Djibo A, Cénac A
Service de médicine interne, Hôpital national, Niamey, Niger.
Sante. 2000 May-Jun;10(3):183-7.
Congenital malaria is defined as the presence of Plasmodium parasites in the erythrocytes of newborns less than seven days old. The aim of this study was to determine the incidence of congenital malaria and its possible clinical consequences. We carried out a prospective survey in Niamey, the capital of Niger (600,000 inhabitants) from July to September 1993. Niamey is in an area of mesoendemic malaria and this period of the year corresponds to the rainy season, when malaria transmission is maximal. Ninety mothers and their newborns were included. We assessed the clinical status of the mother and child at the time of the delivery, and took blood smears to check for parasitemia and blood samples to check for antimalaria antibodies by indirect immunofluorescence (IIF). The placenta was not examined. Clinical signs of malaria (fever, splenomegaly, anemia and jaundice) were absent in all mothers and children and 88 of the 90 children had normal birth weights. Plasmodium falciparum was the only parasite detected, with 49 of the 90 mothers and 12 of the 90 newborns having positive blood smears. Serological tests detected the presence of antimalaria antibodies in 73 of the 90 mothers (81.1%) and 68 of the 90 newborns (75.5%). Thus, we found no cases of congenital malaria with clinical signs in this study, despite the high frequency of parasites and antimalaria antibodies. The reasons for this absence of cases of congenital malaria with symptoms are discussed.
先天性疟疾的定义为出生未满7天的新生儿红细胞中存在疟原虫寄生虫。本研究的目的是确定先天性疟疾的发病率及其可能的临床后果。1993年7月至9月，我们在尼日尔首都尼亚美（60万居民）进行了一项前瞻性调查。尼亚美处于疟疾中度流行地区，一年中的这个时期正值雨季，疟疾传播最为活跃。纳入了90名母亲及其新生儿。我们在分娩时评估了母亲和孩子的临床状况，采集血涂片检查疟原虫血症，并采集血样通过间接免疫荧光法（IIF）检查抗疟疾抗体。未检查胎盘。所有母亲和孩子均无疟疾的临床症状（发热、脾肿大、贫血和黄疸），90名儿童中有88名出生体重正常。仅检测到恶性疟原虫，90名母亲中有49名、90名新生儿中有12名血涂片呈阳性。血清学检测发现90名母亲中有73名（81.1%）、90名新生儿中有68名（75.5%）存在抗疟疾抗体。因此，尽管寄生虫和抗疟疾抗体的检出率很高，但本研究中未发现有临床症状的先天性疟疾病例。文中讨论了未出现有症状的先天性疟疾病例的原因。
