Clinical Profiles of Newborns with Malaria Parasitaemia in Sagamu

Abstract

Congenital malaria parasitaemia, a consequence of transmission of parasites from mother to foetus during pregnancy or delivery, is not uncommon amongst newborns in malaria endemic areas. Its clinical significance is often unclear however, as some researchers report an absence of symptoms in the majority of cases, whilst others report features that are indistinguishable from those of neonatal sepsis. This article describes our observations of a cohort of parasitaemic neonates during a prospective study of congenital malaria in Olabisi Onabanjo University Teaching Hospital, Sagamu. To describe the clinical profiles of newborns with congenital malaria parasitaemia. Screening of a consecutive sample of live newborns (aged 0-3 days) delivered at Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria, for malaria parasitaemia by microscopic examination of stained blood films. Data analysis was done with Epi-info version 6 software, and level of significance set at < 5 percent. Twenty-one (11 percent) of 192 newborns delivered in O.O.U.T.H within the study period were diagnosed as having congenital malaria parasitaemia. Of these, three (14.3 percent) exhibited features attributable to malaria. Prominent features observed in the parasitaemic babies, were anaemia (71.4 percent), fever (14.3 percent) and jaundice (14.3 percent). The symptomatic parasitaemic neonates (n= 3) developed fever and jaundice within 72 hours of life, and their mean fiveminute
Apgar scores, gestational ages, and anthropometric indices were significantly lower than those of their asymptomatic parasitaemic counterparts. Interestingly, malaria parasitaemia alone did not confer a significant reduction in these parameters, although the trend was similar in parasitaemic versus aparasitaemic subjects. The survival rate was higher
in aparasitaemic neonates (98 percent) than parasitaemic newborns (90.5 percent) (p>0.05), and mortality rate amongst symptomatic parasitaemic babies (1/3) was correspondingly higher than that of their asymptomatic counterparts (1/18). Despite the high prevalence of congenital
malaria parasitaemia in newborns in this study, majority of the subjects were asymptomatic, and the incidence of clinical manifestations of illness was low. Long term follow up studies with a larger population of newborns are required to determine the clinical and public health significance of congenital malaria parasitaemia in endemic areas.

Key words: neonates, congenital, malaria, Nigeria