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Malaria in pregnancy

Rada M Savic, Prasanna Jagannathan, Richard Kajubi, Liusheng Huang, Nan Zhang, Moses Were, Abel Kakuru, Mary K Muhindo, Norah Mwebaza, Erika Wallender, Tamara D Clark, Bishop Opira, Moses Kamya, Diane V Havlir, Philip J Rosenthal, Grant Dorsey, Francesca T Aweeka
Background: Dihydroartemsinin-piperaquine is highly efficacious as intermittent preventive therapy for malaria during pregnancy (IPTp). Determining associations between piperaquine exposure, malaria risk, and adverse birth outcomes informs optimal dosing strategies. Methods: HIV-uninfected pregnant women were enrolled in a placebo-controlled trial of IPTp at 12-20 weeks gestation and randomized to: sulfadoxine-pyrimethamine every 8 weeks (n=106), dihydroartemsinin-piperaquine every 8 weeks (n=94), or dihydroartemsinin-piperaquine every 4 weeks (n=100) during pregnancy...
March 14, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Adélaïde Compaoré, Sabine Gies, Bernard Brabin, Halidou Tinto, Loretta Brabin
BACKGROUND: Iron deficiency remains a prevalent adolescent health problem in low income countries. Iron supplementation is recommended but improvement of iron status requires good adherence. OBJECTIVES: We explored factors affecting adolescent adherence to weekly iron and/or folic acid supplements in a setting of low secondary school attendance. METHODS: Taped in-depth interviews were conducted with participants in a randomised, controlled, periconceptional iron supplementation trial for young nulliparous women living in a rural, malaria endemic region of Burkina Faso...
March 14, 2018: Reproductive Health
Paulo Arnaldo, Eduard Rovira-Vallbona, Jerónimo S Langa, Crizolgo Salvador, Pieter Guetens, Driss Chiheb, Bernardete Xavier, Luc Kestens, Sónia M Enosse, Anna Rosanas-Urgell
BACKGROUND: Malaria in pregnancy leads to serious adverse effects on the mother and the child and accounts for 75,000-200,000 infant deaths every year. Currently, the World Health Organization recommends intermittent preventive treatment of malaria in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) at each scheduled antenatal care (ANC) visit. This study aimed to assess IPTp-SP coverage in mothers delivering in health facilities and at the community. In addition, factors associated with low IPTp-SP uptake and malaria adverse outcomes in pregnancy were investigated...
March 12, 2018: Malaria Journal
Michal Fried, Jonathan D Kurtis, Bruce Swihart, Robert Morrison, Sunthorn Pond-Tor, Amadou Barry, Youssoufa Sidibe, Sekouba Keita, Almahamoudou Mahamar, Naissem Andemel, Oumar Attaher, Adama B Dembele, Kadidia B Cisse, Bacary S Diarra, Moussa B Kanoute, David L Narum, Alassane Dicko, Patrick E Duffy
BACKGROUND: Maternal malaria is a tropical scourge associated with poor pregnancy outcomes. Women become resistant to Plasmodium falciparum pregnancy malaria as they acquire antibodies to the variant surface antigen VAR2CSA, a leading vaccine candidate. Because malaria infection may increase VAR2CSA antibody levels and thereby confound analyses of immune protection, gravidity-dependent changes in antibody levels during and after infection, and the effect of VAR2CSA antibodies on pregnancy outcomes were evaluated...
March 9, 2018: Malaria Journal
Chloe R McDonald, Lindsay S Cahill, Joel R Gamble, Robyn Elphinstone, Lisa M Gazdzinski, Kathleen J Y Zhong, Adrienne C Philson, Mwayiwawo Madanitsa, Linda Kalilani-Phiri, Victor Mwapasa, Feiko O Ter Kuile, John G Sled, Andrea L Conroy, Kevin C Kain
Reducing adverse birth outcomes due to malaria in pregnancy (MIP) is a global health priority. However, there are few safe and effective interventions. l-Arginine is an essential amino acid in pregnancy and an immediate precursor in the biosynthesis of nitric oxide (NO), but there are limited data on the impact of MIP on NO biogenesis. We hypothesized that hypoarginemia contributes to the pathophysiology of MIP and that l-arginine supplementation would improve birth outcomes. In a prospective study of pregnant Malawian women, we show that MIP was associated with lower concentrations of l-arginine and higher concentrations of endogenous inhibitors of NO biosynthesis, asymmetric and symmetric dimethylarginine, which were associated with adverse birth outcomes...
March 7, 2018: Science Translational Medicine
James G Beeson, Michelle J L Scoullar, Philippe Boeuf
Decreased l-arginine and nitric oxide bioavailability in pregnant women with malaria contributes to low birth weight, suggesting that l-arginine supplementation could be a potential treatment (McDonald et al ).
March 7, 2018: Science Translational Medicine
Christina Riley, Stephanie Dellicour, Peter Ouma, Urbanus Kioko, Ahmeddin Omar, Simon Kariuki, Zipporah Ng'ang'a, Meghna Desai, Ann M Buff, Julie R Gutman
Prompt diagnosis and effective treatment of acute malaria in pregnancy (MiP) is important for the mother and fetus; data on health-care provider adherence to diagnostic guidelines in pregnancy are limited. From September to November 2013, a cross-sectional survey was conducted in 51 health facilities and 39 drug outlets in Western Kenya. Provider knowledge of national diagnostic guidelines for uncomplicated MiP were assessed using standardized questionnaires. The use of parasitologic testing was assessed in health facilities via exit interviews with febrile women of childbearing age and in drug outlets via simulated-client scenarios, posing as pregnant women or their spouses...
March 5, 2018: American Journal of Tropical Medicine and Hygiene
Nneka U Igboeli, Maxwell O Adibe, Chinwe V Ukwe, Nze C Aguwa
Background: In 2005, Nigeria changed its policy on prevention of malaria in pregnancy to intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP). Indicators of impact of effective prevention and control of malaria on pregnancy (MIP) are low birth weight (LBW) and maternal anaemia by parity. This study determined the prevalence of LBW for different gravidity groups during periods of pre- and postpolicy change to IPTp-SP. Methods: Eleven-year data were abstracted from the delivery registers of two hospitals...
2018: BioMed Research International
Renato Barboza, Flávia Afonso Lima, Aramys Silva Reis, Oscar Javier Murillo, Erika Paula Machado Peixoto, Carla Letícia Bandeira, Wesley Luzetti Fotoran, Luis Roberto Sardinha, Gerhard Wunderlich, Estela Bevilacqua, Maria Regina D'Império Lima, José Maria Alvarez, Fabio Trindade Maranhão Costa, Lígia Antunes Gonçalves, Sabrina Epiphanio, Claudio Romero Farias Marinho
A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper.
March 6, 2018: Scientific Reports
Alinune Nathanael Kabaghe, Michael Give Chipeta, Robert Sean McCann, Dianne Jean Terlouw, Tinashe Tizifa, Zinenani Truwah, Kamija Samuel Phiri, Michèle van Vugt
BACKGROUND: Despite the availability of cost effective malaria control interventions, such as insecticide-treated bed nets (ITN), diagnosis and effective treatment of malaria, and intermittent preventive treatment during pregnancy (IPTp), the lack of equitable access and coverage affect utilization of these interventions in rural communities. Aggregated rates of access and utilization of malaria interventions in national surveys mask substantial variations in intervention coverage. Utilization of interventions and factors affecting utilization need investigation in rural communities...
March 6, 2018: Malaria Journal
Nicolas Dauby, Mariana Figueiredo Ferreira, Deborah Konopnicki, Vo Thanh Phuong Nguyen, Brigitte Cantinieaux, Charlotte Martin
Emerging evidence indicates that migrants from Plasmodium falciparum endemic regions are at risk of delayed presentation of P. falciparum malaria. We report three cases of P. falciparum malaria occurring years after arrival in Europe. All patients were originally from Sub-Saharan Africa. Two subjects had controlled HIV infection and one was a pregnant woman. We performed a literature review of all published cases of delayed presentation of P. falciparum in migrants and identified 32 additional cases. All cases but one originate from sub-Saharan Africa...
February 26, 2018: American Journal of Tropical Medicine and Hygiene
Rebecca F Grais, Ibrahim M Laminou, Lynda Woi-Messe, Rockyath Makarimi, Seidou H Bouriema, Celine Langendorf, Alfred Amambua-Ngwa, Umberto D'Alessandro, Philippe J Guérin, Thierry Fandeur, Carol H Sibley
BACKGROUND: In Niger, malaria transmission is markedly seasonal with most of the disease burden occurring in children during the rainy season. Seasonal malaria chemoprevention (SMC) with amodiaquine plus sulfadoxine-pyrimethamine (AQ + SP) is recommended in the country to be administered monthly just before and during the rainy season. Moreover, clinical decisions on use of SP for intermittent preventive treatment in pregnancy (IPTp) now depend upon the validated molecular markers for SP resistance in Plasmodium falciparum observed in the local parasite population...
February 27, 2018: Malaria Journal
Akhabue K Okojie, O E Okobi, Hamza Dar, Hurmat Malik, Mehreen Arif, Khalid Rauf, Eghosa E Iyare
In Africa, a large number of pregnancies are exposed to Plasmodium falciparum infection. The in-utero environment extremely influences childhood neurodevelopment and behaviour. The complement 5a receptor (C5aR) is linked to several disease conditions. However, the influence of Plasmodium berghei during pregnancy on maternal complement 5a receptor and subsequently on fetal behaviour is unknown. Pregnant mice were intra-peritoneally inoculated on gestational day 13 with 1.02x105 infected red blood cells (iRBCs)...
December 30, 2017: Nigerian Journal of Physiological Sciences: Official Publication of the Physiological Society of Nigeria
V Hamwela, W Ahmed, P A Bath
OBJECTIVES: The study identified available websites on malaria in pregnancy on the World Wide Web and sought to evaluate their readability and information quality. STUDY DESIGN: A purposeful sample of websites were selected which provided information on Malaria in pregnancy. METHODS: A total of 31 websites were identified from searches using Google, Yahoo and Bing search engines. Two generic tools (Discern and HON), one specific tool designed to assess information quality of malaria in pregnancy and readability tests (Flesch Reading Ease and Flesh-Kincaid Grade level) were used to evaluate the websites...
February 22, 2018: Public Health
Lotta Hallamaa, Yin Bun Cheung, Kenneth Maleta, Mari Luntamo, Ulla Ashorn, Melissa Gladstone, Teija Kulmala, Charles Mangani, Per Ashorn
BACKGROUND AND OBJECTIVES: We showed earlier that presumptive infection treatment in pregnancy reduced the prevalence of neonatal stunting in a rural low-income setting. In this article, we assess how these gains were sustained and reflected in childhood growth, development, and mortality. METHODS: We enrolled 1320 pregnant Malawian women in a randomized trial and treated them for malaria and other infections with either 2 doses of sulfadoxine-pyrimethamine (SP) (control), monthly SP, or monthly sulfadoxine-pyrimethamine and 2 doses of azithromycin (AZI-SP)...
February 22, 2018: Pediatrics
R O'Connor, D Morley, E Relihan, A Broderick, C Merry, C Bergin
Malaria is the most serious parasitic infection. At our institution over a two year period there were treatment errors in 18% (n=3) of cases. The aim of this multidisciplinary study was to ensure appropriate and timely treatment of malaria by implementation of a cluster of interventions: reconfiguration of existing guidelines, provision of prescribing information; delivery of education sessions to front-line staff and enabling rapid access to medication. Staff feedback was assessed through a questionnaire. Perceived benefits gained included awareness of guidelines (91%, n= 39), how to diagnose (81%, n =35), how to treat (86%, n=37), that treatment must be prompt (77%, n=33) and where to find treatment out of hours (84%, n=36)...
December 18, 2017: Irish Medical Journal
Alexandre Manirakiza, Eugène Serdouma, Richard Norbert Ngbalé, Sandrine Moussa, Samuel Gondjé, Rock Mbetid Degana, Gislain Géraud Banthas Bata, Jean Methode Moyen, Jean Delmont, Gérard Grésenguet, Abdoulaye Sepou
Malaria in pregnancy is a serious public health problem in tropical areas. Frequently, the placenta is infected by accumulation of Plasmodium falciparum- infected erythrocytes in the intervillous space. Falciparum malaria acts during pregnancy by a range of mechanisms, and chronic or repeated infection and co-infections have insidious effects. The susceptibility of pregnant women to malaria is due to both immunological and humoral changes. Until a malaria vaccine becomes available, the deleterious effects of malaria in pregnancy can be avoided by protection against infection and prompt treatment with safe, effective antimalarial agents; however, concurrent infections such as with HIV and helminths during pregnancy are jeopardizing malaria control in sub-Saharan Africa...
December 31, 2017: Journal of Public Health in Africa
Norliza Mat Ariffin, Farida Islahudin, Mohd Makmor-Bakry, Endang Kumolosasi, Mohd Hafizi A Hamid
Introduction: Primaquine is vital for the management of liver-stage Plasmodium vivax and Plasmodium ovale malaria. However, primaquine effectiveness is dependent on various factors and differs between populations. Therefore, this study was conducted to identify factors that affect the length of stay and relapse during primaquine combination treatment in malaria-infected patients in the local setting. Materials and Methods: A retrospective study on the use of primaquine combination among P...
October 2017: Journal of Pharmacy & Bioallied Sciences
Lurdes Rodrigues-Duarte, Yash Pandya, Rita Neres, Carlos Penha-Gonçalves
Malaria in Pregnancy (MiP) is a distinctive clinical form of Plasmodium infection and is a cause of placental insufficiency leading to poor pregnancy outcomes of pregnancy Maternal innate immunity responses play a decisive role in the development of placental inflammation but the action of fetal-derived factors in MiP outcomes has been overlooked. We investigated the role of Tlr4 and Ifnar1 genes taking advantage of heterogenic mating strategies to dissect the effects mediated by maternal and fetal-derived TLR4 or IFNAR1...
February 12, 2018: Infection and Immunity
Justin Y A Doritchamou, Richard A Akuffo, Azizath Moussiliou, Adrian J F Luty, Achille Massougbodji, Philippe Deloron, Nicaise G Tuikue Ndam
BACKGROUND: Among the Plasmodium species that infect humans, adverse effects of P. falciparum and P. vivax have been extensively studied and reported with respect to poor outcomes particularly in first time mothers and in women living in areas with unstable malaria transmission. Although, other non-falciparum malaria infections during pregnancy have sometimes been reported, little is known about the dynamics of these infections during pregnancy. METHODS AND FINDINGS: Using a quantitative PCR approach, blood samples collected from Beninese pregnant women during the first antenatal visit (ANV) and at delivery including placental blood were screened for Plasmodium spp...
February 12, 2018: PLoS Neglected Tropical Diseases
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