Congenital malaria in a neonate born in a malaria-endemic area: a case report

Abstract

Background: 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. Case presentation: A 48-hour-old male neonate born to an Ethiopian hospital with high malaria transmission rates presented with respiratory distress. Despite receiving antenatal care in a nonendemic zone, the mother delivered in this endemic area. The initial diagnosis was early-onset neonatal sepsis, but persistent fever prompted further investigation. Blood film microscopy revealed coinfection with Plasmodium falciparum and Plasmodium vivax, leading to a diagnosis of congenital malaria. The neonate received intravenous artesunate followed by oral artemisinin-lumefantrine, with a favorable clinical outcome. Conclusion: 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.