Congenital Malaria from a Holo Endemic Zone in Lagos, Nigeria: A continuing huge health challenge

Abstract

The objective of the study was to determine the incidence and associated factors for congenital malaria in our environment. It is a prospective cross sectional study. Two hundred and fifty four cord smears were taken from parturient patients for peripheral thick film and sent to the laboratory for the diagnosis of congenital malaria. They were subsequently divided into two groups depending on the smear results such as group 1, positive  (cases) and group 2 negative (controls). Data regarding demographic  characteristics and pregnancy outcome were then recorded and entered into SPSS version 16. Students t test was used to assess the significance of continuous variables while Chi square used for categorical variables. The level of significance was set at 0.05. One hundred and eight (108) cord blood smears tested positive for malaria parasite giving an incidence of congenital malaria of 42.5% with the highest incidence in primigravidae (47.2%) as well as in mothers aged 34 years and over (39.8%). The mean age, gravidity of mothers with positive smear in the cord blood were 32.01 years and 2.14 respectively .There were statistically significant differences between the two groups regarding birth weight and gravidity, and occupation of the patients,( p<0.05). The results showed that the incidence of congenital malaria was 42.5% while primigravid patients and mothers aged 34 years and over were particularly at risk of having babies with congenital malaria. A re-appraisal of our malaria prevention strategies through  massive education programmes; targeting use of ITN, drugs use in IPTs and prompt treatment of malaria in pregnancy is recommended. As women without signs and symptoms of malaria can still transmit the parasite  congenitally as shown in this study, it is recommended that every newborn in holoendemic areas should be closely observed for prompt treatment as the case may arise.

Keywords: Congenital malaria, incidence, associated factors, holoendemic zone, health challenge