Malaria parasite positivity among febrile neonates

Abstract

Background: Malaria, earlier considered rare in neo-nates, has been reported with in-creasing frequency in the last dec-ade. Neonatal malaria diagnosis is challenging because the clinical features are non-specific, variable and also overlap with bacterial infection. Aim: To determine the prevalence of neonatal malaria and the asso-ciated clinical features in newborn babies with fever. Patients and methods: One hun-dred and fifty neonates with fever admitted into the Newborn unit of the University of Calabar Teach-ing Hospital, over a six month period, were recruited consecu-tively. Symptoms and signs for each neonate were documented. Blood film for malaria parasites and investigation for sepsis work-up were done before commence-ment of drugs. Results: One hundred and fifty babies were recruited. Most (85.3%) of the babies were aged ≤7 days. One hundred and thirty six (90.7%) of the mothers were booked for antenatal care (ANC). Most of the babies were from primiparous women (54.7%). Six babies (4%) had malaria para-sitaemia with four (2.7%) being congenital malaria and two (1.3%) acquired malaria. Plasmodium falciparum was the only species identified. All six with malaria were from the 136 booked moth-ers. Four of the affected six neo-nates also had septicaemia. The clinical features in babies with malaria only were, fever, fast breathing and jaundice while those with malaria and bacterial co-infection had, in addition, poor suck. Conclusion: Malaria infection and septicemia can coexist in some Nigerian newborns and since the clinical presentation of each of these condition are closely similar, it is recommend that malaria para-site investigation be included as part of the investigation in the newborns with fever. This ap-proach can help to avoid a delay in applying the appropriate therapeu-tic intervention