Impact of Malaria in Pregnancy as Latin America Approaches Elimination

Yanow, Stephanie K.; Gavina, Kenneth; Gnidehou, Sédami; Maestre, Amanda

doi:10.1016/j.pt.2016.01.008

Cited by 15 publications

(21 citation statements)

References 75 publications

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“…It has been proposed that exposure to P. vivax can elicit IgG responses that cross-react with VAR2CSA-type PfEMP1 ( 16 , 23 ). This hypothesis is consistent with both the pregnancy restriction of VAR2CSA reactivity in Africa (where P. vivax is rare and not an important cause of placental malaria [ 24 ]) and the apparent absence of such restriction in Colombia (where P. vivax is common).…”

Section: Resultsmentioning

confidence: 99%

IgG Responses to the Plasmodium falciparum Antigen VAR2CSA in Colombia Are Restricted to Pregnancy and Are Not Induced by Exposure to Plasmodium vivax

et al. 2018

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Section: Resultsmentioning

confidence: 99%

IgG Responses to the Plasmodium falciparum Antigen VAR2CSA in Colombia Are Restricted to Pregnancy and Are Not Induced by Exposure to Plasmodium vivax

et al. 2018

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“…Despite the accelerated progress toward malaria elimination in most of Latin America, 6,32 an estimated 4.3 million women are at risk of MiP each year in this continent. 1 Here, we show that antenatal malaria remains common in the main malaria hotspot of Brazil, affecting 8.0% of our study participantscomparable with the recent prevalence estimate at 7.9% in Guayaramerín, an endemic setting in Bolivia next to the border with Brazil.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] The clinical implications of malaria during pregnancy remain understudied in low-endemicity regions where Plasmodium vivax predominates, such as Latin America. 2,5,6 This is partially due to the fact that infections with P. vivax are believed to cause less severe clinical consequences in pregnant women than those with P. falciparum, although an increased risk of LBW and anemia associated with infection has been documented in large studies. 2,5,[7][8][9][10] Erythrocytes parasitized with the former species do not sequester massively in the intervillous spaces as they do in P. falciparum infections, 11,12 but some MiP-associated histological changes in the placenta, such as syncytial knotting and increased thickness of the placental barrier, have been recently documented in Brazil 12,13 and may affect fetal nutrition and growth because of impaired transport and secretory functions.…”

Section: Introductionmentioning

confidence: 99%

The Hidden Burden of Plasmodium vivax Malaria in Pregnancy in the Amazon: An Observational Study in Northwestern Brazil

Pincelli

Neves

Lourenço

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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We measured the prevalence of malaria in pregnancy and estimated its impact on birth weight and length and maternal hemoglobin in 1,180 women from Juruá Valley, the main malaria hotspot in Brazil. Antenatal malaria episodes, 74.6% of them due to , were microscopically diagnosed in 8.0% of the women and were associated with an average reduction in birth weight-scores of 0.35 (95% confidence interval [CI] = 0.14-0.57) and in birth length -scores of 0.31 (95% CI = 0.08-0.54), compared with malaria-free pregnancies. Affected mothers had a mean decrease in hemoglobin concentration at delivery of 0.33 g/100 mL (95% CI = 0.05-0.62 g/100 mL); 51.6% were anemic. The timing and frequency of antenatal infections influenced pregnancy outcomes and first- or second-trimester infections were not associated with decreased birth weight and length and maternal hemoglobin at delivery. Although repeated antenatal vivax infections were associated with poorer birth outcomes, even a single vivax malaria episode was associated with a significant reduction in birth weight and length and maternal hemoglobin. Overall, 7.5% women had the parasite's DNA found in peripheral blood at delivery. Most (83.1%) of these 89 perinatal infections were due to and only 7.9% of them progressed to symptomatic disease after delivery. and DNA was found in 0.6% and 0.3% of 637 cord blood samples examined, respectively, but only one newborn developed clinical neonatal malaria. Our results further challenge the notion that vivax malaria is relatively benign during pregnancy and call for better strategies for its prevention.

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“…In Colombia, the current national guidelines for malaria control recommend the active detection of cases at each antenatal care visit in all pregnant women living in endemic areas of the country [6]. However, the diagnosis of malaria in pregnancy by conventional diagnostic tools, such as microscopy or rapid diagnostic tests (RDTs), remains challenging for the detection of low-density infections, common in areas of low to moderate endemicity such as Latin America [4,7,8]. Moreover, the unique ability of P. falciparum parasites to massively sequester in the placenta also contributes to a reduced detectability of maternal infections in peripheral blood [4,8,9].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of highly sensitive diagnostic tools for the detection of P. falciparum in pregnant women attending antenatal care visits in Colombia

Vásquez

Vélez

Medina

et al. 2020

BMC Pregnancy Childbirth

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Background: In low transmission settings early diagnosis is the main strategy to reduce adverse outcomes of malaria in pregnancy; however, microscopy and rapid diagnostic tests (RDTs) are inadequate for detecting lowdensity infections. We studied the performance of the highly sensitive-RDT (hsRDT) and the loop mediated isothermal DNA amplification (LAMP) for the detection of P. falciparum in pregnant women. Methods: A cross-sectional study was conducted in two malaria-endemic municipalities in Colombia. We screened pregnant women in the context of an antenatal care program in health facilities and evaluated five tests (microscopy, conventional RDT, hsRDT, LAMP and nested polymerase chain reaction-PCR) for the detection of P. falciparum in peripheral blood, using a quantitative reverse transcription PCR (qRT-PCR) as the reference standard. Diagnostic performance of hsRDT and LAMP were compared with routine testing. Results: The prevalence of P. falciparum was 4.5% by qRT-PCR, half of those infections were subpatent. The sensitivity of the hsRDT (64.1%) was slightly better compared to microscopy and cRDT (59 and 53.8% respectively). LAMP had the highest sensitivity (89.7%) for detecting P. falciparum and the ability to detect very low-density infections (minimum parasite density detected 0.08 p/μL). Conclusions: There is an underestimation of Plasmodium spp. infections by tests routinely used in pregnant women attending antenatal care visits. LAMP methodology can be successfully implemented at local hospitals in malaria-endemic areas. The relevance of detecting and treating this sub-patent P. falciparum infections in pregnant women should be evaluated.

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Impact of Malaria in Pregnancy as Latin America Approaches Elimination

Cited by 15 publications

References 75 publications

IgG Responses to the Plasmodium falciparum Antigen VAR2CSA in Colombia Are Restricted to Pregnancy and Are Not Induced by Exposure to Plasmodium vivax

IgG Responses to the Plasmodium falciparum Antigen VAR2CSA in Colombia Are Restricted to Pregnancy and Are Not Induced by Exposure to Plasmodium vivax

The Hidden Burden of Plasmodium vivax Malaria in Pregnancy in the Amazon: An Observational Study in Northwestern Brazil

Evaluation of highly sensitive diagnostic tools for the detection of P. falciparum in pregnant women attending antenatal care visits in Colombia

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