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Malaria in pregnancy

David Teye Doku, Mumuni Mukaila Zankawah, Addae Boateng Adu-Gyamfi
BACKGROUND: The burden of malaria in terms of morbidity and mortality is huge is Sub-Saharan Africa, particularly among pregnant women. Among the measures to curb down this burden include intermittent preventive treatment (IPT) and effective case management. These strategies were adopted by Ghana and implemented since 2003; however, there is still high dropout rate in IPT coverage. This study sought to investigate factors contributing to high dropout rate between IPT1 and IPT3 in the Tamale Metropolis, one of the health facilities with the highest IPT dropout rates in Ghana...
October 10, 2016: BMC Research Notes
Mary Prahl, Prasanna Jagannathan, Tara I McIntyre, Ann Auma, Lila Farrington, Samuel Wamala, Mayimuna Nalubega, Kenneth Musinguzi, Kate Naluwu, Esther Sikyoma, Rachel Budker, Hilary Vance, Pamela Odorizzi, Patience Nayebare, John Ategeka, Abel Kakuru, Diane V Havlir, Moses R Kamya, Grant Dorsey, Margaret E Feeney
BACKGROUND: In malaria-endemic areas, the first exposure to malaria antigens often occurs in utero when the fetal immune system is poised towards the development of tolerance. Children exposed to placental malaria have an increased risk of clinical malaria in the first few years of life compared to unexposed children. Recent work has suggested the potential of pregnancy-associated malaria to induce immune tolerance in children living in malaria-endemic areas. A study was completed to evaluate the effect of malaria exposure during pregnancy on fetal immune tolerance and effector responses...
October 7, 2016: Malaria Journal
Sophie Desmonde, Tessa Goetghebuer, Claire Thorne, Valériane Leroy
PURPOSE OF REVIEW: The number of HIV-exposed but uninfected (HEU) infants exposed to both HIV and multiple antiretroviral drugs in utero and during prolonged breastfeeding is increasing in low-income countries where HIV prevalence is the highest. We review recent evidence on the effects of perinatal/postnatal exposure to maternal HIV and combined antiretroviral therapy (cART) on health outcomes of HEU children (mitochondrial and metabolic toxicity, adverse pregnancy outcomes, neurodevelopment, growth, infectious morbidity, and mortality)...
September 2016: Current Opinion in HIV and AIDS
Pilar Requena, Edmilson Rui, Norma Padilla, Flor E Martínez-Espinosa, Maria Eugenia Castellanos, Camila Bôtto-Menezes, Adriana Malheiro, Myriam Arévalo-Herrera, Swati Kochar, Sanjay K Kochar, Dhanpat K Kochar, Alexandra J Umbers, Maria Ome-Kaius, Regina Wangnapi, Dhiraj Hans, Michela Menegon, Francesca Mateo, Sergi Sanz, Meghna Desai, Alfredo Mayor, Chetan C Chitnis, Azucena Bardají, Ivo Mueller, Stephen Rogerson, Carlo Severini, Carmen Fernández-Becerra, Clara Menéndez, Hernando Del Portillo, Carlota Dobaño
P. vivax infection during pregnancy has been associated with poor outcomes such as anemia, low birth weight and congenital malaria, thus representing an important global health problem. However, no vaccine is currently available for its prevention. Vir genes were the first putative virulent factors associated with P. vivax infections, yet very few studies have examined their potential role as targets of immunity. We investigated the immunogenic properties of five VIR proteins and two long synthetic peptides containing conserved VIR sequences (PvLP1 and PvLP2) in the context of the PregVax cohort study including women from five malaria endemic countries: Brazil, Colombia, Guatemala, India and Papua New Guinea (PNG) at different timepoints during and after pregnancy...
October 2016: PLoS Neglected Tropical Diseases
R L Goldenberg, J B Griffin, B D Kamath-Rayne, M Harrison, D J Rouse, K Moran, B Hepler, A H Jobe, E M McClure
OBJECTIVE: Stillbirths are among the most common adverse pregnancy outcomes, with 98% occurring in low-income countries. More than one-third occur in sub-Saharan Africa (SSA). However, the medical conditions causing stillbirths and interventions to reduce stillbirths from these conditions are not well documented. We estimated the reductions in stillbirths possible with combinations of interventions. DESIGN: We developed a computerised model to estimate the impact of various interventions on stillbirths caused by the most common conditions...
October 5, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Florence Mgawadere, Regine Unkels, Adetoro Adegoke, Nynke van den Broek
BACKGROUND: Assessing the feasibility of conducting a prospective Reproductive Age Mortality Survey (RAMOS) study in the low-income setting of Mangochi District, Malawi to obtain cotemporaneous estimates of the number, cause of and conditions associated with maternal deaths (MD) in all women of reproductive age (WRA) (n = 207 688). METHODS: MD among all deaths of WRA were identified using the ICD-10 definition. Cause of death and contributing conditions identified by a panel of experts using the classification system for deaths during pregnancy, childbirth and puerperium (ICD-MM)...
September 29, 2016: BMC Pregnancy and Childbirth
Charlotte G Neumann, Winstone Nyandiko, Abraham Siika, Natalie Drorbaugh, Goleen Samari, Grace Ettyang, Judith A Ernst
This paper describes morbidity in a group of HIV-positive drug-naïve rural women in western Kenya. A total of 226 drug-naïve HIV-positive women were evaluated for baseline morbidity, immune function, and anthropometry before a food-based nutrition intervention. Kenyan nurses visited women in their homes and conducted semi-structured interviews regarding symptoms and physical signs experienced at the time of the visit and during the previous week and physical inspection. Blood and urine samples were examined for determination of immune function (CD4, CD8, and total lymphocyte counts), anaemia, malaria, and pregnancy status...
September 2016: African Journal of AIDS Research: AJAR
Enesia Banda Chaponda, R Matthew Chico, Jane Bruce, Charles Michelo, Bellington Vwalika, Sungano Mharakurwa, Mike Chaponda, James Chipeta, Daniel Chandramohan
Malarial infection and curable sexually transmitted and reproductive tract infections (STIs/RTIs) are important causes of adverse birth outcomes. Reducing the burden of these infections in pregnancy requires interventions that can be easily integrated into the antenatal care (ANC) package. However, efforts to integrate the control of malarial infection and curable STIs/RTIs in pregnancy have been hampered by a lack of evidence related to their coinfection. Thus, we investigated the prevalence of coinfection among pregnant women of rural Zambia...
September 26, 2016: American Journal of Tropical Medicine and Hygiene
Silke Fernandes, Elisa Sicuri, Diawara Halimatou, James Akazili, Kalifa Boiang, Daniel Chandramohan, Sheikh Coulibaly, Sory Ibrahim Diawara, Kassoum Kayentao, Feiko Ter Kuile, Pascal Magnussen, Harry Tagbor, John Williams, Arouna Woukeu, Matthew Cairns, Brian Greenwood, Kara Hanson
BACKGROUND: Emergence of high-grade sulfadoxine-pyrimethamine (SP) resistance in parts of Africa has led to growing concerns about the efficacy of intermittent preventive treatment of malaria during pregnancy (IPTp) with SP. The incremental cost-effectiveness of intermittent screening and treatment (ISTp) with artemether-lumefantrine (AL) as an alternative strategy to IPTp-SP was estimated followed by a simulation of the effects on cost-effectiveness of decreasing efficacy of IPTp-SP due to SP resistance...
2016: Malaria Journal
Holger W Unger, Per Ashorn, Jordan E Cates, Kathryn G Dewey, Stephen J Rogerson
BACKGROUND: In low-resource settings, malaria and macronutrient undernutrition are major health problems in pregnancy, contributing significantly to adverse pregnancy outcomes such as preterm birth and fetal growth restriction. Affected pregnancies may result in stillbirth and neonatal death, and surviving children are at risk of poor growth and infection in infancy, and of non-communicable diseases in adulthood. Populations exposed to macronutrient undernutrition frequently reside in malaria-endemic areas, and seasonal peaks of low food supply and malaria transmission tend to coincide...
2016: BMC Medicine
Freda Dzifa Intiful, Edwin Kwame Wiredu, George Awuku Asare, Matilda Asante, David Nana Adjei
INTRODUCTION: Pregnancy during the adolescent period is challenging mainly because of the nutritional demands of both the adolescent and pregnancy period. The risk for anaemia increases especially in developing countries such as Ghana where malaria is endemic and the practice of pica is common. In this study, we sought to determine the prevalence of anaemia, pica practice and malaria infection among pregnant adolescent girls and assess the extent to which these factors are associated...
2016: Pan African Medical Journal
Arnaud Chêne, Sophie Houard, Morten A Nielsen, Sophia Hundt, Flavia D'Alessio, Sodiomon B Sirima, Adrian J F Luty, Patrick Duffy, Odile Leroy, Benoit Gamain, Nicola K Viebig
Placental malaria caused by Plasmodium falciparum infection constitutes a major health problem manifesting as severe disease and anaemia in the mother, impaired fetal development, low birth weight or spontaneous abortion. Prevention of placental malaria currently relies on two key strategies that are losing efficacy due to spread of resistance: long-lasting insecticide-treated nets and intermittent preventive treatment during pregnancy. A placental malaria vaccine would be an attractive, cost-effective complement to the existing control tools...
2016: Malaria Journal
E E Idih, B U Ezem, E A Nzeribe, A O Onyegbule, B C Duru, C C Amajoyi
BACKGROUND: Despite the global efforts made to eradicate malaria, it continues to be a significant cause of morbidity and mortality in both neonates and the parturients. This study was done to determine the relationship between placental parasitemia, average neonatal birth weight and the relationship between the use of malaria preventive measures and the occurrence of placental parasitemia with the aim to improving maternal and neonatal outcome. PATIENTS AND METHODS: This cross-sectional study was done at the labor ward unit of the Federal Medical Center, Owerri, from December 2013 to May 2014...
July 2016: Nigerian Medical Journal: Journal of the Nigeria Medical Association
Mwayiwawo Madanitsa, Linda Kalilani, Victor Mwapasa, Anna M van Eijk, Carole Khairallah, Doreen Ali, Cheryl Pace, James Smedley, Kyaw-Lay Thwai, Brandt Levitt, Duolao Wang, Arthur Kang'ombe, Brian Faragher, Steve M Taylor, Steve Meshnick, Feiko O Ter Kuile
BACKGROUND: In Africa, most plasmodium infections during pregnancy remain asymptomatic, yet are associated with maternal anemia and low birthweight. WHO recommends intermittent preventive therapy in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP). However, sulfadoxine-pyrimethamine (SP) efficacy is threatened by high-level parasite resistance. We conducted a trial to evaluate the efficacy and safety of scheduled intermittent screening with malaria rapid diagnostic tests (RDTs) and treatment of RDT-positive women with dihydroartemisinin-piperaquine (DP) as an alternative strategy to IPTp-SP...
September 2016: PLoS Medicine
Georges Danhoundo, Mary E Wiktorowicz, Sanni Yaya
Although malaria in pregnancy predisposes women to increased perinatal mortality and morbidity, complex issues underlie its persistence. To develop a better understanding of the factors affecting women's access to Intermittent Preventive Treatment in Benin, we used the theoretical lens of "sensemaking" to clarify policymakers', health professionals', and women's perspectives concerning preventive policies and barriers to access. Several assumptions were found to underlie Benin's malaria preventive policy that contribute to the unintended effect of deterring pregnant women in poverty from accessing preventive treatment...
September 12, 2016: Health Care for Women International
Pamela M Odorizzi, Margaret E Feeney
Pregnancy-associated malaria, including placental malaria, causes significant morbidity and mortality worldwide. Recently, it has been suggested that in utero exposure of the fetus to malaria antigens may negatively impact the developing immune system and result in tolerance to malaria. Here, we review our current knowledge of fetal immunity to malaria, focusing on the dynamic interactions between maternal malaria infection, placental development, and the fetal immune system. A better understanding of the long-term impact of in utero malaria exposure on the development of natural immunity to malaria, immune responses to other childhood pathogens, and vaccine immunogenicity is urgently needed...
October 2016: Trends in Molecular Medicine
Jan D Warncke, Ioannis Vakonakis, Hans-Peter Beck
During the asexual cycle, Plasmodium falciparum extensively remodels the human erythrocyte to make it a suitable host cell. A large number of exported proteins facilitate this remodeling process, which causes erythrocytes to become more rigid, cytoadherent, and permeable for nutrients and metabolic products. Among the exported proteins, a family of 89 proteins, called the Plasmodium helical interspersed subtelomeric (PHIST) protein family, has been identified. While also found in other Plasmodium species, the PHIST family is greatly expanded in P...
December 2016: Microbiology and Molecular Biology Reviews: MMBR
Jodie Dionne-Odom, Rahel Mbah, Nicole J Rembert, Samuel Tancho, Gregory E Halle-Ekane, Comfort Enah, Thomas K Welty, Pius M Tih, Alan T N Tita
Objectives. We estimated seroprevalence and correlates of selected infections in pregnant women and blood donors in a resource-limited setting. Methods. We performed a cross-sectional analysis of laboratory seroprevalence data from pregnant women and voluntary blood donors from facilities in Cameroon in 2014. Rapid tests were performed to detect hepatitis B surface antigen, syphilis treponemal antibodies, and HIV-1/2 antibodies. Blood donations were also tested for hepatitis C and malaria. Results. The seroprevalence rates and ranges among 7069 pregnant women were hepatitis B 4...
2016: Infectious Diseases in Obstetrics and Gynecology
Valérie Briand, Jean-Yves Le Hesran, Mayfong Mayxay, Paul N Newton, Gwladys Bertin, Sandrine Houzé, Sommay Keomany, Yom Inthavong, Nanthasane Vannavong, Keobouphaphone Chindavongsa, Bouasy Hongvanthong, Nadine Fievet
BACKGROUND: There are no data on the burden of malaria in pregnancy (MiP) in Laos, where malaria still remains prevalent in the south. METHODS: Two cross-sectional surveys were conducted in 2014 to assess the prevalence of MiP in Vapi District, Salavan Province, southern Laos: the first consisted of screening 204 pregnant women during pregnancies [mean (95 % CI) gestational age: 23 (22-25) weeks] living in 30 randomly selected villages in Vapi District; the second was conducted among 331 pregnant women, who delivered during the study period in Vapi and Toumlane District Hospitals and in Salavan Provincial Hospital...
2016: Malaria Journal
Mary K Muhindo, Abel Kakuru, Paul Natureeba, Patricia Awori, Peter Olwoch, John Ategeka, Patience Nayebare, Tamara D Clark, Atis Muehlenbachs, Michelle Roh, Betty Mpeka, Bryan Greenhouse, Diane V Havlir, Moses R Kamya, Grant Dorsey, Prasanna Jagannathan
BACKGROUND: Indoor residual spraying of insecticide (IRS) is a key intervention for reducing the burden of malaria in Africa. However, data on the impact of IRS on malaria in pregnancy and birth outcomes is limited. METHODS: An observational study was conducted within a trial of intermittent preventive therapy during pregnancy in Tororo, Uganda. Women were enrolled at 12-20 weeks of gestation between June and October 2014, provided with insecticide-treated bed nets, and followed through delivery...
2016: Malaria Journal
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