Pregnant women are a reservoir of malaria transmission in Blantyre, Malawi

Malaria Journal

Research

Phillip C Thesing¹  Terrie E Taylor²  Lauren M Cohee³  Miriam K Laufer³  Sarah Boudová³  Steve Kamiza⁴  Atis Muehlenbachs⁵  Linda Kalilani-Phiri⁶ 

[1] Blantyre Malaria Project, University of Malawi College of Medicine, Blantyre, Malawi;Blantyre Malaria Project, University of Malawi College of Medicine, Blantyre, Malawi;Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, ichigan State University, East Lansing, MI, USA;Center for Vaccine Development, School of Medicine, University of Maryland, Baltimore, MD, USA;Department of Histopathology, University of Malawi College of Medicine, Blantyre, Malawi;Department of Pathology, University of Washington, Seattle, WA, USA;University of Malawi College of Medicine, Blantyre, Malawi;

关键词: Malaria;    Pregnancy;    Malawi;    Gametocyte;    Intermittent preventive treatment;    Sulphadoxine-pyrimethamine;   

DOI  :  10.1186/1475-2875-13-506

 received in 2014-10-02, accepted in 2014-12-09,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundDuring pregnancy, women living in malaria-endemic regions are at increased risk of malaria infection and can harbour chronic placental infections. Intermittent preventive treatment with sulphadoxine-pyrimethamine (SP-IPTp) is administered to reduce malaria morbidity. It was hypothesized that the presence of placental malaria infection and SP-IPTp use would increase the risk of peripheral blood gametocytes, the parasite stage that is transmissible to mosquitoes. This would suggest that pregnant women may be important reservoirs of malaria transmission.MethodsLight microscopy was used to assess peripheral gametocytaemia in pregnant women enrolled in a longitudinal, observational study in Blantyre, Malawi to determine the association between placental malaria and maternal gametocytaemia. The relationship between SP-IPTp and gametocytaemia was also examined.Results2,719 samples from 448 women were analysed and 32 episodes of microscopic gametocytaemia were detected in 27 women. At the time of enrolment 22 of 446 women (4.9%) had gametocytaemia and of the 341 women for whom there was sufficient sampling to analyse infection over the entire course of pregnancy, 27 (7.9%) were gametocytaemic at least once. Gametocytaemia at enrolment was associated with placental malaria, defined as malaria pigment or parasites detected by histology or qPCR, respectively (OR: 32.4, 95% CI: 4.2-250.2), but was not associated with adverse maternal or foetal outcomes. Administration of SP-IPTp did not affect gametocyte clearance or release into peripheral blood.ConclusionsGametocytaemia is present in 5% of pregnant women at their first antenatal visit and associated with placental malaria. SP-IPTp does not alter the risk of gametocytaemia. These data suggest that pregnant women are a significant reservoir of gametocyte transmission and should not be overlooked in elimination efforts. Interventions targeting this population would benefit from reaching women prior to first antenatal visit.

【 授权许可】

CC BY   
© Boudová et al.; licensee BioMed Central. 2014