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Congenital malaria in the United States: a review of cases from 1966 to 2005 Lesko CR; Arguin PM; Newman RDArch Pediatr Adolesc Med 2007[Nov]; 161 (11): 1062-7OBJECTIVES: 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reported to the US National Malaria Surveillance System between January 1, 1966, and December 31, 2004, including 1 unpublished case from 2005, encompassing all years for which data were collected and available.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.|Female[MESH]|Humans[MESH]|Infant, Newborn[MESH]|Malaria, Vivax/drug therapy/epidemiology[MESH]|Malaria/*congenital/drug therapy/epidemiology/microbiology[MESH]|Population Surveillance[MESH]|Pregnancy[MESH]|Pregnancy Complications, Infectious/*epidemiology/microbiology[MESH]|Primaquine/therapeutic use[MESH]|Retrospective Studies[MESH]|United States/epidemiology[MESH] |
