital malaria using nested PCR amplification of the small subunit 18S RNA gene to detect low-level parasitemia and identify Plasmodium species in 204 mother-neonate pairs. Cord-blood parasitemia was detected in four babies by PCR, giving a prevalence of 2.0%. The newborns of primidgravidae were more susceptible to congenital malaria than those of multigravidae (P < 0.0001). There was a strong correlation between placental malaria and congenital malaria (odds ratio = 10.1, 95% confidence interval = 1.3-76.1, P = 0.0487). We conclude that the prevalence of congenital malaria in Calabar detected by PCR is lower than has been reported in this environment through microscopy.

PMID: 21363974 [PubMed - in process]PMCID: PMC3042812 [Available on 2012/3/4]

MALARIA: congenital malaria

BACKGROUND:
Congenital malaria has been increasingly documented in endemic regions. It is important to recognize those clinical features that are due to congenital malaria, which if undetected, might worsen the morbidity of the newborn. The aim of this study was to document the clinical presentation of neonates with congenital malaria born at the Lagos University Teaching Hospital and followed up for 28 days.
METHODS: A total of 100 consecutive mothers and their newborns were recruited between August and October 2002 (during the rainy season) from the labour ward and followed up from birth to 28 days of age. Blood films from the placentae and babies were stained with Giemsa stain within 24 hours of collection. All parasitaemic babies that became symptomatic were screened for sepsis using acute phase responses and cultures. All data were entered into a prepared proforma. Symptoms were attributed to malaria when sepsis screening was negative.
RESULTS: Congenital malaria was documented in 13.6% of babies at delivery. Jaundice, irritability and poor feeding were most common symptoms associated with congenital malaria. Irritability and poor feeding had positive predictive values (PPV) of 100% on Day 14.
CONCLUSION: Babies who present with poor feeding and irritability on Day 14 of life should be screened for malaria in addition to the routine investigations for neonatal sepsis.
http://www.ncbi.nlm.nih.gov/pubmed/20499743?dopt=Abstract