Andarge Biniyam Demisse, Almaw Kebede
College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
Department of Pediatrics, Dil-Fana Hospital, Arba Minch, Ethiopia.
J Med Case Rep. 2025 Aug 31;19(1):434. doi: 10.1186/s13256-025-05525-3.
Malaria remains a significant public health concern, particularly in Africa, where children under 5 years of age are affected. While mosquito bites are the primary transmission route, congenital malaria caused by transplacental or perinatal transmission can also occur. This case report highlights the challenges in diagnosing congenital malaria and emphasizes the importance of considering it in neonates, especially those born in or with a travel history to endemic areas.
We report a case of congenital malaria in a 48 h-old male neonate born to a 23 year-old Ethiopian primigravida. The mother, who had received antenatal care in a nonendemic area, was diagnosed and treated for uncomplicated Plasmodium falciparum malaria with artemether-lumefantrine (Coartem) one week before delivery. The delivery occurred at a hospital in a malaria-endemic zone. The neonate presented with respiratory distress and persistent fever, initially managed as early-onset neonatal sepsis. However, blood film microscopy confirmed parasitemia with coinfection of P. falciparum and P. vivax, with a parasite density of 1120 parasites/μL. The mother was asymptomatic at the time of the neonate's diagnosis and tested negative for malaria by both Rapid Diagnostic Test (RDT) and microscopy. The neonate was successfully treated with intravenous artesunate followed by oral artemisinin-lumefantrine, with complete clinical recovery.
Despite the nonspecific symptoms, this case emphasizes the importance of considering congenital malaria in neonates, particularly those with a history of travel to endemic areas. Blood film microscopy confirmed coinfection and guided effective antimalarial therapy. Strengthening antenatal care services, including intermittent preventive treatment during pregnancy, is recommended to reduce the burden of congenital malaria.
疟疾仍然是一个重大的公共卫生问题，尤其是在非洲，5岁以下儿童深受其害。虽然蚊虫叮咬是主要传播途径，但经胎盘或围产期传播引起的先天性疟疾也可能发生。本病例报告突出了诊断先天性疟疾的挑战，并强调了在新生儿中考虑此病的重要性，特别是那些在流行地区出生或有旅行史的新生儿。
我们报告一例先天性疟疾病例，患儿为一名48小时大的男婴，其母亲是一名23岁的埃塞俄比亚初产妇。母亲在非流行地区接受了产前护理，在分娩前一周被诊断为单纯性恶性疟原虫疟疾，并接受了蒿甲醚-本芴醇（科泰复）治疗。分娩在疟疾流行区的一家医院进行。新生儿出现呼吸窘迫和持续发热，最初被当作早发型新生儿败血症处理。然而，血涂片显微镜检查证实存在疟原虫血症，同时感染恶性疟原虫和间日疟原虫，寄生虫密度为1120个寄生虫/微升。新生儿诊断时母亲无症状，快速诊断检测（RDT）和显微镜检查均显示疟疾检测呈阴性。新生儿接受静脉注射青蒿琥酯治疗，随后口服青蒿素-本芴醇，临床完全康复。
尽管症状不具特异性，但本病例强调了在新生儿中考虑先天性疟疾的重要性，特别是那些有流行地区旅行史的新生儿。血涂片显微镜检查证实了混合感染，并指导了有效的抗疟治疗。建议加强产前护理服务，包括孕期间歇性预防治疗，以减轻先天性疟疾的负担。
