American Journal of Epidemiology and Infectious Disease
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American Journal of Epidemiology and Infectious Disease. 2022, 10(3), 79-88
DOI: 10.12691/ajeid-10-3-1
Open AccessArticle

Prevalence, Risk Factors and Treatment Outcomes of Congenital Malaria among Neonates Hospitalized in Hospitals of Douala, Cameroon

Thomas Kuete1, , Raïssa Anne Chantal Aurelie Moukoko Doualla1, Danièle Keddy Mangamba1, 2, Mathio Esther Barla3, Diomede Noukeu4, Cecile Okalla1, 3 and Albert Same Ekobo1

1Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, Cameroon

2Bonassama District Hospital, Douala Cameroon

3General Hospital of Douala, Cameroon

4Gynaeco-Obstetric and Pediatric Hospital of Douala, Cameroon

Pub. Date: October 13, 2022

Cite this paper:
Thomas Kuete, Raïssa Anne Chantal Aurelie Moukoko Doualla, Danièle Keddy Mangamba, Mathio Esther Barla, Diomede Noukeu, Cecile Okalla and Albert Same Ekobo. Prevalence, Risk Factors and Treatment Outcomes of Congenital Malaria among Neonates Hospitalized in Hospitals of Douala, Cameroon. American Journal of Epidemiology and Infectious Disease. 2022; 10(3):79-88. doi: 10.12691/ajeid-10-3-1

Abstract

The relevance of transplacental acquired malaria is still not clear in many malaria endemic areas. This study was designed to evaluate the prevalence, risk factors and antimalarial treatment outcomes of laboratory-confirmed congenital malaria cases in Douala. Methodology. This was a hospitalized-based cross-sectional study undertaken among under seven days neonates hospitalized between January 2018 and May 2018 in the neonatalogy units of three Douala-based hospitals in Cameroon. For each eligible neonate, maternal and perinatal data were collected. The newborn was immediately examined for physical and clinical symptoms by a pediatrician or a neonanatologist, peripheral blood was screened in laboratory for detection of malaria parasites using microscopy and the “One Step Malaria HRP-II (P.f) and pLDH (Pan) Antigen Rapid Test” malaria rapid diagnostic test. Each laboratory-confirmed malaria case was treated accordingly as severe malaria. Data were analyzed as univariate with Pearson Khi2 and Fisher Exact Tests considering a P-value< 0.05 as statistically significant. Results. A total of 139 hospitalized neonates aged less than 7 days were included in the study. The sex ratio was 1.17. The prevalence of laboratory-confirmed congenital malaria was 3.6% by both microscopy and RDT. Only Plasmodium falciparum asexual stage was detected. Plasmodium loads were low (range: 192-320 asexual stages/µl of blood). Hyperthermia and jaundice were most predictive clinical signs of Plasmodium congenital malaria. Young mother age (p=0.002) and malaria episode during pregnancy (p=0.01) were associated with congenital malaria. P. falciparum confirmed congenital malaria cases were successfully managed with antimalarial monotherapies namely artemether, artesunate or quinine. Mortality among Plasmodium carrying neonates who received antimalarial treatment was 0%. Conclusion. Plasmodium falciparum congenital malaria was an etiology of neonatal infection among neonates hospitalized in Douala. Laboratory-confirmed congenital malaria cases were treated successfully as severe malaria. Congenital malaria should therefore be included in the list of differential diagnosis of neonatal infection at least in neonate with fever or jaundice, and those born to young mothers or mothers with pregnancy malaria.

Keywords:
congenital malaria newborn microscopy rapid diagnostic test prevalence risk factors outcomes Douala Cameroon

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References:

[1]  World Health Organization. World malaria report 2021. 322 pages. 2021.
 
[2]  World Health Organization. WHO policy brief for the implementation of intermittent preventive treatment of malaria in pregnancy using sulfadoxinepyrimethamine (IPTp-SP). April, 2013. http://www.who.int/malaria/publications/atoz/iptp-sp-updated-policy-brief-24 jan 2014. pdf?ua=1(accessed Dec 7, 2017).
 
[3]  Osungbade, K. O. and Oladunjoye, O. O. Prevention of congenital transmission of malaria in Sub-Saharan African countries: challenges and implications for health system strengthening. Journal of Tropical Medicine 2012, Article ID 648456, 6 pages.
 
[4]  Uneke, C. J.. Impact of placental Plasmodium falciparum malaria on pregnancy and perinatal outcome in sub-Saharan Africa. II. Effects of placental malaria on perinatal outcome; malaria and HIV. Yale J. Biol. Med 80: 95-103. 2007.
 
[5]  Sharma, L. and Shukla, G. Placental malaria: a new insight into the pathophysiology. Frontiers in Medicine 4: 117. July 2017.
 
[6]  World Health Organization. Report on malaria in the world 2016. WHO/HTM/GMP/2017.4: 24 pages.
 
[7]  Mwangoka, G. W., Kimera, S. I. and Mboera, L. E. G. Congenital Plasmodium falciparum infection in neonates in Muheza District, Tanzania. Malar J 7: 117. 2008.
 
[8]  Carlier, Y., Truyens, C., Deloron, P. and Peyron, F. Congenital parasitic infections: a review. Acta Tropica 2012, 121: 55-70.
 
[9]  Mwaniki, M. K., Talbert, A. W., Mturi, F. N., Berkley, J. A., Kager, P., Marsh, K. and Newton, C. R. Congenital and neonatal malaria in a rural Kenyan district hospital: en eight-year analysis. Malar J. 9: 313. 2010.
 
[10]  Tao, Z-Y., Fang, Q., Liu, X., Culleton, R., Tao, L., Xia, H. and Gao, Q. Congenital malaria in China. PLoS Negl Trop Dis8(3): e2622. March 2014.
 
[11]  Danwang, C., Bigna, J. J., Nzalie, R. N. T. and Robert, A. Epidemiology of clinical congenital and neonatal malaria in endemic settings: a systematic review and meta‑analysis. Malar J, 19: 312. 2020.
 
[12]  Cardona-Arias, J. A. and Carmona-Fonseca, J. Congenital malaria: frequency and epidemiology in Colombia, 2009-2020. PLoS ONE 2022, 17(2): e0263451.
 
[13]  Chiabi, A., Lendem, I., Kobela, M., Mah, E., Tietche, F. and Tchokoteu, P. F. Incidence of congenital malaria in two neonatology units in Yaoundé, Cameroon. Journal de Pédiatrie et de Puériculture, 25: 301-308. 2012. [In French]
 
[14]  Monebenimp, F., Chelo, D., Kamo, H. and Obama, M. T.. Congenital malaria: diagnostic difficulties in a newborn in the Yaoundé University Teaching Center, Cameroon. Health Sci Dis, l 14 (3): 1-4. 2013. [In French]
 
[15]  Nti Mvilongo, P. T., Amin, E. T., Njumkeng, C., Fondungallah, A. J. and Nde Fon, P. Congenital malaria: prevalence and risk factors in the Fako Division of the Southwest Region of Cameroon”. Global Scientific Research Journal Public Health 1(1): 1-8. 2018.
 
[16]  Enyuma, C. O. A., Meremikwu, M. M., Udo, J. J., Anah, M. U., Asindi, A. A. Malaria parasite positivity among febrile neonates. Niger J Paed 41(4): 2014 321-325.
 
[17]  Hangi, M., Achan, J., Saruti, A., Quinlan, J. and Idro, R. Congenital malaria in newborns presented at Tororo General Hospital in Uganda: a cross-sectional study. Am J Trop Med Hyg 100(5): 1158-1163, 2019.
 
[18]  Fitri, L. E., Jahja, N. E. , Huwae, I., R., Nara, M., B., Berens-Riha, N. Congenital malaria in newborns selected for low birth-weight, anemia, and other possible symptoms in Maumere, Indonesia. Korean J Parasitol 52 (6): 639-644, December 2014.
 
[19]  Bhatia, R., Rajwaniya, D. and Agrawal, P. Congenital malaria due to Plasmodium vivax infection in a neonate. Case Reports in Pediatrics 2016, Article ID 1929046, 2 pages.
 
[20]  Gülaşı, S. and Özdener, N. Congenital malaria: Importance of diagnosis and treatment in pregnancy. The Turkish Journal of Pediatrics 58: 195-199. March-April 2016.
 
[21]  Kisito, N., Fousséni, D., Minodier, P., Sawadogo, O., Sanon, H., Housséini, T. F. and Diarra, Y. Congenital Plasmodium falciparum malaria disease: epidemiological, clinical, biological, therapeutic and pronostic in Ouagadougou, Burkina-Faso. Pan African Medical Journal 2014, 18: 47.
 
[22]  Olupot‑Olupot, P., Eregu, E. I. E., Naizuli, K., Ikiror, J., Acom, L. and Burgoine, K. Neonatal and congenital malaria: a case series in malaria endemic eastern Uganda. Malar J, 17: 171. 2018.
 
[23]  Bah, E. M. , Baldé, I. S., Diallo, I. S., Adiallo, B., Diallo, T. S., Soumah, A. F. M., Camara, M. K. and Sy, T. Congenital malaria and pregnancy monitoring parameters in health facilities in Guinea. Open Journal of Obstetrics and Gynecology, 9(1). 2019.
 
[24]  Tahirou, I., Zara, M. O., Oustapha, M. L., Kamayé, M., Mahamadou, D., Ibrahim, A., Daou, M., Soumana, A. and Ibrahim, M. L. Congenital malaria and its associated factors at Issaka Gazobi maternity of Niamey in Niger. Int J Pediatr 2020: 1-6. 2020.
 
[25]  Saghir, S., Moukit, M., Kouach, J., Assoufi, N., Abilkassem, R. and Agadr, A. What about the treatment of asymptomatic forms of congenital malaria: case report and review of the literature. Pan African Medical Journal 35: 116. 202.
 
[26]  Kajoba, D., Egesa, W. I., Jean Petit, H., Matan, M. O., Laker, G., Waibi, W. M. and Asiimwe, D. Congenital malaria in a 2-day-old neonate: A case report and literature review. Case Reports in Infectious Diseases 2021. Article ID 9960006, 4 pages.
 
[27]  Thapar, R. K., Saxena, A. and Devgan, A. Congenital malaria. Medical Journal Armed Forces India 64: 185-186. 2008.
 
[28]  Mbongo, J. A., Bowassa, G. E., Koulimaya Gombet, C. E. and Iloki, L. H. Paludisme congénital au Centre Hospitalier et Universitaire de Brazzaville: une étude épidémiologique. Health Sci. Dis, 16 (4). October-November-December 2015. Available at www. Hsd-fmsb.org.
 
[29]  Sagbo, G. G., Noudamadjo, A., Agossou, J., Adédémy, J. D., Obossou, A. A. and Lokossou, S. D. Epidemiological, clinical biological therapeutic features and outcome of congenital malaria at the Borgou regional University Teaching Hospital (CHUD-B) in Benin in 2015. Open Journal of Pediatrics 7: 263-271. 2017.
 
[30]  Dicko-Traoré, F., Sylla, M., Djimdé, A., Diakité, A., Diawara, M. and Togo, B. Congenital and neonatal malaria in sub-Sahara Africa, a scarce event? Journal de Pédiatrie et de Puériculture, 24: 57-61. 2011.
 
[31]  Menendez, C. and Mayor, A. Congenital malaria: the least known consequence of malaria in pregnancy. Seminars in Fetal and Neonatal Medicine 12(3): 207-213. June 2007.
 
[32]  Ministry of Public Health of Cameroon. Profil sanitaire analytique 2016–Cameroun. http:/ww w.afro.who.int/fr/Cameroun/consulté en avril 2018. [In French].
 
[33]  Cheesebrough, M. District laboratory practice in tropical countries Cambridge: Cambridge University press. 1998.
 
[34]  World Health Organization. Assessment and monitoring of antimalarial drug efficacy for the treatment of uncomplicated falciparum malaria Geneva; 2003.
 
[35]  World Health Organization. Microscopy for the detection, identification and quantification of malaria parasites on stained thick and thin blood films in research settings: Procedure, Manual methods. World Health Organization Report 2015, 36 pages.
 
[36]  National malaria control program of Cameroon. Guide de prise en charge du paludisme au Cameroun à l’usage du personnel de santé. 50 pages. mai 2013. [In French]
 
[37]  Okafor, U. H., Oguonu, T., and Onah, H. E. Risk factors associated with congenital malaria in Enugu, South Eastern Nigeria. J Obstet Gynaecol 26(7): 612-6. 2006.
 
[38]  Omer, S. A., Adam, I., Noureldien, A., Elhaj, H., Guerrero-Latorre, L., Silgado, A., Sulleiro, E. A. and Molina, I. Congenital malaria in newborns delivered to mothers with malaria-infected placenta in Blue Nile State, Sudan. J Trop Pediatr 2020, 66(4): 428-434.
 
[39]  Campos, I. M., Uribe, M. L., Cuesta, C., Franco-Gallego, A., Carmona-Fonseca, J. and Maestre, A. Diagnosis of gestational, congenital, and placental malaria in Colombia: comparison of the efficacy of microscopy, nested polymerase chain reaction, and histopathology. Am J Trop Med Hyg 2011, 84(6): 929-935.
 
[40]  Riley, E. M., Wagner, G. E., Akanmori, B. D. and Koram, K. A. Do maternally acquired antibodies protect infants from malaria infection? Parasite Immunol 23: 51-59. 2001.
 
[41]  Billig, E. M., McQueen, P. G. and McKenzie, F. E. Fetal haemoglobin and the dynamics of paediatric malaria. Malaria Journal 11: 396. 2012.
 
[42]  Malhotra, I., Mungai, P., Muchiri, E., Kwiek, J. J., Meshnick, S. R., King, C. L. Umbilical cord-blood infections with Plasmodium falciparum malaria are acquired antenatally in Kenya. J. Infect. Dis 2006. 194(2), 176-183. 15 July 2006.
 
[43]  Menendez, C., Bardaji, A., Sigauque, B., Sanz, S., Aponte, J. J., Mabunda, S., Alonso P. L. Malaria prevention with IPTp during pregnancy reduces neonatal mortality. PLoS One 2010, 5: e9438.
 
[44]  Hommerich, L., von Oertzen, C., Bedu-Addo, G., Holmberg, V., Acquah, P. A. , Eggelte, T. A., Bienzle, U. and Mockenhaupt, F. P. Decline of placental malaria in southern Ghana after the implementation of intermittent preventive treatment in pregnancy. Malar J, 6:144. 2007.
 
[45]  Diouf, F. N., Faye, P. M., Ba, I. D., Ba, A., Kaimba, L. C. Prévalence du paludisme congénital infestation à Plasmodium falciparum au centre hospitalier régional de Ziguinchor/Sénégal, Revue CAMES SANTE 2015, 3(1). 2015. [In French].