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  • The Internet Journal of Pediatrics and Neonatology
  • Volume 16
  • Number 1

Case Study

Congenital Malaria

R Bansal

Keywords

congenital, malaria, plasmodium

Citation

R Bansal. Congenital Malaria. The Internet Journal of Pediatrics and Neonatology. 2013 Volume 16 Number 1.

Abstract

Malaria during first few months of life may be due transplacental transfer of parasitized maternal
erythrocytes. A twenty day infant is described who presented with fever, jaundice and feeding problems. Peripheral smear showed all stages of Plasmodium vivax. The neonate was successfully treated with chloroquine. We emphasize the need for keeping a differential diagnosis of malaria in suspected cases of neonatal sepsis even in low endemic areas and also the importance of adequate antenatal medical therapy for malaria.

 

INTRODUCTION

Malaria is an important vector borne infectious disease. Malaria during first few months of life may be due transplacental transfer of parasitized maternal erythrocytes1. Clinically apparent congenital malaria is rare in areas in which malaria is endemic and levels of maternal antibody are high2. Congenital malaria has an occurrence rate of 0.3 % in immune mothers and 7.4% in nonimmune mothers3-5.

The new born child can manifest with fever, irritability, feeding problems, hepatosplenomegally, anemia, jaundice, low birth weight and loose stools. Occasionally, drowsiness, restlessness and cyanosis may be seen. The onset of symptoms is between 10 to 28 days of age with a range from 14 hours of life to eight weeks of age1,2,6-8.

CASE REPORT

A full term male baby born to a primi gravida mother by normal vaginal route at home presented at twenty day of life with complaints of fever for last three days, yellowish discoloration of eyes and face since one day and

DISCUSSION

Malaria kills a child somewhere in the world every minute9. According to the latest estimates, there were about 219 million cases of malaria in 2010 and an estimated 660 000 deaths, mostly children in Africa10.Currently in India, 80.5% of the 1.2 billion population lives in malaria risk areas. Official figures for malaria in India, indicate 1.5

References

1. Arvin AM, Maldonado YA. Protozoan and Helminth Infections. In: JS Remington, JO Klein, editors. Infectious Diseases of the Fetus and Newborn Infant. 4th ed. Philadelphia: WB Saunders 1995; 765-8.
2. Krause PJ. Malaria (Plasmodium).In: Behrman RE, Keligman R, Jenson HB, editors. Nelson Textbook of Pediatrics. 17th ed. Philadelphia: WB Saunders 2004; 1139-43.
3. Covell G. Congenital malaria. Trop Dis Bull 1950; 1147-67.
4. Akindele J A, Sowunmi A, Abohweyere AE. Congentital malaria in a hyperendemic area: a preliminary study. Ann Trop Paediatr 1993; 13:273-6.
5. Mcgregor IA. Epidemiology, malaria and pregnancy. Am J Trop Med Hyg 1984; 33: 517-25
6. Subramanian D, Moise KJ, White AC. Imported malaria in pregnancy: Report of four cases and review of management. Clin Infect Dis 1992; 15:408.
7. Ibhanescbhor SE. Clinical characteristics of neonatal malaria. J Trop Pediatr 1995; 41: 330-3.
8. Hendrickse RG, Brabin BJ. Paediatrics in the Tropics. In Gordon Cook, editor. Mansion’s Tropical Diseases. 20th ed. London: W B Saunders, 1996; 371.
9. UNICEF-Health-Malaria. www.unicef.org/health/index_malaria.html. Apr 23, 2013.
10. WHO. Malaria Factsheet N 94. Reviewed Mar 2013.
11. Malaria situation. National Vector Borne Disease control Programme. Available at http://nvbdcp.gov.in/Doc/Malaria%20Situation_Sep.pdf
12. Yeager, A. S.: Protozoan and helminth infections, in "Infectious Diseases of the Fetus and Newborn Infant". Editors: J. S, Remington and J. O. Klein, 2nd edition, W. B. Saunders Company, Philadelphia, 1983, pp. 563-569.
13. Fischer PR. Malaria and newborns. J Trop Pediatrics 2003; 49: 132-134.
14. Paul R, Sinha PK, Bhattacharya R, Amit K. Banerjee AK, Raychaudhuri P, Mondal J. Study of C reactive protein as a prognostic marker in malaria from Eastern India. Adv Biomed Res. 2012;1:41.

Author Information

Rajesh Bansal, MD Associate Prof.
Deptt. of Pediatrics, Teerthankar Mahaveer Medical College
Moradabad
drrajesh29@rediffmail.com

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