Changing Trends in P. falciparum Burden, Immunity, and Disease in Pregnancy
N. Engl. j. med
; : 1607-1617, out.22.2015. ilus, graf
Artigo
em Inglês
| AIM (África), Sec. Est. Saúde SP, RDSM
| ID: biblio-1527423
Biblioteca responsável:
MZ1.1
ABSTRACT
Background:
Prevention of reinfection and resurgence is an integral component of the goal to eradicate malaria. However, the adverse effects of malaria resurgences are not known.Methods:
We assessed the prevalence of Plasmodium falciparum infection among 1819 Mozambican women who delivered infants between 2003 and 2012. We used microscopic and histologic examination and a quantitative polymerase-chain-reaction (qPCR) assay, as well as flow-cytometric analysis of IgG antibody responses against two parasite lines.Results:
Positive qPCR tests for P. falciparum decreased from 33% in 2003 to 2% in 2010 and increased to 6% in 2012, with antimalarial IgG antibody responses mirroring these trends. Parasite densities in peripheral blood on qPCR assay were higher in 2010-2012 (geometric mean [±SD], 409±1569 genomes per microliter) than in 2003-2005 (44±169 genomes per microliter, P=0.02), as were parasite densities in placental blood on histologic assessment (50±39% of infected erythrocytes vs. 4±6%, P<0.001). The malaria-associated reduction in maternal hemoglobin levels was larger in 2010-2012 (10.1±1.8 g per deciliter in infected women vs. 10.9±1.7 g per deciliter in uninfected women; mean difference, -0.82 g per deciliter; 95% confidence interval [CI], -1.39 to -0.25) than in 2003-2005 (10.5±1.1 g per deciliter vs. 10.6±1.5 g per deciliter; difference, -0.12 g per deciliter; 95% CI, -0.67 to 0.43), as was the reduction in birth weight (2863±440 g in women with past or chronic infections vs. 3070±482 g in uninfected women in 2010-2012; mean difference, -164.5 g; 95% CI, -289.7 to -39.4; and 2994±487 g vs. 3117±455 g in 2003-2005; difference, -44.8 g; 95% CI, -139.1 to 49.5).Conclusions:
Antimalarial antibodies were reduced and the adverse consequences of P. falciparum infections were increased in pregnant women after 5 years of a decline in the prevalence of malaria. (Funded by Malaria Eradication Scientific Alliance and others).
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Brasil
Base de dados:
AIM (África)
/
RDSM
/
Sec. Est. Saúde SP
Assunto principal:
Complicações Infecciosas na Gravidez
/
Imunoglobulina G
/
Malária Falciparum
Limite:
Adulto
/
Feminino
/
Humanos
/
Gravidez
País/Região como assunto:
África
Idioma:
Inglês
Revista:
N. Engl. j. med
Ano de publicação:
2015
Tipo de documento:
Artigo
Instituição/País de afiliação:
Barcelona Institute for Global Health (ISGlobal), Barcelona Center for International Health Research (CRESIB), and Hospital Clínic-Universitat de Barcelona/ES
/
Centro de Investigação em Saúde da Manhiça (CISM)/ES
/
Centro de Investigação em Saúde da Manhiça (CISM)/MZ
/
International Center for Genetic Engineering and Biotechnology/IN