PREVALENCE, RISK FACTORS AND CLINICAL FEATURES OF MALARIA IN NEONATES ADMITTED INTO TWO TERTIARY HOSPITALS IN JOS, PLATEAU STATE

Abstract

Malaria is a leading cause of morbidity and mortality in children and pregnant women in
Nigeria. Malaria was thought to be rare in neonates. However, recent studies report
increasing prevalence in neonates. There appears to be paucity of evidence associating use of
ITNs and IPT-SP to prevention of neonatal malaria. Clinical features of neonatal malaria
have also not been adequately reported. This study was undertaken to assess the prevalence,
risk factors and clinical features of malaria in neonates admitted into two tertiary hospitals in
Jos, Plateau State.
Three hundred and one neonates aged 0-28 days admitted into the neonatal units of Jos
University Teaching Hospital and Bingham University Teaching Hospital, Jos were recruited
to the study. Giemsa stained blood films were examined by light microscopy. Haematocrit
was obtained. Also, blood culture and full blood count were carried out for subjects with
probable sepsis and those with malaria parasitaemia. Human Immunodeficiency virus (HIV)
screening was carried for all mothers in accordance with the national HIV rapid testing
algorithm.
Of the 301 neonates enrolled, 16 had malaria parasitaemia giving a prevalence of 5.3%.
Congenital malaria accounted for 87.5% of cases of neonatal malaria. Plasmodium
falciparum was responsible for all the cases of malaria parasitaemia. Maternal use of ITNs
was significantly associated with protection against neonatal malaria (p=0.025) and reduced
risk of having babies who were small for gestational age (p=0.006). Maternal use of IPT-SP
was associated with reduced risk of having babies that were small for gestational age
(p=0.021) but conferred no significant protection against neonatal malaria (p=0.362). There
was no association between neonatal malaria and maternal age, parity, parental
socioeconomic class and maternal HIV infection. Malaria parasitaemia was characterized by
low parasite density. The median parasite density was 255 (72,385) parasites/µl. All neonates
with malaria were symptomatic. Fever was the only statistically significant clinical feature
seen in 10 (66.7%) of the cases (p=0.03).
Malaria is not rare in neonates on admission in Jos. Maternal use of ITNs was superior to
IPT-SP in protecting against malaria transmission in neonates. Efforts should be made to
encourage the use of ITNs in pregnant women and nursing mothers as an effective method of
preventing malaria in their neonates.

PREVALENCE, RISK FACTORS AND CLINICAL FEATURES OF MALARIA IN NEONATES ADMITTED INTO TWO TERTIARY HOSPITALS IN JOS, PLATEAU STATE