Prevalence, pattern, and determinants of placental malaria in a population of southeastern Nigerian parturients

Ezebialu, Ifeanyichukwu U.; Eke, Ahizechukwu C.; Ezeagwuna, Dorothy Amauche; Nwachukwu, Chukwuemeka E; Ifediata, Francis; Ezebialu, C. U.

doi:10.1016/j.ijid.2012.07.014

Cited by 22 publications

(43 citation statements)

References 18 publications

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“…In one study, among 109 patients with acute placental malarial, peripheral blood malaria was apparent by microscopy in 47% of cases (Ismail et al, ). In another study, 254 (70%) of 365 women with peripheral malaria also had parasitized term placentas resulting in a significant ( p < 0.001) association between peripheral malaria and placental malaria (Ezebialu et al, ).…”

Section: Characteristics Of Placental Malariamentioning

confidence: 99%

“…This sensitivity is due to the generation of infected RBCs with PfEMP1 receptors with active Duffy binding‐like (DBL)γ domains (referred to as VAR2CSA receptors) that can bind to the chondroitin sulfate A (CSA) portion of chondroitin sulfate A proteoglycans which is the target receptor in the placenta. These infected RBCs with VAR2CSA receptors start out as a small portion of the total infected RBCS but are selected for and develop rapidly (Achur, Valiyaveettil, Alkhalil, Ockenhouse, & Gowda, ; Brabin et al, ; Salanti et al, ; Srivastava et al, ; Ezebialu et al, ; Ouédraogo et al, ; Kalilani‐Phiri et al, ; Pehrson et al, ; Sharma & Shukla, ). Women in endemic areas likely have immunity to the common form of malaria caused by infected RBCs that bind to CD36 receptors but primigravidae do not have immunity to VAR2CSA‐binding infected RBCs that bind in the placenta and cause placental malaria.…”

Section: Malaria In Pregnancymentioning

confidence: 99%

“…Women in endemic areas likely have immunity to the common form of malaria caused by infected RBCs that bind to CD36 receptors but primigravidae do not have immunity to VAR2CSA‐binding infected RBCs that bind in the placenta and cause placental malaria. Infected pregnant women eventually form antibodies that block the binding of infected RBCs to chondroitin sulfate A proteoglycans and infections during subsequent pregnancies are not as severe (Desai et al, ; Duffy & Fried, ; Ezebialu et al, ; McLean, Ataide, Simpson, Beeson, & Fowkes, ; Moore et al, ; Rogerson, ; Rogerson, Hviid, Duffy, Leke, & Taylor, ; Sharma & Shukla, ; Uneke, , ).…”

Section: Malaria In Pregnancymentioning

confidence: 99%

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Genesis of placental sequestration in malaria and possible targets for drugs for placental malaria

Clark

2019

Birth Defects Research

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Malaria during pregnancy results in intrauterine growth restriction, fetal anemia, and infant mortality. Women are more susceptible to malaria during pregnancy due to malaria-induced inflammation and the sequestration of infected red blood cells in the placenta, which bind to the chondroitin sulfate portion of syndecan-1 on the syncytiotrophoblast and in the intervillous space. Syndecan-1 is a dimeric proteoglycan with an extracellular ectodomain that is cleaved from the transmembrane domain (referred to as "shedding") by matrix metalloproteinases (MMPs), likely the secreted MMP-9. The ectodomain includes four binding sites for chondroitin sulfate, which are proximal to the transmembrane domain, and six distal binding sites primarily for heparan sulfate. This "shedding" of syndecan-1 is inhibited by the presence of the heparan sulfate chains, which can be removed by heparanase. The intervillous space contains fibrin strands and syndecan-1 ectodomains free of heparan sulfate. The following is proposed as the sequence of events that leads to and is primarily responsible for sequestration in the intervillous space of the placenta. Inflammation associated with malaria triggers increased heparanase activity that degrades the heparan sulfate on the membrane-bound syndecan-1. Inflammation also upregulates MMP-9 and the removal of heparan sulfate gives MMP-9 access to cleave syndecan-1, thereby releasing dimeric syndecan-1 ectodomains with at least four chondroitin sulfate chains attached. These multivalent ectodomains bind infected RBCs together leading to their aggregation and entrapment in intervillous fibrin. This mechanism suggests possible new targets for anti-placental malaria drugs such as the inhibition of MMP-9. Doxycycline is an antimalarial drug which inhibits MMP-9. K E Y W O R D Sfibrin, heparanase, malaria, metalloproteinase, placenta, sequestration, syndecan-1

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Section: Characteristics Of Placental Malariamentioning

confidence: 99%

Section: Malaria In Pregnancymentioning

confidence: 99%

Section: Malaria In Pregnancymentioning

confidence: 99%

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Genesis of placental sequestration in malaria and possible targets for drugs for placental malaria

Clark

2019

Birth Defects Research

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“…Malaria occurs most often in pregnant women and young children . The greatest burden is in tropical regions, and in Africa, malaria remains one of the most common diagnoses . For many years, malaria has been a leading cause of death in sub‐Saharan Africa especially among children, although the number of deaths is decreasing, helped by the availability of rapid diagnostic tests, prevention programmes and antimalarial medicines .…”

Section: Introductionmentioning

confidence: 99%

Medicines dispensers' knowledge on the implementation of an artemisinin-based combination therapy policy for the treatment of uncomplicated malaria in Tanzania

Mwita

Jande

Marwa

et al. 2017

J Pharm Health Serv Res

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Objectives In 2005, Tanzania changed its policy for uncomplicated malaria treatment from sulphadoxine–pyrimethamine (SP) to artemisinin‐based combination therapy (ACT), specifically artemether–lumefantrine (ALU). SP remains the medicine of choice for intermittent preventive treatment in pregnancy (IPTp). There is a need to assess dispensers' knowledge regarding the treatment of uncomplicated malaria and IPTp in Tanzania given appreciable self‐purchasing to improve future care. Methods Descriptive cross‐sectional design with structured questionnaires to capture quantitative data, with qualitative data captured using focus groups. The study was performed at 32 private pharmacies and 33 Accredited Drug Dispensing Outlets in the Nyamagana and Sengerema Districts in Tanzania, with 20 dispensers included in the qualitative discussions. Key findings The knowledge level of dispensers in the private medicine outlets was variable. Most dispensers knew ALU was first‐line treatment in uncomplicated malaria, however variable knowledge about taking ALU with fatty meals. Generally, dispensers had poor knowledge about dosing intervals for SP in IPTp and variable knowledge regarding treatments in the first trimester. Overall, 49% had good knowledge and 48% had moderate knowledge of ACT in uncomplicated malaria. There was a significant relationship between dispenser type and knowledge of ACT but no statistical relationship between the level of knowledge on IPTp and the dispenser. Conclusions The majority of dispensers in private medicines outlets have good knowledge on ACT policy in the treatment of uncomplicated malaria; however, few dispensers had good knowledge on IPTp, which may contribute to irrational dispensing of SP. This needs addressing given the extent of self‐purchasing in Tanzania.

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“…The vast majority of cases of malaria occur in pregnant women and young children, with the burden of the disease highest among tropical regions including Nigeria . Malaria is one of the major public health problems in Nigeria, with a quarter of the burden in Africa occurring in Nigeria .…”

Section: Introductionmentioning

confidence: 99%

Antimalarial treatment patterns among pregnant women attending antenatal care clinics in south east Nigeria and the future implications

et al. 2016

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Prevalence, pattern, and determinants of placental malaria in a population of southeastern Nigerian parturients

Cited by 22 publications

References 18 publications

Genesis of placental sequestration in malaria and possible targets for drugs for placental malaria

Genesis of placental sequestration in malaria and possible targets for drugs for placental malaria

Medicines dispensers' knowledge on the implementation of an artemisinin-based combination therapy policy for the treatment of uncomplicated malaria in Tanzania

Antimalarial treatment patterns among pregnant women attending antenatal care clinics in south east Nigeria and the future implications

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