Abstract:

Background: Congenital malaria has generally been considered rare in areas where malaria is endemic, however it is increasingly being reported among babies born to mothers residing in endemic areas. Given the high morbidity and mortality associated with malaria it is important to determine the current situation in the lake zone. This study was designed to determine the prevalence of congenital malaria and associated factors among newborns delivered at Bugando Medical Centre in Mwanza, Tanzania.

Materials and methods: A cross-sectional study was conducted on 383 mothers who delivered at Bugando Medical Centre between July and September 2008. Serial sampling was used to obtain the sample size. The Sociodemographic and clinical characteristic of mothers were documented. Samples of maternal, placental, cord and neonatal blood were taken and stained with Giemsa and examined for malaria parasites.

Results: The prevalence of congenital malaria was 14/383 ana parasite counts were generally low ranging from 4-10 parasites/200 WBCs. Positive parasitemia was found in 24 (6.2%) of mother’s peripheral blood smears, 6 (1.6%) and 2 (0.5%) of the placental and cord blood smears, respectively. Plasmodium falciparum was the only species identified.

In the multivariate regression model, factors the remained independently associated with congenital malaria were positive maternal parasitemia (OR 5.65, {95%CI 1.40 – 22.77}, P=0.02) and mothers’ level of education; secondary/higher Learning (OR 3.5, {95%CI 1.16; 10.52}, P=0.03).

Conclusion: Congenital malaria is not uncommon as previously thought. Maternal parasitemia during delivery and maternal level of education (secondary or higher) were found to be associated with congenital malaria.

Recommendation: Malaria should also be considered in the work up for neonatal sepsis. Pregnant women who present with fever during ANC/delivery should be screened and treated for malaria, and neonates born to parasitemic mother should be screened for malaria and if infected followed up for development of symptoms or spontaneous clearance of parasites. A large multicenter study should be done to evaluate other factors which may be associated with congenital malaria.