TITLE:
Congenital Malaria in the Borgou/Alibori Regional University Teaching Hospital: Myth or Reality?
AUTHORS:
Joseph Agossou, Falilatou Agbeille Mohamed, Mèdétinmè Gérard Kpanidja, Alphonse Noudamadjo, Julien Didier Adédémy, Zinsou Rodrigue Ahodègnon
KEYWORDS:
Congenital Malaria, Prevention, Benin
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.9 No.3,
July
9,
2019
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.