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Congenital Malaria in newborns delivered to Malaria-Infected mothers in hilly region of northern India: Is it really deadly?

Author(s):

Avinish Singh, Balram Ji Omar, Swathi Chacham, Jaya Chaturvedi, Sriparna Basu, Kriti Mohan* and Rahul Bhakat  

Abstract:


Background: Malaria is endemic in many states of India. Though there are reports of maternal and congenital malaria from endemic areas, however there remains paucity of data from hilly terrains. The present study evaluated the prevalence, clinical and microbiological spectrum of maternal and congenital malaria at a tertiary health care facility in Northern India over a period of 18 months.

Methods: In this observational study, mothers along with their new borns were evaluated for malaria by maternal, placental and cord blood smear examination and rapid point-of-care diagnostic serological tests. Positive cases were confirmed by polymerase chain reaction. Mother-newborn duos were followed up till discharge from hospital.

Results: A total of 843 mothers delivered during the study period and were screened along with their newborns and placentae. A total of Ten (1.18%) mothers had evidence of malarial parasitemia (Plasmodium vivax, n=7 and Pl. falciparum, n=3), however none of the placental and cord blood samples were positive for malaria. Overall, 127 (15.1%) neonates required admission in neonatal intensive care unit for various morbidities. Incidence of small for gestational age (SGA) was high (n=210; 24.9%). Multivariate logistic regression analysis demonstrated maternal malaria to be an independent contributor for SGA [Odds Ratio (95% Confidence Interval), 10.7 (2.06 - 49.72)]. However, only 2% variance of SGA could be explained by maternal malaria alone.

Conclusions: We report an encouragingly lower incidence of maternal malaria in mothers attending for delivery and a ‘Zero’ incidence for placental and congenital malaria during the study period as compared to national data (upto 7.4% in non-immune mothers), although maternal malaria could be a causative factor for SGA.

Keywords:

Congenital malaria, maternal, placenta, small for gestational age

Affiliation:

Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, Rishikesh, Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, Department of Pediatrics, All India Institute of Medical Sciences, Gorakhpur, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh



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