Conference abstract

Malaria parasite blood smear positive neonates in Sierra Leone: when should we test for malaria in the neonatal unit?

Pan African Medical Journal - Conference Proceedings. 2018:9(27).14 Aug 2018.
doi: 10.11604/pamj-cp.2018.9.27.754
Archived on: 14 Aug 2018
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Keywords: Malaria parasite blood smear, congenital malaria, neonatal malaria, Sierra Leona

Malaria parasite blood smear positive neonates in Sierra Leone: when should we test for malaria in the neonatal unit?

Kirolos Sandy1,&, Italia Cenere2, María Belén2

1Sierra Leone National ETAT Project, Sierra Leone, 2Médecins Sans Frontières, OCBA, Koinadugu Project, Sierra Leone Mission, Koinadugu, Sierra Leone

&Corresponding author
Kirolos Sandy, Sierra Leone National ETAT Project, Sierra Leone


Introduction: congenital malaria is defined as malaria parasitaemia in the first week of life and neonatal malaria occurs from day 8 to 28 of life. Although it is thought to be uncommon in endemic countries, the reported incidence in Sub-saharan Africa is varied. The aim of this study was to give a report on the prevalence of positive blood smears for P. falciparum in a cohort of neonates in a Sierra Leonean district hospital.

Methods: a retrospective review was carried out of all neonatal admissions over 6 months, between 1st February 2017 and 31st July 2017, to a district hospital in the Northern Province of Sierra Leone. Neonates with P. falciparum positive blood smears were identified and analysed.

Results: over the study period the total number of admissions to the neonatal unit was 135. Twenty-six neonates had a blood smear for malaria parasites tested. Criteria for testing were clinician dependant, however persistent pyrexia while on IV antibiotics was the most common reason for testing. Of those tested, 8 (30.8) were positive for P. falciparum. The median age at admission was 2 days (range 1 - 10 days), with 3 of 8 being admissions from the community. The median level of parasitaemia identified was 80/μL (range 60 - 500/μL). 7 of 8 were symptomatic, with the common feature of pyrexia > 38°C, and were commenced on IV Artesunate, along with IV antibiotics.

Conclusion: this case series has identified that 30.8% of neonates with blood smears tested during admission were P. falciparum positive. Pyrexia was the most common symptom among these patients; however it was not possible to exclude neonatal sepsis as the attributable cause in this setting. Although there is no data on the incidence and burden of clinical malaria in neonates in Sierra Leone, this case series highlights the importance of having a high level of suspicion for malaria in pyrexial neonates in endemic regions.