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Abstract
RESUME
Le paludisme congénital se caractérise par la mise en évidence d’hématies parasitées chez le nouveau-né avant le septième jour de vie. Il résulte du passage transplacentaire de plasmodiums ou de globules rouges maternels parasités, qui contaminent le fœtus. Cette affection, rarement évoquée en pratique courante devant un nouveau-né malade, peut atteindre des prévalences de 46% dans des zones de forte endémicité en Afrique au sud du Sahara. Nous avons admis en hospitalier un nouveau-né de trois heures de vie pour asphyxie néonatale. L’histoire prénatale maternelle révélait une prophylaxie anti palustre insuffisante et une fièvre en péripartum traitée avec succès par la quinine. Le nouveau-né, suspect d’infection néonatale précoce, a été mis sous antibiothérapie prophylactique. L’apparition de la fièvre au 5e jour de vie, suivie d’une recherche de plasmodiums négative, a motivé l’institution d’une deuxième ligne d’antibiotiques. La persistance de la fièvre, 48 heures après ce changement thérapeutique, a conduit à répéter l’examen de la goutte épaisse qui s’est avérée positive. La mise sous quinine a entrainé une défervescence thermique en 24 heures voire une nette amélioration de l’état général et un arrêt de l’antibiothérapie au vu des cultures négatives. Le diagnostic de paludisme congénital a été définitivement retenu.
ABSTRACT
CONGENITAL MALARIA: A DIAGNOSTIC DELAY IN A NEWBORN AT THE UNIVERSITY TEACHING HOSPITAL IN YAOUNDE, CAMEROON.Congenital malaria is characterized by the presence of parasites in newborn’s red blood cells before the seventh day of life. It results in a transplacental transfer of these infested red blood cells from mother to child. This disease, rarely mentioned in usual practice in front of a sick newborn, may reach a 46% rate in highly endemic area in Sub Saharan Africa. We admitted a three day old newborn in hospital for birth asphyxia. Prenatal history of the mother revealed insufficient prophylactic treatment for malaria and fever at per partum treated successfully with quinine. The newborn, suspected having early neonatal sepsis, was put on prophylactic antibiotherapy. The resurgence of fever at day five of life followed by the negative results of blood film motivated the administration of second line antibiotics. The persistence of fever 48 hours after these changes led to the repeating of blood film examination that ended being positive. Quinine treatment induced a drop of fever and a recovering of good general state within 24 hours. Antibiotics were stopped because the results of specimen cultured were negative. The diagnosis of congenital malaria was definitely retained.
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References
- Larkin GL, Thuma PE. Congenital malaria in a hyperendemic area. Am J Trop Med Hyg 1991 ; 45 : 587-92.
- Ligny C, de Gentile L, Chabasse D et al. Paludisme et grossesse. À propos d'une observation de paludisme congénital à Plasmodium falciparum. Ann Pediatr (Paris) 1989; 36 : 669-74.
- Poespoprodjo JR, Hasanuddin A, Fobia W et al. Case report: severe congenital malaria acquired in utero. Am. J. Trop Med. Hyg., 82 (4), 2010, pp. 563-565
- Ekanem AD, Anah MU , Udo JJ , 2008 . The prevalence of congenital
- malaria among neonates with suspected sepsis in Calabar. Nigeria. Trop Doct 38: 73 – 76.
- WHO Evidence Review Group : Intermittent Preventive Treatment in pregnancy (IPTp) with Sulfadoxine-Pyrimethamine (SP) WHO Headquarters, Geneva, 9-11 July 2012.
- Steketee RW, Nahlen BL, Parise ME et al. The burden of malaria in pregnancy in malaria endemic area. Am. J. Trop. Med. Hyg., 2001; 64 (1,2) S, 28-35.
- Kayentao K, Garner P, Van Eijk AM et al. Intermittent Preventive Therapy for Malaria during pregnancy using 2 VS 3 or more doses of Sulfadoxine-Pyrimethamin and risk of low birth weight in Africa. JAMA 2013- vol 309, N° 6.
- Lemardeley P, Raïga J, chambon R. Prévention et lutte contre le paludisme chez les femmes enceintes en milieu urbain (Yaoundé, Cameroun). Cahier de santé 1997; 7:239-45
- Kayode OO, Olubunmi OO. Prevention of congenital transmission of malaria in Sub-Saharan African countries: challenges and implications for health system strengthening
- J Trop Med. Vol 1012, Article ID 648456, 6 pages doi:
- 1155/2012/648456.
- Olabisi AO, Ejezie GC, Odey FA et al. Congenital Malaria in Calabar, Nigeria : The molecular perspectiveAm. J. Trop. Med. Hyg., 84 (3), 2011, pp. 386-389.
- Enweronu-Laryea CC, Adjei GO, Mensah B et al. Prevalence of congenital malaria in high-risk Ghanaian newborns: a cross-sectional study. Malaria Journal 2013, 12:17 doi: 10.1186/1475-2875-12-17.
- Soumana A, Tankari G, Zoubairou H. Contribution à l’étude du paludisme congenital.
- Rev. CAMES- Série A, Vol. 04, 2006 pp.24-26.
- Siriez JY, De Pontual L, Poilane I et al. Paludisme congénital à Plasmodium malariae chez un nouveau-né de mère séropositive pour le VIH. Med Trop 2005, 65 : 477-481.
- Wagner G, Kwadwo K, David et al. High incidence of asymptomatic malaria infection in a birth cohort of children less than one year of age in Ghana, detected by multicopy gene polymerase chain reaction. Am. J. Trop. Med. Hyg. 1998; 59 (1): 115-23.
- Ahmad H and Farhad H. Congenital malaria in a neonate. Arch Iranian Med 2005; 8(3): 226-28.
- Balaka B, Agbere Ad, Bonkoungou P. Paludisme congénital-maladie à Plasmodium falciparum chez le nouveau-né à risque infectieux. Arch Pediatr 2000; 7: 243-48.
- Udeniya IJ, Schmidt JA, Aikawa M et al. Falciparum malaria-infected human erythrocytes specifically bind to cultured human endothelial cells. Sci. 1981; 213: 555-7.
- Piñeros-Jiménez JG, Alvarez G, Tobon A et al. Congenital malaria in Urabá, Colombia.
- Malaria Journal 2011, 10:239.
- Kamwendo DD, Dzinjalamala FK, Snounou et al. Plasmodium falciparum: PCR detection and genotyping of isolates from peripheral, placental, and cord blood of pregnant Malawian women and their infants. Trans R Soc Trop Med Hyg 2002, 96:145-49.
- Mwangoka GW, Kimera SI, Mboera LE. Congenital Plasmodium falciparum infection in neonates in Muheza district, Tanzania. Malarial Journal 2008, 7:117.
- Poespoprodjo JR, Afdal H, Wendelina Fobia W. Severe Congenital Malaria Acquired in utero Am. J. Trop. Med. Hyg. 82(4), 2010, pp. 563–65.
References
Larkin GL, Thuma PE. Congenital malaria in a hyperendemic area. Am J Trop Med Hyg 1991 ; 45 : 587-92.
Ligny C, de Gentile L, Chabasse D et al. Paludisme et grossesse. À propos d'une observation de paludisme congénital à Plasmodium falciparum. Ann Pediatr (Paris) 1989; 36 : 669-74.
Poespoprodjo JR, Hasanuddin A, Fobia W et al. Case report: severe congenital malaria acquired in utero. Am. J. Trop Med. Hyg., 82 (4), 2010, pp. 563-565
Ekanem AD, Anah MU , Udo JJ , 2008 . The prevalence of congenital
malaria among neonates with suspected sepsis in Calabar. Nigeria. Trop Doct 38: 73 – 76.
WHO Evidence Review Group : Intermittent Preventive Treatment in pregnancy (IPTp) with Sulfadoxine-Pyrimethamine (SP) WHO Headquarters, Geneva, 9-11 July 2012.
Steketee RW, Nahlen BL, Parise ME et al. The burden of malaria in pregnancy in malaria endemic area. Am. J. Trop. Med. Hyg., 2001; 64 (1,2) S, 28-35.
Kayentao K, Garner P, Van Eijk AM et al. Intermittent Preventive Therapy for Malaria during pregnancy using 2 VS 3 or more doses of Sulfadoxine-Pyrimethamin and risk of low birth weight in Africa. JAMA 2013- vol 309, N° 6.
Lemardeley P, Raïga J, chambon R. Prévention et lutte contre le paludisme chez les femmes enceintes en milieu urbain (Yaoundé, Cameroun). Cahier de santé 1997; 7:239-45
Kayode OO, Olubunmi OO. Prevention of congenital transmission of malaria in Sub-Saharan African countries: challenges and implications for health system strengthening
J Trop Med. Vol 1012, Article ID 648456, 6 pages doi:
1155/2012/648456.
Olabisi AO, Ejezie GC, Odey FA et al. Congenital Malaria in Calabar, Nigeria : The molecular perspectiveAm. J. Trop. Med. Hyg., 84 (3), 2011, pp. 386-389.
Enweronu-Laryea CC, Adjei GO, Mensah B et al. Prevalence of congenital malaria in high-risk Ghanaian newborns: a cross-sectional study. Malaria Journal 2013, 12:17 doi: 10.1186/1475-2875-12-17.
Soumana A, Tankari G, Zoubairou H. Contribution à l’étude du paludisme congenital.
Rev. CAMES- Série A, Vol. 04, 2006 pp.24-26.
Siriez JY, De Pontual L, Poilane I et al. Paludisme congénital à Plasmodium malariae chez un nouveau-né de mère séropositive pour le VIH. Med Trop 2005, 65 : 477-481.
Wagner G, Kwadwo K, David et al. High incidence of asymptomatic malaria infection in a birth cohort of children less than one year of age in Ghana, detected by multicopy gene polymerase chain reaction. Am. J. Trop. Med. Hyg. 1998; 59 (1): 115-23.
Ahmad H and Farhad H. Congenital malaria in a neonate. Arch Iranian Med 2005; 8(3): 226-28.
Balaka B, Agbere Ad, Bonkoungou P. Paludisme congénital-maladie à Plasmodium falciparum chez le nouveau-né à risque infectieux. Arch Pediatr 2000; 7: 243-48.
Udeniya IJ, Schmidt JA, Aikawa M et al. Falciparum malaria-infected human erythrocytes specifically bind to cultured human endothelial cells. Sci. 1981; 213: 555-7.
Piñeros-Jiménez JG, Alvarez G, Tobon A et al. Congenital malaria in Urabá, Colombia.
Malaria Journal 2011, 10:239.
Kamwendo DD, Dzinjalamala FK, Snounou et al. Plasmodium falciparum: PCR detection and genotyping of isolates from peripheral, placental, and cord blood of pregnant Malawian women and their infants. Trans R Soc Trop Med Hyg 2002, 96:145-49.
Mwangoka GW, Kimera SI, Mboera LE. Congenital Plasmodium falciparum infection in neonates in Muheza district, Tanzania. Malarial Journal 2008, 7:117.
Poespoprodjo JR, Afdal H, Wendelina Fobia W. Severe Congenital Malaria Acquired in utero Am. J. Trop. Med. Hyg. 82(4), 2010, pp. 563–65.