Malaria in pregnancy in the Asia-Pacific region

Rijken, Marcus J.; McGready, Rose; Boel, Machteld E.; Poespoprodjo, Jeanne Rini; Singh, Neeru; Syafruddin, Din; Rogerson, Stephen J.; Nosten, François

doi:10.1016/s1473-3099(11)70315-2

Cited by 163 publications

(169 citation statements)

References 120 publications

(199 reference statements)

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“…Recent reports supported the concept that detection and treatment of pregnant malaria during early gestation prevents miscarriage both in P. vivax and P. falciparum infections [31,43]. At delivery, placental infection by P. vivax has been confirmed both in cases from America and Asia [35,[45][46][47].…”

Section: Dynamics Of Gestational and Placental Malariamentioning

confidence: 88%

“…Regarding P. vivax infections during pregnancy, mortality is rarely seen, but there is association with multiple relapses, anemia, abortion, and a reduction in birth weight in pregnant women with malaria [11,[43][44][45]. Pregnant women are also more likely to experience relapses than non-pregnant ones [44].…”

Section: Dynamics Of Gestational and Placental Malariamentioning

confidence: 99%

“…A recent review of malaria in the Asian-Pacific region reported a median proportion of pregnant women infected with malaria in antenatal clinics of 15.3% (range 1.2-40.8), and in delivery rooms of 8.1% (range 1.6 -18.5), according to thick smear evaluation test [45]. In addition, the median proportion of reported placental parasitaemia was 11.0% (range 1.4 -29.1).…”

Section: Asian-pacific Regionmentioning

confidence: 99%

“…Levels of antibodies to surface antigens of placental-binding infected erythrocytes are low before pregnancy and increase with successive pregnancies in women exposed to P. falciparum [84]. Despite increased susceptibility during pregnancy to P. vivax infection remains to be clarified, experts coincide in the observation of complications due to severe anemia and induction of pre-term delivery [45,50,85].…”

Section: Specific Antimalarial Immunity During Pregnancymentioning

confidence: 99%

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Immune responses during gestational malaria: a review of the current knowledge and future trend of research

Maestre

Carmona‐Fonseca

2014

J Infect Dev Ctries

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Women pregnant with their first child are susceptible to severe P. falciparum disease from placental malaria because they lack immunity to placenta-specific cytoadherence proteins. In subsequent pregnancies, as immunity against placental parasites is acquired, there is a reduced risk of adverse effects of malaria on the mother and fetus and asymptomatic parasitaemia is common. In the case of vivax malaria, with increasing reports of severe cases in Asia and South America, the effects of infection by this species during pregnancy remain to be elucidated. This review summarized the main aspects involved in the acquisition of specific antimalarial immune responses during pregnancy with emphasis in research carried out in America and Asia, in order to offer a framework of interpretation for studies on pregnant women with malaria which are recently being produced in these regions. The authors conclude that (1) Effective humoral responses during gestational malaria are mainly directed against variant surface antigens codified by genes of the var2Csa family of P. falciparum; (2) Acquisition of immunity against these variant antigens depends on the degree and intensity of transmission, and the chance increases with age and successive pregnancies; (3) Antibody development is guided by specific cellular immune responses in cases of placental and maternal infection, and (4) The study of the significance of acquisition of specific immunity against both P. falciparum and P. vivax in America, should be performed.

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Section: Dynamics Of Gestational and Placental Malariamentioning

confidence: 88%

Section: Dynamics Of Gestational and Placental Malariamentioning

confidence: 99%

Section: Asian-pacific Regionmentioning

confidence: 99%

Section: Specific Antimalarial Immunity During Pregnancymentioning

confidence: 99%

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Immune responses during gestational malaria: a review of the current knowledge and future trend of research

Maestre

Carmona‐Fonseca

2014

J Infect Dev Ctries

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“…Beeson, I. Mueller, F.J. Fowkes, and S.J. Rogerson, unpublished observations) (32). P. vivax and P. falciparum parasitemias (by microscopy and real-time PCR) and hemoglobin (Hb) were assessed at enrollment and delivery, and birth weight was recorded.…”

Section: Study Site and Populationmentioning

confidence: 99%

Pregnancy and Malaria Exposure Are Associated with Changes in the B Cell Pool and in Plasma Eotaxin Levels

Requena

Campo

Umbers

et al. 2014

The Journal of Immunology

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Pregnancy triggers immunological changes aimed to tolerate the fetus, but its impact on B lymphocytes is poorly understood. In addition, exposure to the Plasmodium parasite is associated with altered distribution of peripheral memory B cell (MBC) subsets. To study the combined impact of high malaria exposure and pregnancy in B cell subpopulations, we analyzed PBMCs from pregnant and nonpregnant individuals from a malaria-nonendemic country (Spain) and from a high malaria-endemic country (Papua New Guinea). In the malaria-naive cohorts, pregnancy was associated with a significant expansion of all switched (IgD−) MBC and a decrease of naive B cells. Malaria-exposed women had more atypical MBC and fewer marginal zone–like MBC, and their levels correlated with both Plasmodium vivax– and Plasmodium falciparum–specific plasma IgG levels. Classical but not atypical MBC were increased in P. falciparum infections. Moreover, active atypical MBC positively correlated with proinflammatory cytokine plasma concentrations and had lower surface IgG levels than the average. Decreased plasma eotaxin (CCL11) levels were associated with pregnancy and malaria exposure and also correlated with B cell subset frequencies. Additionally, active atypical and active classical MBC expressed higher levels of eotaxin receptor CCR3 than the other B cell subsets, suggesting a chemotactic effect of eotaxin on these B cell subsets. These findings are important to understand immunity to infections like malaria that result in negative outcomes for both the mother and the newborn and may have important implications on vaccine development.

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Primaquine at alternative dosing schedules for preventing relapse in people withPlasmodium vivaxmalaria

Milligan

Daher

Graves

2017

Cochrane Database of Systematic Reviews

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Malaria in pregnancy in the Asia-Pacific region

Cited by 163 publications

References 120 publications

Immune responses during gestational malaria: a review of the current knowledge and future trend of research

Immune responses during gestational malaria: a review of the current knowledge and future trend of research

Pregnancy and Malaria Exposure Are Associated with Changes in the B Cell Pool and in Plasma Eotaxin Levels

Primaquine at alternative dosing schedules for preventing relapse in people withPlasmodium vivaxmalaria

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