Table 2.

Congenital malaria case studies in twins

Study no.	Study	Pv/Pf	Zygosity	Sex (M/F)	Diagnosis	Infected individual	Treatment	Mother on antimalarial	Findings
1.	Bradbury34; England, 1977	Pv	DZ	NA	Detected at birth, positive by microscopy	2nd twin	Chloroquine	No	Early placental separation was probably responsible for the infection of the second twin
2.	Devlin and Bannatyne38; Canada, 1977	Pv	NA	NA	Detected in the mother during the 3rd month of pregnancy and postpartum by microscopy. Detected in twins at 3rd week of birth by microscopy	Both twins, mother	Chloroquine	Chloroquine + primaqine	Developed jaundice on the 4th day, slow weight gain, and fever on days 21–22
3.	Cummins et al.32; England 1990	Pv	MZ	NA	Detected 1 month after birth, positive by microscopy	1st twin	Chloroquine	No	Probable twin-to-twin transfusion. Both twins were treated
4.	Balatbat et al.31; USA, 1995	Pv	DZ	F	Detected 1 month after birth, positive by microscopy	2nd twin	Chloroquine	No	A probable case of perinatal transmission with an uninfected mother and twin sibling
5.	Opare33; Ghana, 2012	Pf	MZ	M	Detected post-delivery, Mother, and twins both positive by microscopy	Both twins, mother	Quinine	SP as prophylaxis	Congenital malaria in both twins. Evaluation of newborns for congenital malaria is recommended
6.	Mudji et al.35; Democratic Republic of the Congo, 2017	Pf	NA	F	Detected on 35 weeks of gestation, mother and child both positive by microscopy	Both twins, mother	Quinine; 1st twin recovered, 2nd died	SP as prophylaxis	Gestational and congenital malaria, premature birth with the possibility of bacterial co-infection
7.	Conroy et al.37; Uganda, 2019	Pf	DZ	NA	Detected on 14 weeks 6 days of gestation, mother negative by microscopy	Mother, 2nd twin	DP	DP	Differences in neurodevelopmental outcomes in placental malaria-discordant dizygotic twins

DP = dihydroartemisinin–piperaquine; DZ = dizygous; MZ = monozygous; NA = information not available; SP = sulphadoxine pyrimethamine.