The Impact of Malaria in Pregnancy on Infant Susceptibility to Malaria Infection

Background Annually 125 million pregnancies are at risk of malaria infection. However, the impact of exposure to malaria in pregnancy on neurodevelopment in children is not well understood. We hypothesized that malaria in pregnancy and associated maternal immune activation result in neurodevelopmental delay in exposed offspring. Methods and findings Between April 2014 and April 2015, we followed 421 Malawian mother–baby dyads (median [IQR] maternal age: 21 [19, 28] years) who were previously enrolled (median [IQR] gestational age at enrollment: 19.7 [17.9, 22.1] weeks) in a randomized controlled malaria prevention trial with 5 or 6 scheduled assessments of antenatal malaria infection by PCR. Children were evaluated at 12, 18, and/or 24 months of age with cognitive tests previously validated in Malawi: the Malawi Developmental Assessment Tool (MDAT) and the MacArthur–Bates Communicative Development Inventories (MCAB-CDI). We assessed the impact of antenatal malaria (n [%] positive: 240 [57.3]), placental malaria (n [%] positive: 112 [29.6]), and maternal immune activation on neurocognitive development in children. Linear mixed-effects analysis showed that children exposed to antenatal malaria between 33 and 37 weeks gestation had delayed language development across the 2-year follow-up, as measured by MCAB-CDI (adjusted beta estimate [95% CI], −7.53 [−13.04, −2.02], p = 0.008). Maternal immune activation, characterized by increased maternal sTNFRII concentration, between 33 and 37 weeks was associated with lower MCAB-CDI language score (adjusted beta estimate [95% CI], −8.57 [−13.09, −4.06], p < 0.001). Main limitations of this study include a relatively short length of follow-up and a potential for residual confounding that is characteristic of observational studies. Conclusions This mother–baby cohort presents evidence of a relationship between malaria in pregnancy and neurodevelopmental delay in offspring. Malaria in pregnancy may be a modifiable risk factor for neurodevelopmental injury independent of birth weight or prematurity. Successful interventions to prevent malaria during pregnancy may reduce the risk of neurocognitive delay in children.

Download Full-text

Malaria in pregnancy in rural Gabon: a cross-sectional survey on the impact of seasonality in high-risk groups

Malaria Journal ◽

10.1186/1475-2875-12-412 ◽

2013 ◽

Vol 12 (1) ◽

pp. 412 ◽

Cited By ~ 9

Author(s):

Mario J Jäckle ◽

Christian G Blumentrath ◽

Rella M Zoleko ◽

Daisy Akerey-Diop ◽

Jean-Rodolphe Mackanga ◽

...

Keyword(s):

High Risk ◽

Risk Groups ◽

Malaria In Pregnancy ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Impact ◽

In Pregnancy

Download Full-text

Malaria in Pregnancy in Nigeria: A Literature Review

International Healthcare Research Journal ◽

10.26440/ihrj/0311.02315 ◽

2020 ◽

Vol 3 (11) ◽

pp. 346-348

Author(s):

Joseph Omang ◽

Antor O Ndep ◽

Dominic Offiong ◽

Fidelis Otu ◽

Kenneth Onyejose

Keyword(s):

Pregnant Women ◽

Malaria Infection ◽

Well Being ◽

Malaria In Pregnancy ◽

Sub Saharan Africa ◽

Infected Mosquito ◽

Insecticide Treated Nets ◽

Health Seeking ◽

Systematic Analysis ◽

In Pregnancy

Malaria is caused by the parasite plasmodium which can be spread to humans through the bite of an infected mosquito. Of the five types of plasmodium (P. Falciparium, P.Ovale, P. Malaria, P. Vivax and P. Knowlesi), the plasmodium falciparium is the deadliest and affects the lives of almost 40 per cent of the world’s population with pregnant women and children under-five years of age being the most affected. This mini-review involved the collation of findings from recent studies in regards to the prevalence of malaria infection among pregnant women and infants. A systematic analysis of recent literature on the prevalence of malaria in pregnancy from many authors was carried out and the facts synthesized to make an easy read. From the analysis of literature, Ten Thousand women and 200,000 babies were reported to be dying annually from complications of malaria in pregnancy which recorded a prevalence of 85 per cent in sub-Saharan Africa. More so, Fifty per cent of pregnant women were discovered to be carrying plasmodium falciparium in their placenta without even experiencing malaria signs/ symptoms, and this development was reported to have been responsible for Twenty per cent of stillbirths and 11 per cent of all maternal deaths. Malaria infection is considered a major threat to the lives and well-being of pregnant women and infants. Therefore, stakeholders should ensure that every clinical diagnosis of malaria in pregnancy is confirmed with a laboratory plasmodium falciparium-based diagnosis before the administration of antimalarial drugs. Furthermore there should be a stepping –up on the distribution of insecticide treated nets alongside enlightenment of pregnant women on ways of preventing mosquito bite. Instituting the aforementioned approaches is key to improving the health- seeking behaviour of pregnant women in particular and the wider population in general thus enabling them to stay malaria free throughout the period of pregnancy and infancy.

Download Full-text

Trends of malaria infection in pregnancy in Ghana over the past two decades: a review

Malaria Journal ◽

10.1186/s12936-021-04031-3 ◽

2022 ◽

Vol 21 (1) ◽

Author(s):

Joseph Osarfo ◽

Gifty Dufie Ampofo ◽

Harry Tagbor

Keyword(s):

Malaria Transmission ◽

Malaria Infection ◽

Low Birthweight ◽

Parasite Prevalence ◽

Forest Zone ◽

The Past ◽

Apparent Reduction ◽

The Impact ◽

Submicroscopic Parasitaemia ◽

In Pregnancy

Abstract Background There has been a global decline in malaria transmission over the past decade. However, not much is known of the impact of this observation on the burden of malaria infection in pregnancy in endemic regions including Ghana. A narrative review was undertaken to help describe trends in malaria infection in pregnancy in Ghana. Among others, such information is important in showing any progress made in malaria in pregnancy control. Methods To describe trends in pregnancy-associated malaria infection in Ghana, a search and review of literature reporting data on the prevalence of asymptomatic Plasmodium falciparum infection in pregnancy was conducted. Results Thirty-six (36) studies, conducted over 1994–2019, were included in the review. In the northern savannah zone with largely seasonal malaria transmission, prevalence appeared to reduce from about 50–60% in 1994–2010 to 13–26% by 2019. In the middle transitional/forest zone, where transmission is perennial with peaks in the rainy season, prevalence apparently reduced from 60% in the late 1990 s to about 5–20% by 2018. In the coastal savannah area, there was apparent reduction from 28 to 35% in 2003–2010 to 5–11% by 2018–2019. The burden of malaria infection in pregnancy continues to be highest among teenagers and younger-aged pregnant women and paucigravidae. Conclusions There appears to be a decline in asymptomatic parasite prevalence in pregnancy in Ghana though this has not been uniform across the different transmission zones. The greatest declines were noticeably in urban settings. Submicroscopic parasitaemia remains a challenge for control efforts. Further studies are needed to evaluate the impact of the reduced parasite prevalence on maternal anaemia and low birthweight and to assess the local burden of submicroscopic parasitaemia in relation to pregnancy outcomes.

Download Full-text

The Impact of Malaria in Pregnancy on Changes in Blood Pressure in Children During Their First Year of Life

Hypertension ◽

10.1161/hypertensionaha.113.02238 ◽

2014 ◽

Vol 63 (1) ◽

pp. 167-172 ◽

Cited By ~ 10

Author(s):

Omolola O. Ayoola ◽

Olayemi O. Omotade ◽

Isla Gemmell ◽

Peter E. Clayton ◽

J. Kennedy Cruickshank

Keyword(s):

Blood Pressure ◽

Malaria In Pregnancy ◽

First Year ◽

First Year Of Life ◽

The Impact ◽

In Pregnancy

Download Full-text

Plasmodium falciparum malaria during pregnancy: the impact of parasitaemia and anaemia on birthweight

10.1101/2021.08.12.21261986 ◽

2021 ◽

Author(s):

Dawood Ackom Abass ◽

Abdul-Hakim Mutala ◽

Christian Kwasi Owusu ◽

Bernard Walter Lartekwei Lawson ◽

Kingsley Badu

Keyword(s):

Risk Factors ◽

Pregnant Women ◽

Falciparum Malaria ◽

Low Birthweight ◽

Young Age ◽

Malaria In Pregnancy ◽

Cross Sectional ◽

Longitudinal Cohort ◽

The Impact ◽

In Pregnancy

Abstract Malaria in pregnancy remains a major problem of public health concern in Sub-Saharan Africa due to its endemicity and the diverse consequences on both the mother and the baby. Much attention, therefore, is needed to fully understand the epidemiology of the disease and to mitigate the devastating outcomes. The present study aimed at investigating malaria in pregnancy, its adverse effects on pregnant women and the impact on birthweight of babies. A total of 222 pregnant women gave their consent and were recruited into the study during their routine Antenatal care visits. This study employed a combination of cross-sectional and longitudinal cohort study designs. For 122 women in the cross-sectional arm, blood samples and data were obtained once, whilst 100 women in the longitudinal cohort arm were followed up from recruitment until delivery. Demographic information, obstetric history and risk factors were obtained by administering questionnaires. About 1.0 ml of venous blood was drawn to determine malaria parasitaemia and anaemia status of the participants. The birthweights of the babies were also taken at delivery. The prevalence of malaria and anaemia was 19.8% and 27.0% respectively at registration for all 222 participants. All infections were P. falciparum malaria. One hundred and forty-six (65.8%) of participants had ITN but only 72 (32.4%) used it the previous night. Young age and rural settings were risk factors for malaria. Young age and malaria positive pregnant women had increased risk of anaemia. In the follow-up group which ended with 54 participants, the overall prevalence of malaria and anaemia were 18.7% and 32.4% respectively. Fifty-two (96.3%) of pregnant women attended ANC ≥ 4 times and 55.6% took ≥ 3 doses of SP. There were two cases of miscarriage. Low birthweight occurred in 5.6% of babies. Both malaria and anaemia during pregnancy had no significant impact on birthweight of the babies. Although few of the babies had low birthweight, this number can be further reduced when pregnant women attend ANC and take SP at the recommended number of times.

Download Full-text

Problem of Malaria Infection

Saintika Medika ◽

10.22219/sm.v7i2.4071 ◽

2017 ◽

Vol 7 (2) ◽

Author(s):

Soebaktiningsih .

Keyword(s):

Public Health ◽

Plasmodium Falciparum ◽

Combination Treatment ◽

Health Problem ◽

Molecular Basis ◽

Malaria Infection ◽

Public Health Problem ◽

Malaria In Pregnancy ◽

Tropical Country ◽

In Pregnancy

Malaria is still Public Health Problem in tropical country. Failure of Mefloquine – Artesunate combination treatment of uncomplicated Plasmodium falciparum beginning to fail is due to the delayed clearance times and elevated Artesunate IC50, suggest thatArtesunate resistance may be emerging on background of Mefloquine resistance ( Rogers et al 2009). Pathogenesis of malaria in pregnancy is related to the ability of Plasmodium falciparum intra erythrocyte to sequester in the placenta. Study to understand the molecular basis of susceptibility to malaria in pregnancy has been advanced through the discovery of Chondroitin Sulfat A (CSA) molecule that support the accumulation of infected erythrocytes (IE) by Plasmodium falciparum in the placenta

Download Full-text

EFFECT OF COMMUNITY-BASED SCHEDULED SCREENING AND TREATMENT (CSST) OF MALARIA IN PREGNANCY ON INFANT MALARIA INFECTION IN A SEASONAL MALARIA TRANSMISSION SETTING

BMJ Global Health ◽

10.1136/bmjgh-2016-000260.76 ◽

2017 ◽

Vol 2 (Suppl 2) ◽

pp. A29.3-A30

Author(s):

Ngozi Moneke-Anyanwoke ◽

Julia Mwesigwa ◽

Muna Affara ◽

Jasseh Momodou ◽

Ed Clarke ◽

...

Keyword(s):

Malaria Transmission ◽

Malaria Infection ◽

Malaria In Pregnancy ◽

Community Based ◽

Transmission Setting ◽

In Pregnancy

Download Full-text

Anaemia, Body Mass Index and Risk Factors Association with Malarious Pregnant Women in Ebonyi State, Nigeria

Journal of Advances in Medical and Pharmaceutical Sciences ◽

10.9734/jamps/2020/v22i430167 ◽

2020 ◽

pp. 32-38

Author(s):

C. A. Imakwu ◽

J. C. Ozougwu ◽

O. P. Okeke ◽

G. U. Amana ◽

S. C. Eziuzor

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Pregnant Women ◽

Body Mass ◽

Primary Education ◽

Rainy Season ◽

Malaria Infection ◽

Malaria In Pregnancy ◽

Sub Saharan Africa ◽

In Pregnancy

Aims: Malaria in pregnancy is a weighty health problem in sub-Saharan Africa where 90% of the global malaria burden occurs, therefore there is urgent need for more researches on malaria in pregnancy to reduce its mortality and morbidity. Anaemia, body mass index and risk factors association with malarious pregnant women in Ebonyi State was investigated in this study. Study Design: A cross-sectional study on malaria infection among pregnant women in Ebonyi State, Nigeria was carried out from April 2011 to March 2012 from two selected hospitals. Methodology: Venous blood samples were collected for thick and thin films blood smears for microscopic examinations. Presence or absence of anaemia was determined by measuring haemoglobin concentration spectrophotometrically using the cyanmethemoglobin method. Chi-square (χ2) was used to analyse the data collected. Statistical significance was set at P < 0.05. Results: The result showed that out of 360 pregnant women sampled with average age of (26.54 ± 4.61), infection rate of 150 (41.7%) was observed. The prevalence of anaemia was 202(56.1%) and it was highly associated with malaria, infection was higher among pregnant women who were anaemic than those who were not. Also, body mass index is associated with malaria as it showed its highest prevalence amongst overweight pregnant women. The risk factors associated with malaria in this study were rainy season, primigravidae and primary education. Conclusion: Increased awareness about anaemia, body mass index and risk factors such as rainy season, primigravidae and primary education association with malaria as established in this study could help in the reduction of the burden of malaria among pregnant women.

Download Full-text

Sub-optimal Intermittent Preventive Treatment in pregnancy (IPTp) is associated with an increased risk of submicroscopic P. falciparum infection in pregnant women: a prospective cohort study in Benin

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1355 ◽

2020 ◽

Author(s):

Cornélia P A Hounkonnou ◽

Nicaise Tuikue Ndam ◽

Nadine Fievet ◽

Manfred Accrombessi ◽

Emmanuel Yovo ◽

...

Keyword(s):

Gestational Age ◽

Negative Binomial ◽

Intermittent Preventive Treatment ◽

Preventive Treatment ◽

Malaria In Pregnancy ◽

Sub Saharan Africa ◽

Increased Risk ◽

Sub Saharan ◽

The Impact ◽

In Pregnancy

Abstract Background Harmful maternal and neonatal health outcomes result from malaria in pregnancy, the prevention of which primarily relies on intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP). WHO recommends IPTp-SP in sub-Saharan Africa, but implementation is highly heterogeneous and often sub-optimal in terms of the number of doses and their timing. In this study, we assessed the impact of this heterogeneity on malaria in pregnancy, mainly with respect to submicroscopic Plasmodium falciparum infections. Methods We used data from 273 Beninese women followed throughout pregnancy. Screening for P. falciparum infections, using both microscopy- and polymerase chain reaction (PCR) -based methods, was performed monthly, and information on IPTp-SP dose was collected. Gestational age was estimated by repeated ultrasound scans. Using a negative binomial model, we investigated the effect of IPTp-SP doses and timing, after 17 weeks of gestation, on the number of P. falciparum infections, focusing on submicroscopic infections detectable only by PCR. Results At least two IPTp-SP doses were taken by 77.3% of the women. The median gestational age at first IPTp-SP dose was 22 weeks. A late first IPTp-SP dose (>21.2 weeks) was marginally associated with an increased number of P. falciparum infections (adjusted incidence rate ratio [aIRR] =1.3; p=0.098). The number of IPTp-SP doses was not associated with the number of submicroscopic infections (aIRR=1.2, p=0.543). Conclusion A late first IPTp-SP dose fail to provide optimal protection against P. falciparum, especially submicroscopic infections. This highlights the need for a new antimalarial drug for IPTp that could be taken early in pregnancy.

Download Full-text