Report of five cases of severe neonatal Plasmodium vivax malaria in Urabá, Colombia

Neonatal malaria is a type of malaria that occurs during the first month of life. In the last half century, the reports of malaria parasites in neonates generally have been associated with congenital transmission. However, in recent years, cases have appeared with increasing frequency, especially in Africa. In Latin America, the incidence of neonatal malaria is unknown, with only isolated cases reported. Cases of neonatal malaria were identified and characterized to better recognize the frequency and symptoms of cases as they occur in Colombia. Between March 2002-March 2004, a search for cases of neonatal malaria was made in the hospitals of the Turbo and Apartadó counties (Urabá, Antioquia Province). The following date were compiled: (1) characteristics of the mother, (2) demographic characteristics of the neonates, (3) clinical characteristics of the disease, and (4) laboratory results. Five cases were discovered of neonatal vivax malaria; however, only one met the criteria for congenital infection. Three patients had institutional delivery and two had a maternal history of gestational malaria, but none underwent a screening test for malaria. One of the four mothers were primaparous and half of them were younger than 20 years. All neonates had fever and presented some sign of severe disease during the first medical examination; each had hemoglobin levels compatible with severe neonatal anemia. No neonate had received the recommended treatment for this type of malaria. Five cases of severe neonatal malaria were reported, caused by infections of P. vivax, which normally does not produce severe disease. Since none of the malaria cases were recognized or treated at the local hospitals, advisories to medical professionals are recommended concerning neonatal malaria, particularly in endemic regions.