Case report and transplacental transmission of Plasmodium vivax in an Malaria endemic Area of southern Iran

Background: Plasmodium vivax and congenital infection malaria is an important cause of morbidity worldwide. Congenital malaria, in which infants are directly infected with malaria parasites from their mother prior to or during birth, is a potentially life-threatening condition that occurs at relatively low rates in malaria endemic regions. Malaria is endemic to Afghanistan and also south and southeastern Iran, and also borderline Iran, Afghanistan and Pakistan, and reported cases in this are almost exclusively in travelers, and migrant returning mostly with their families from malaria-endemic areas. Imported P. vivax malaria cases and occurrences of An stephensi followed by An culicifacies in this area s most important to malaria transmission. Iran is categorized in the elimination phase and Afghanistan has plan to gradual integration of malaria control into routine health-care delivery.Objectives: The aim is to prevention of deficits of congenital malaria among newborn babies, and cut of its probable transmission in southern Iran, where Anopheles stephensi was found the main vector followed by An.culicifacies. Materials and Methods: We describe a 26-days-old girl child patient who resident in Chahganjali village, Ziarat-Ali area, Roodan county, Hormozgan province ,southern Iran, Hers families migrant from Afghanistan to Iran in 2016. They decided migrate to Iran so departed the Afghanistan and travel to Iran via Pakistan. They travel 2 nd International Congress of Vector-Borne Diseases & Climate Change; 4 th National Congress of Medical Entomology. Shiraz University of Medical Sciences, Shiraz, IRAN; Nov. 13-15, 2019 to Sistan & Baluchistan province, southeastern Iran via Moshghel point of entry, and then Kerman and Hormozghan Provinces and staying in the Chahghanjali village. . They has been on a trip for a total of 4 days. Father and mother of the patient had P. vivax malaria detected with active case detection surveillance by expert malaria team of Roudan Health center one days staying in the village and informed consent was obtained from the patients for present of this report. The confirmations of malaria cases and treatment were performed by Roudan Health Center under supervisors of Head of Health Center and Engineer Habibi, malaria expert at this center. All blood films were stained with Giemsa and, RDT test kit were examined for parasites at the Roudan Health Center. For thick films, parasites and leukocytes were counted in the same fields.Results: A 26-days-old girl child patient with congenital infection p. vivax malaria had been confirm by malaria experts of Roudan Health center. She was seen at an malaria expert at hers villages because of shivering, chills, fever of 40°C, and sweating. Hers families travel history indicated a settle down to the village after 4 days trip, in 2016. At a physical examination, she did appear ill. All rapid diagnostic test (RDT) and blood smear microscopic slide were performed at the house and showed an infection with P. vivax. She received a 3-day course of chloroquine syrup based on Iranian CDC protocol for treatment. Three days after treatment, the patient fully recovered and had good health. She fully recovered and in follow-up visits at the outpatients Health center, no trophozoite vivax malaria parasites were seenon a thick blood smear. The use of RDT kit and microscopic blood smear for diagnosis and chloroquin syrup for congenital infection malaria treatment result for P. vivax was positive.Conclusion: we report one congenital infection malaria P. vivax patients without any history of malaria, hers mother travel to a malaria-endemic area, Afghanistan and Pakistan via Iran. Physicians and malaria experts should be aware of the possibility of congenital infection malaria, who returned from malaria-endemic area. More rapid communication and cross border meeting between physicians and public health authorities in borderlines suggested.

Keywords:

Congenital malaria , Hormozgan , Border lines , Iran , Afghanistan , Pakistan.