Thomas Kuete^1,, Raïssa Anne Chantal Aurelie Moukoko Doualla¹, Danièle Keddy Mangamba^{1, 2}, Mathio Esther Barla³, Diomede Noukeu⁴, Cecile Okalla^{1, 3}, Albert Same Ekobo¹

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.

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