A landmark nationwide review has raised fresh concerns about the health of Nigerian newborns, revealing that babies are still being born with malaria contracted from their mothers during pregnancy, with reported prevalence ranging from 5.1 per cent to an alarming 96.3 per cent across different studies.

The study, published in the Malaria Journal, warns that congenital malaria—a condition in which malaria parasites are transmitted from an infected mother to her baby before or during birth—remains an under-recognised but significant public health challenge in Nigeria, one of the world’s most malaria-endemic countries.

The review was conducted by 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, and Nicholas Aderinto.

The researchers said the wide variation in reported prevalence reflects differences in malaria transmission, diagnostic methods, healthcare access, and study settings across the country, but stressed that the findings underscore the urgent need to strengthen maternal and newborn malaria care.

The systematic review analysed evidence from 12 studies conducted across Nigeria and found that congenital malaria often presents with symptoms that can easily be mistaken for other newborn illnesses.

Fever emerged as the most commonly reported symptom, raising concerns that infected babies could be misdiagnosed or receive delayed treatment because the disease closely resembles neonatal sepsis and other serious infections.

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Although treatment outcomes were generally positive, the researchers noted that some of the reviewed studies reported severe complications and deaths, underscoring the potentially life-threatening consequences of delayed diagnosis and treatment.

The review also found that healthcare facilities across Nigeria have relied on different antimalarial medicines—including chloroquine, quinine, amodiaquine, sulfadoxine-pyrimethamine, and artemisinin-based combination therapies (ACTs)—to treat congenital malaria, highlighting the lack of a standardised treatment protocol for affected newborns.

The authors warned that pregnant women remain especially vulnerable to malaria infection because pregnancy reduces natural immunity, increasing the risk of transmitting the parasite to the unborn child.

They stressed that preventing malaria during pregnancy remains one of the most effective ways to protect newborns from congenital malaria.

They called for urgent improvements in malaria screening during pregnancy, wider access to quality antenatal care, better diagnostic tools for newborns, and the development of standardised treatment guidelines to ensure early detection and effective management of the disease.

The researchers also urged policymakers to strengthen preventive measures, including routine antenatal services, the use of insecticide-treated mosquito nets, preventive malaria interventions for pregnant women, and improved surveillance in high-burden communities.

They warned that without stronger surveillance, early diagnosis, and consistent treatment protocols, congenital malaria will remain a hidden threat to newborn survival in Nigeria despite ongoing national and global efforts to reduce the country’s malaria burden.

The authors also called for further research to better understand the long-term health outcomes of babies born with congenital malaria and to identify the most effective treatment strategies for improving survival.