Malaria and other neglected infections in pregnant migrants: A retrospective study in Northern Italy.

OBJECTIVES

This study assessed the prevalence of neglected infectious diseases among pregnant migrant women in a single referral center in Northern Italy, focusing on conditions not routinely included in antenatal screening or in the national list of free-of-charge examinations during pregnancy, such as malaria, schistosomiasis, strongyloidiasis, soil-transmitted helminthiases (STHs), human T-lymphotropic virus types 1/2 (HTLV-1/2), and Chagas disease.

METHODS

We performed a retrospective observational study at the Department of Infectious-Tropical Diseases and Microbiology (DITM), IRCCS Sacro Cuore Don Calabria Hospital (Verona, Italy), between February 2023 and March 2025. Pregnant migrants referred for infectious disease screening were included. Alongside routine antenatal tests, risk-based investigations (serological, molecular, and parasitological assays) were applied according to region of origin, travel history, and time since arrival.

RESULTS

Eighty-five women underwent extended testing (median age 28 years), originating from 22 countries (52% Africa, 27% Eastern Europe, 18% Asia, 7% South America). Fifty-nine percent had arrived within the past year. Routine screening identified three syphilis cases, one chronic HBV infection, and one past HCV exposure. Malaria was detected in 5/29 women tested (17.2%), all asymptomatic or mildly symptomatic. Schistosoma serology was positive in 10/36 (27.8%), Strongyloides serology in 5/84 (5.9%), and HTLV-1/2 in 3/60 (5.0%). One Ascaris lumbricoides infection was diagnosed by stool microscopy. No cases of HIV or Trypanosoma cruzi infection were found.

CONCLUSIONS

Risk-based screening revealed a significant prevalence of neglected infections, including malaria and HTLV-1/2, with potential maternal and neonatal consequences. Tailored infectious disease screening should be integrated into antenatal care for migrant women, while larger prospective studies are needed to support evidence-based guidelines.