Prevalence, characteristics, and treatment outcome of congenital malaria in Nigeria: a systematic review

Emmanuel Kokori; Gbolahan Olatunji; Bonaventure Michael Ukoaka; Israel Charles Abraham; Rosemary Komolafe; Victor Oluwatomiwa Ajekiigbe; Ntishor Gabriel Udam; Stanley Eneh; Chidiogo Ezenwoba; Adetola Emmanuel Babalola; Oluwatobi Omoworare; Nicholas Aderinto

doi:10.1186/s12936-025-05257-1

Prevalence, characteristics, and treatment outcome of congenital malaria in Nigeria: a systematic review

Malar J. 2025 Jan 22;24(1):24. doi: 10.1186/s12936-025-05257-1.

Affiliations

¹ Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria.
² Department of Internal Medicine, Asokoro District Hospital, Abuja, Nigeria.
³ Bloomberg School of Public Health, John Hopkins University, Maryland, USA.
⁴ Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria.
⁵ University of Calabar, Calabar, Nigeria.
⁶ Community Health Department, Obafemi Awolowo University, Ile-Ife, Osun, Nigeria.
⁷ Department of Medicine, University of Benin Teaching Hospital, Benin, Nigeria.
⁸ Faculty of Dentistry, College of Medicine, University of Ibadan, Ibadan, Nigeria.
⁹ Department of Medicine and Surgery, Lagos State University, Lagos, Nigeria.
¹⁰ Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria. nicholasoluwaseyi6@gmail.com.

Abstract

Background: Congenital malaria remains a significant public health challenge in Nigeria, particularly in regions with high malaria endemicity. The increased vertical transmission of malaria is partly associated with the high susceptibility of women to malaria during pregnancy. This systematic review aimed to assess the prevalence, characteristics, and treatment outcomes of congenital malaria in Nigeria.

Methods: Twelve studies were included in this review. Studies were retrieved from multiple electronic databases such as PubMed, EMBASE, Google Scholar, Scopus, Web of Science, African Journals Online (AJOL), and Cochrane Library and subjected to a multistage screening per established eligibility criteria. The study was registered with PROSPERO and was conducted per PRSIMA-established guidelines. Quality assessment of included studies was done using the Critical Appraisal Skills Programme (CASP) framework, while a narrative synthesis synthesized and summarized extracted data.

Results: The prevalence of congenital malaria in Nigeria ranged from as low as 5.1% to as high as 96.3%. Clinical manifestations were often non-specific, with fever being the most common symptom. Treatment regimens included a variety of antimalarial drugs, such as chloroquine, sulfadoxine-pyrimethamine, amodiaquine, quinine, and artemisinin-based combination therapy. While treatment outcomes were generally positive, some studies reported complications and deaths.

Conclusions: The findings highlight the need for improved diagnostic tools, standardized treatment protocols, and targeted interventions in high-burden areas. Further research is required to investigate the long-term health outcomes of neonates with congenital malaria and to evaluate the effectiveness of different treatment strategies. By addressing these gaps, effective prevention and management strategies can be developed to reduce the burden of congenital malaria in Nigeria.

Keywords: Clinical characteristics; Congenital malaria; Nigeria; Prevalence; Treatment outcomes.

Publication types

Systematic Review
Review

MeSH terms

Antimalarials* / therapeutic use
Female
Humans
Infant, Newborn
Malaria* / drug therapy
Malaria* / epidemiology
Malaria* / prevention & control
Nigeria / epidemiology
Pregnancy
Prevalence
Treatment Outcome

Substances

Antimalarials