Malaria congénita: estudio rertrospectivo 2000-2011. Hospital "Menca de Leoni", ciudad guayana estado bolívar / Congenital malaria: a retrospective study from 2000 to 2011. Hospital

La Malaria denominada fiebre palúdica o paludismo constituye un problema de salud en gran parte de los países tropicales y subtropicales. El paludismo congénito es transmitido verticalmente desde la madre al niño durante el embarazo o en el momento delparto. Con la presente investigación se pretende actualizar el estudio literario sobre la malaria congénita y demostrar la incidencia de casos en la población Guayacitana. Se revisaron 8 casos con diagnostico de malaria congénita que ingresaron al Hospital “Menca de Leoni” en el periodo comprendido entre 2000 y 2011. Se estudiaron las variables sexo, edad, procedencia, intervalo entre elinicio de síntomas y el diagnóstico, manifestaciones clínicas, agente etológico, edad en el momento del diagnóstico, tiempo de gestaciónde la madre al momento de adquirir la infección, hallazgos hematológicos y tratamiento. El sexo mayormente afectado fue el masculino, todos los casos se presentaron en menores de 1 mes. La edad de gestación más frecuente al momento de adquirir lainfección fue el tercer trimestre. Las manifestaciones clínicas más frecuentes fueron fiebre y palidez cutánea. La forma parasitaria más frecuente fue el Plasmodium vivax. La mayoría de los niños recibió tratamiento con monoterapia antipalúdica a base de Cloroquina, con evolución clínica satisfactoria. La frecuencia del paludismo congénito se ha incrementado recientemente en nuestro país.La forma parasitaria más frecuente es la del Plasmodium vivax, por lo que el tratamiento indicado es la Cloroquina, con la cual se obtiene una respuesta favorable en la mayoría de los casos

Malaria is a major health problem in many of the tropical and subtropical countries. Congenital malaria is transmitted vertically frommother to child during pregnancy or at delivery. The objectives of the present study are to update the literature study on congenital malaria and to show the incidence of cases in the population of Ciudad Guayana, Bolívar, Venezuela. Eight children who were admitted to the Hospital “Menca de Leoni” during 2000 to 2011 were included. Variables studied were: gender, age, interval between the beginning of de symptoms and diagnosis, clinical findings, etiologic agent, age at diagnosis, gestation age at the moment of acquiring the infection,hematologic findings and treatment. Boys were affected more frequently, all cases presented during the first month of age. The gestation age most frequent at the moment of acquiring the infection was the third trimester. Most frequent clinical findings were fever and skin pallor. The most frequent parasitic form was Plasmodium vivax. Treatment with chloroquine was indicated in most of children with good clinical outcome. Conclusions: The predominant symptom of congenital malaria in the studied children was fever and the highest percentage presented parasitaemia by Plasmodium vivax. Most patients received treatment with antimalarial monotherapy based on chloroquine, with satisfactory clinical outcome

Congenital malaria--a case report from a non-endemic area

Eighteen day old neonate presented with features of early neonatal sepsis. History of mother revealed a travel from non-endemic area of malaria to endemic area, and on the 7th gestational age mother detected as having malaria. She was treated with quinine and cured. Baby was also evaluated for congenital malaria in first few neonatal days and discharged. Now the baby on evaluation shows anemia, hepatosplenomegaly and diagnosed with a Plasmodium vivax infection on peripheral smear. The quinine failed to prevent transplacental transmission. Prolonged interval between birth and onset of symptoms may be explained by transmission late in pregnancy or during delivery or by presence of transplacentally acquired maternal antibody (IgG). Mother acquired malarial infection after travel to an endemic area and transmitted to the baby. A high level of suspicion is warranted in babies of malaria infected mothers even when the neonate peripheral smear shows no evidence of infection.