Congenital Malaria Among Newborns Admitted for Suspected Neonatal Sepsis In Abuja.

Abstract

Background:Signs and symptoms of congenital malaria do not differ much from those of neonatal sepsis: both can co-exist, and most times very difficult to differentiate clinically.

Objective:To document the prevalence, risk factors for congeni tal malar ia among neonates admitted for suspected neonatal sepsis, and determine sensitivity, specificity and predictive values of some common signs and symptoms.

Method:Blood for culture, thin and thick blood film for malaria parasite were taken for all cases of suspected neonatal sepsis at the special care baby unit of the hospital, from August 2007 to December 2009

Results: A total of 266 newborns (150 males and 116 females) with suspected neonatal sepsis were recruited. Their mean admission we ight wa s 2.5±0.87 kg, gestational age was 36.1±3.5 weeks, and age of 5.1±2.3 days. While 76 (28.6%) had malaria parasites in their blood film, 97 (36.5%) were blood culture positive, and 12 (4.5%) had both positive blood culture and malaria
parasite. Among the recruited babies, 82.4% were noticed to have low parasite density, 13.2% had moderate density, while 2.6% had high density. Peripartum pyrexia, prematurity and intrauterine HIV exposure, were found to have signi f icant associat ion with congenital malaria, (OR = 7.9, 7.2, 4.4) for peripatum pyrexia, prematurity and HIV exposure, p values <0.05. None of the clinical feature had good sensitivity, specificity or predictive value for congenital malaria, and only 1.6% death was recorded in a baby with high parasite density.

Conclusion:Congenital malaria is common in newborns wi th suspected neonatal sepsis. History of peripartum pyrexia, prematurity and intrauterine HIV exposure was associated with increased risk of the disease.