School of Microbiology, University of Antioquia, Medellín, Colombia.
"Grupo de Investigación César Uribe Piedrahíta", Faculty of Medicine, University of Antioquia, Medellín, Colombia.
PLoS One. 2022 Feb 18;17(2):e0263451. doi: 10.1371/journal.pone.0263451. eCollection 2022.
Congenital Malaria (CM) is an underestimated and under-researched problem in Colombia, despite its severe clinical, epidemiological, economic, and public health consequences. The objective was to determine the general frequency of CM, the specific frequency of CM by diagnostic test and plasmodial species, and identify its associated factors. A retrospective study was carried out using the records of 567 newborns. qPCR and Thick Blood Smear (TBS) were performed. The frequency of infection was determined with a 95% confidence interval. Associated factors were identified by non-parametric tests and odds ratios; the confusion was controlled with a logistic regression model. All cases corresponded to submicroscopic CM (negative with TBS and positive with PCR), and the frequency was 12.2% (95%CI = 9.4-14.9). The detection was statistically higher in the umbilical cord with 16,2% (95%CI = 12.4-19.9) versus peripheral blood of the newborn with 2.2% (95%CI = 0.7-4.9). CM was statistically higher in newborn whose mothers had malaria in the last year, gestational and placental malaria. The median birth weight in newborn infected with CM was lower compared to the one of healthy neonates. Because the control program in Colombia is based on TBS, it must be improved with the inclusion of other tests that allow the detection of submicroscopic CM. In addition, the program has other limitations such as do not have specific actions for pregnant women and have a passive surveillance system. These difficulties do not allow to show the magnitude of CM, its consequences on neonatal and infant health, constituting a serious problem of health injustice.
先天性疟疾（CM）在哥伦比亚是一个被低估和研究不足的问题，尽管它对临床、流行病学、经济和公共卫生都有严重的影响。本研究的目的是确定 CM 的总体发生率、特定诊断试验和疟原虫种类的 CM 发生率，并确定其相关因素。采用回顾性研究方法，使用了 567 名新生儿的记录。进行了 qPCR 和厚血涂片（TBS）检测。采用 95%置信区间确定感染频率。采用非参数检验和比值比识别相关因素；采用逻辑回归模型控制混杂因素。所有病例均为亚临床 CM（TBS 阴性，PCR 阳性），发生率为 12.2%（95%CI=9.4-14.9）。在脐带血中的检测率为 16.2%（95%CI=12.4-19.9），明显高于新生儿外周血中的 2.2%（95%CI=0.7-4.9）。在母亲去年患有疟疾、妊娠期和胎盘疟疾的新生儿中，CM 的发生率更高。与健康新生儿相比，感染 CM 的新生儿的出生体重中位数较低。由于哥伦比亚的控制方案基于 TBS，因此必须通过包括其他允许检测亚临床 CM 的检测方法来改进该方案。此外，该方案还存在其他局限性，例如没有针对孕妇的具体措施，以及存在被动监测系统。这些困难使得无法显示 CM 的严重程度、其对新生儿和婴儿健康的影响，构成了严重的卫生不公平问题。
