Neonatal and Congenital malaria (NCM): A Case Series in Tigray region, Ethiopia

Background Congenital malaria (CM) is the direct infection of a neonate with malaria parasites from their mother prior to or during birth. Neonatal malaria (NM) is acquired through mosquito bites after birth in the neonatal period. Both neonatal and congenital malaria (NCM) are potentially life-threatening conditions that can mimic other neonatal conditions, such as neonatal sepsis; therefore, these conditions can be misdiagnosed and mistreated. Although NCM is widely recognized in most parts of the world, including Africa, there is currently a scarcity of data and experience regarding NCM in the Tigray region specifically and in Ethiopia generally. The purpose of this case series was to increase awareness of clinicians to the practice of screening, treatment and prevention of NCM, particularly in endemic areas. Case presentation : We present a series of six cases (four congenital and two neonatal malaria cases). The age of their mothers ranged from 23–30 years, and their birth experience ranged from 1–5. Four of the six mothers had a history of malaria attack and treatment, three of whom were during the present pregnancy and one of whom had an attack in the immediate postpartum period. The age of the neonates at admission ranged from 1 day to 16 days. All six neonates were brought by their parents with the primary complaint of fever. Blood smears of four of the six neonates revealed ring stages of Plasmodium falciparum, and Plasmodium vivax was detected in one of the neonates. Additionally, a mixture of Plasmodium falciparum and P. vivax was detected in another neonate. Antimalarial and first-line antibiotics were administered to all six neonates. Five of them were treated successfully and recovered, and one of them died while she was on treatment. Conclusion Neonatal congenital malaria should be considered in any newborn with clinical features of neonatal sepsis from a malaria-endemic area, particularly those who present with fever. Routine malaria prevention strategies and malaria screening tests should be considered for neonates in malaria-endemic areas.