Congenital and Neonatal Malaria in Ethiopia: A Narrative Review

Malaria remains a major public health problem in Ethiopia. Congenital malaria results from transplacental transmission of malaria parasites from mother to fetus before or during delivery, whereas neonatal malaria is acquired after birth, typically through mosquito bites within the first 28 days of life. Both conditions are associated with significant neonatal morbidity and mortality in endemic settings. Despite Ethiopia's high malaria burden, evidence on congenital and neonatal malaria remains fragmented and limited.

This narrative review synthesizes the existing literature on congenital and neonatal malaria in Ethiopia, highlighting epidemiology, clinical presentation, diagnosis, management, and prevention, with the aim of informing clinical practice and guiding future research.

Published studies reporting congenital and neonatal malaria in Ethiopia were identified through searches of PubMed, Google Scholar, Medline, and grey literature sources. Evidence was synthesized narratively, with emphasis on patterns, themes, and clinical implications. All eligible studies identified through PRISMA-guided screening were incorporated into the synthesis.

Ten studies conducted in Ethiopia reported a total of 46 cases of congenital and neonatal malaria. Plasmodium falciparum was the predominant species (35 cases), followed by Plasmodium vivax (eight cases) and mixed infections (three cases). Forty cases were classified as congenital malaria, whereas six were neonatal malaria. Most reports were case reports or case series, reflecting the limited scope of available data.

Congenital and neonatal malaria in Ethiopia are under recognized despite the country's substantial malaria burden. P. falciparum is the dominant causative species. Greater clinical awareness, improved diagnostic vigilance, and larger epidemiological studies are urgently needed to better define disease burden and optimize prevention and management strategies for this vulnerable population.