Congenital malaria in Nigeria: A systematic review and meta-analysis

Congenital malaria (CM), a rare condition where malaria parasites are transmitted from mother to child during pregnancy or delivery. The World Health Organization (WHO) highlights the heightened vulnerability of both mothers and neonates in malaria-endemic regions. To assess the prevalence of CM in Nigeria, a systematic review and quality-effects meta-analysis were conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Study selection, data extraction, and methodological quality assessment were performed independently by two investigators. Literature databases, including PubMed, AJOL, Google Scholar, Malaria Consortium Library and Web of Science, were searched for published data between January 2000 and December 2024 reporting congenital malaria in neonates (0-7 days). From 483 studies identified, 35 studies comprising 9503 neonates met the inclusion criteria. The pooled prevalence of congenital malaria was 12.7 % (95 % CI: 7.3-19.2), with high heterogeneity (I² = 97.3, Q = 1241.3, P < 0.0001). The average parasite count from neonates with congenital malaria was 56.6/μl. Neonates with both malaria and septicaemia were 4.8 % (3.4-6.7). Subgroup analyses of maternal‑neonate pairings revealed maternal, placental, baby peripheral and cord blood malaria parasitaemia prevalences of 25.5 %, 20.3 %, 12.9 %, and 11.1 %, respectively. The average maternal age of parasitaemic babies was 29.05 ± 4.3 years. These findings emphasise the significant burden of congenital malaria in Nigeria, with potential adverse outcomes for newborn health. CM remains a critical public health concern in endemic regions. Enhanced surveillance and targeted interventions are imperative to reduce CM transmission and improve health outcomes.