Prevalence of gestational, placental and congenital malaria in north-west Colombia.

BACKGROUND: The frequency of pregnancy-associated malaria is increasingly being documented in American countries. In Colombia, with higher frequency of Plasmodium vivax over Plasmodium falciparum infection, recent reports confirmed gestational malaria as a serious public health problem. Thick smear examination is the gold standard to diagnose malaria in endemic settings, but in recent years, molecular diagnostic methods have contributed to elucidate the dimension of the problem of gestational malaria. The study was aimed at exploring the prevalence of gestational, placental and congenital malaria in women who delivered at the local hospitals of north-west Colombia, between June 2008 and April 2011. METHODS: A group of 129 parturient women was selected to explore the prevalence of gestational, placental and congenital malaria in a descriptive, prospective and transversal (prevalence) design. Diagnosis was based on the simultaneous application of two independent diagnostic tests: microscopy of thick blood smears and a polymerase chain reaction assay (PCR). RESULTS: The prevalence of gestational malaria (thick smear /PCR) was 9.1%/14.0%; placental malaria was 3.3%/16.5% and congenital malaria was absent. A history of gestational malaria during the current pregnancy was significantly associated with gestational malaria at delivery. Plasmodium vivax caused 65% of cases of gestational malaria, whereas P. falciparum caused most cases of placental malaria. CONCLUSIONS: Gestational and placental malaria are a serious problem in the region, but the risk of congenital malaria is low. A history of malaria during pregnancy may be a practical indicator of infection at delivery.

Plasmodium vivax congenital malaria in an area of very low endemicity in Guatemala: implications for clinical and epidemiological surveillance in a malaria elimination context.

This is a report of the first Plasmodium vivax congenital malaria case in Guatemala and the first case in Latin America with genotypical, histological and clinical characterization. The findings show that maternal P. vivax infection still occurs in areas that are in the pathway towards malaria elimination, and can be associated with detrimental health effects for the neonate. It also highlights the need in very low transmission areas of not only maintaining, but increasing awareness of the problem and developing surveillance strategies, based on population risk, to detect the infection especially in this vulnerable group of the population.

Malaria congénita: estudio rertrospectivo 2000-2011. Hospital "Menca de Leoni", ciudad guayana estado bolívar / Congenital malaria: a retrospective study from 2000 to 2011. Hospital

La Malaria denominada fiebre palúdica o paludismo constituye un problema de salud en gran parte de los países tropicales y subtropicales. El paludismo congénito es transmitido verticalmente desde la madre al niño durante el embarazo o en el momento delparto. Con la presente investigación se pretende actualizar el estudio literario sobre la malaria congénita y demostrar la incidencia de casos en la población Guayacitana. Se revisaron 8 casos con diagnostico de malaria congénita que ingresaron al Hospital “Menca de Leoni” en el periodo comprendido entre 2000 y 2011. Se estudiaron las variables sexo, edad, procedencia, intervalo entre elinicio de síntomas y el diagnóstico, manifestaciones clínicas, agente etológico, edad en el momento del diagnóstico, tiempo de gestaciónde la madre al momento de adquirir la infección, hallazgos hematológicos y tratamiento. El sexo mayormente afectado fue el masculino, todos los casos se presentaron en menores de 1 mes. La edad de gestación más frecuente al momento de adquirir lainfección fue el tercer trimestre. Las manifestaciones clínicas más frecuentes fueron fiebre y palidez cutánea. La forma parasitaria más frecuente fue el Plasmodium vivax. La mayoría de los niños recibió tratamiento con monoterapia antipalúdica a base de Cloroquina, con evolución clínica satisfactoria. La frecuencia del paludismo congénito se ha incrementado recientemente en nuestro país.La forma parasitaria más frecuente es la del Plasmodium vivax, por lo que el tratamiento indicado es la Cloroquina, con la cual se obtiene una respuesta favorable en la mayoría de los casos

Malaria is a major health problem in many of the tropical and subtropical countries. Congenital malaria is transmitted vertically frommother to child during pregnancy or at delivery. The objectives of the present study are to update the literature study on congenital malaria and to show the incidence of cases in the population of Ciudad Guayana, Bolívar, Venezuela. Eight children who were admitted to the Hospital “Menca de Leoni” during 2000 to 2011 were included. Variables studied were: gender, age, interval between the beginning of de symptoms and diagnosis, clinical findings, etiologic agent, age at diagnosis, gestation age at the moment of acquiring the infection,hematologic findings and treatment. Boys were affected more frequently, all cases presented during the first month of age. The gestation age most frequent at the moment of acquiring the infection was the third trimester. Most frequent clinical findings were fever and skin pallor. The most frequent parasitic form was Plasmodium vivax. Treatment with chloroquine was indicated in most of children with good clinical outcome. Conclusions: The predominant symptom of congenital malaria in the studied children was fever and the highest percentage presented parasitaemia by Plasmodium vivax. Most patients received treatment with antimalarial monotherapy based on chloroquine, with satisfactory clinical outcome

Neonatal Plasmodium vivax malaria.

Congenital malaria is a condition rarely diagnosed, even in endemic countries. This tropical disease is associated with high mortality in the absence of timely recognition and prompt therapy, particularly when is due to Plasmodium falciparum, however Plasmodium vivax can also lead to relevant morbidity and mortality. We report an unusual case of a 19- day-old male newborn with neonatal vivax malaria, suspected primarily on the basis of positive maternal history, which presented with low birth weight, thrombocytopenia and a significant parasitemia. He responded satisfactorily to chloroquine antimalarial therapy, being successfully discharged 10 days after admission. Blood smears remained negative during the first 2 months of follow up. At 8 weeks of follow-up, she showed remarkable weight gain and was developing normally with age-appropriate anthropometry with no subsequent complications.

Congenital malaria in Urabá, Colombia.

BACKGROUND: Congenital malaria has been considered a rare event; however, recent reports have shown frequencies ranging from 3% to 54.2% among newborns of mothers who had suffered malaria during pregnancy. There are only a few references concerning the epidemiological impact of this entity in Latin-America and Colombia. OBJECTIVE: The aim of the study was to measure the prevalence of congenital malaria in an endemic Colombian region and to determine some of its characteristics. METHODS: A prospective, descriptive study was carried out in the mothers who suffered malaria during pregnancy and their newborns. Neonates were clinically evaluated at birth and screened for Plasmodium spp. infection by thick smear from the umbilical cord and peripheral blood, and followed-up weekly during the first 21 days of postnatal life through clinical examinations and thick smears. RESULTS: 116 newborns were included in the study and 80 umbilical cord samples were obtained. Five cases of congenital infection were identified (four caused by P. vivax and one by P. falciparum), two in umbilical cord blood and three in newborn peripheral blood. One case was diagnosed at birth and the others during follow-up. Prevalence of congenital infection was 4.3%. One of the infected newborns was severely ill, while the others were asymptomatic and apparently healthy. The mothers of the newborns with congenital malaria had been diagnosed with malaria in the last trimester of pregnancy or during delivery, and also presented placental infection. CONCLUSIONS: Congenital malaria may be a frequent event in newborns of mothers who have suffered malaria during pregnancy in Colombia. An association was found between congenital malaria and the diagnosis of malaria in the mother during the last trimester of pregnancy or during delivery, and the presence of placental infection.

Congenital malaria, an important differential diagnosis to consider when evaluating febrile infants of immigrant mothers.

Congenital malaria is reported rarely in the United States and almost exclusively affects infants of immigrant mothers. Because of its nonspecific presentation with fever during the first 3 months of life, it is an important differential diagnosis when evaluating such infants with fever in the pediatric emergency department. A complete and accurate travel and residency history on the infant's family should be sought during evaluation. As intercontinental travel and immigration increases, emergency department physicians should be alert to the diagnosis of malaria in ill neonates and young infants. We discuss a case of congenital malaria in a 26-day-old infant and review the clinical features of previously reported cases in the United States.