Sub-microscopic infections and long-term recrudescence of Plasmodium falciparum in Mozambican pregnant women
Malar. j. (Online)
; 8(9): 1-9, jan 9. 2009. tab, ilus, graf
Article
in English
| AIM (Africa), RSDM
| ID: biblio-1525554
Responsible library:
MZ1.1
ABSTRACT
Background:
Control of malaria in pregnancy remains a public health challenge. Improvements in its correct diagnosis and the adequacy of protocols to evaluate anti-malarial drug efficacy in pregnancy, are essential to achieve this goal.Methods:
The presence of Plasmodium falciparum was assessed by real-time (RT) PCR in 284 blood samples from pregnant women with clinical complaints suggestive of malaria, attending the maternity clinic of a Mozambican rural hospital. Parasite recrudescences in 33 consecutive paired episodes during the same pregnancy were identified by msp1 and msp2 genotyping.Results:
Prevalence of parasitaemia by microscopy was 5.3% (15/284) and 23.2% (66/284) by RT-PCR. Sensitivity of microscopy, compared to RT-PCR detection, was 22.7%. Risk of maternal anaemia was higher in PCR-positive women than in PCR-negative women (odds ratio [OR] = 1.92, 95% confidence interval [CI] 1.09-3.36). Genotyping confirmed that recrudescence after malaria treatment occurred in 7 (21%) out of 33 pregnant women with consecutive episodes during the same pregnancy (time range between recrudescent episodes 14 to 187 days).Conclusion:
More accurate and sensitive diagnostic indicators of malaria infection in pregnancy are needed to improve malaria control. Longer follow-up periods than the standard in vivo drug efficacy protocol should be used to assess anti-malarial drug efficacy in pregnancy
Full text:
Available
Collection:
National databases
/
MZ
Database:
AIM (Africa)
/
RSDM
Main subject:
Plasmodium falciparum
/
Pyrimethamine
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Protozoan Proteins
/
Malaria, Falciparum
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Pregnancy Complications, Parasitic
Limits:
Female
/
Humans
/
Pregnancy
Language:
English
Journal:
Malar. j. (Online)
Year:
2009
Document type:
Article
Institution/Affiliation country:
Institut d'Investigacions biomèdiques august Pi i Sunyer, universitat de barcelona+ES
/
Institut d'Investigacions biomèdiques august Pi i Sunyer, universitat de barcelona+MZ