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Arch Pediatr Adolesc Med. 2007 Nov;161(11):1062-7.

Congenital malaria in the United States: a review of cases from 1966 to 2005.

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  • 1Malaria Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.

Abstract

OBJECTIVES:

To provide an updated review and examine any trends among congenital malaria cases that might help guide diagnosis, treatment, and public health recommendations.

DESIGN:

Retrospective case series.

SETTING:

United States.

PARTICIPANTS:

We reviewed all cases of congenital malaria reported to the US National Malaria Surveillance System between January 1, 1966, and December 31, 2004, including 1 unpublished case from 2005, encompassing all years for which data were collected and available.

MAIN EXPOSURES:

Maternal characteristics, including travel history, and malaria treatment. Main Outcome Measure Characteristics of congenitally acquired cases of malaria.

RESULTS:

For the 81 cases of congenital malaria reported in the United States in the past 40 years, the predominant infecting species was Plasmodium vivax (81%). Most mothers (96%) were foreign born, and 55 of 65 women (85%), for whom time of most recent exposure was known, were exposed 1 year or less before delivery. A common error in the treatment of infants with congenital malaria was the unnecessary administration of primaquine phosphate for P vivax infection.

CONCLUSIONS:

Health care professionals should have heightened vigilance for malaria in pregnant women who have emigrated from or traveled to malaria-endemic areas within the past year, as well as in their offspring. Such women with episodes of fever during pregnancy should have a blood film to test for malaria performed promptly and should be treated appropriately. Treatment of a mother does not negate the need for heightened vigilance in her newborn. Health care professionals should be aware that congenital P vivax malaria does not need to be treated with primaquine.

PMID:
17984408
[PubMed - indexed for MEDLINE]
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