Infantile Malaria in A Non-Endemic Region Associated With Transfusion Transmission in A Preterm Neonate

Abstract

Malaria is a parasitic infection primarily transmitted through the bite of infected Anopheles mosquitoes and remains endemic in many tropical and subtropical regions. However, sporadic cases continue to be reported in non-endemic regions, particularly among vulnerable populations such as neonates, where transmission routes may be atypical. In such settings, two important non-vector transmission routes include congenital malaria and transfusion transmitted malaria. Congenital malaria occurs via transplacental transmission or exposure to maternal blood during delivery, whereas transfusion transmitted malaria results from infected donor blood. Congenital malaria typically presents within the first few weeks of life with nonspecific symptoms such as fever, anemia, hepatosplenomegaly, and thrombocytopenia. Transfusion transmitted malaria, although rare in non-endemic regions, remains a concern due to asymptomatic parasitemia in donors. Delayed diagnosis is common due to low clinical suspicion, making awareness of these alternative transmission routes critical. This report aims to highlight diagnostic challenges and emphasize the importance of considering transfusion related malaria in neonates in non-endemic regions.