Omidiji Moyinolorun Oluwakayode, Lesi Foluso Ebun Afolabi, Esezobor Christopher Imokhuede, Fajolu Iretiola Bamikeolu, Oyibo Wellington Aghoghovwia, Daramola Adetola
Queen Elizabeth Hospital, Gayton Road, Kings Lynn, PE30 4ET, UK.
Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria.
Sci Rep. 2025 Mar 28;15(1):10709. doi: 10.1038/s41598-025-94800-w.
Congenital malaria is an important cause of morbidity and mortality in newborns. Signs and symptoms of congenital malaria are non-specific and could be confused with Neonatal sepsis. There has been a recent decline in malaria burden worldwide attributed to a new strategy recommended by the WHO including the use of intermittent preventive treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPT-SP) during pregnancy, long lasting insecticide treated nets, malaria case management with Artemisinin-based combination therapy etc. This study sets out to determine the effect of these changes on the prevalence of congenital malaria in two centres in Lagos, Nigeria. Using a cross-sectional observational descriptive design, a total of 291 mother and newborn pairs were enrolled from an urban area and a semi-rural area in Lagos between April and October 2014. About three-fifths of the total study population was derived from the urban centre. A pre-designed questionnaire was used to extract basic physical and demographic information such as the use of IPT-SP during pregnancy. Malaria microscopy was carried out on the maternal blood samples, and the corresponding newborns' heel prick and cord blood samples while the placenta tissues were examined for malaria pigments. Malaria parasitaemia, cord blood and congenital malaria were 0.34%, 0% and 0% respectively while that of placental malaria pigmentation was 18.9%. Placental malaria incidence was less in mothers who received IPT-SP in pregnancy (p = 0.016). Placental malaria incidence was higher in mothers ≤ 24 years (p = 0.044) and the less educated women had a higher prevalence of placental malaria (p = 0.001). The incidence of placental malaria was higher in the semi-rural area (92.7% vs. 7.3%, p ≤ 0.0001). Newborns of mothers with placental malaria had lower birth weight (2881.8 vs. 3100.7 g, p = 0.020) and smaller head circumference (34.3 vs. 35.1 cm, p = 0.006). This study demonstrated a significant decline in the prevalence of congenital malaria reflecting the recently reported decline in the burden of malaria in the general population in Africa. Use of IPT-SP during pregnancy, urban area residence and higher educational status appear to have been protective against malaria. A regular surveillance is however necessary considering the dynamics involved in malaria drug resistance.
先天性疟疾是新生儿发病和死亡的重要原因。先天性疟疾的体征和症状不具有特异性，可能会与新生儿败血症相混淆。由于世界卫生组织推荐的一项新战略，包括在孕期使用周效磺胺 - 乙胺嘧啶（IPT - SP）进行疟疾间歇性预防治疗、长效驱虫蚊帐、采用以青蒿素为基础的联合疗法进行疟疾病例管理等，全球疟疾负担最近有所下降。本研究旨在确定这些变化对尼日利亚拉各斯两个中心先天性疟疾患病率的影响。采用横断面观察性描述设计，2014年4月至10月期间，从拉各斯的一个市区和一个半农村地区共纳入了291对母婴。约五分之三的研究总人群来自市区中心。使用预先设计的问卷收集基本身体和人口统计学信息，如孕期IPT - SP的使用情况。对母亲的血液样本、相应新生儿的足跟刺血和脐带血样本进行疟疾显微镜检查，同时检查胎盘组织中的疟色素。疟疾寄生虫血症、脐带血和先天性疟疾的发生率分别为0.34%、0%和0%，而胎盘疟色素沉着的发生率为18.9%。孕期接受IPT - SP的母亲胎盘疟疾发病率较低（p = 0.016）。年龄≤24岁的母亲胎盘疟疾发病率较高（p = 0.044），受教育程度较低的女性胎盘疟疾患病率较高（p = 0.001）。半农村地区胎盘疟疾发病率较高（92.7%对7.3%，p≤0.0001）。患有胎盘疟疾的母亲所生新生儿出生体重较低（2881.8对3100.7克，p = 0.020），头围较小（34.3对35.1厘米，p = 0.006）。本研究表明先天性疟疾患病率显著下降，这反映了最近报道的非洲普通人群疟疾负担的下降。孕期使用IPT - SP、居住在市区和较高的教育水平似乎对疟疾有预防作用。然而，考虑到疟疾耐药性的动态变化，定期监测是必要的。
