Editorial Commentary: Plasmodium vivaxInfection during Pregnancy: An Important Problem in Need of New Solutions

Abstract

Plasmodium vivax the most widespread parasite causing human malaria is responsible for an estimated 130-435 million infections annually and is the major cause of malaria in most of Asia and Latin America. Although P. vivax infection is commonly considered to be much more benign than Plasmodium falciparum infection historical evidence suggests significant mortality associated with P. vivax malaria in the pre-antimalarial era and death caused by P. vivax malaria has been increasingly recognized over the past few years. In this issue of Clinical Infectious Diseases Poespoprodjo et al. report the impact of P. vivax infection on pregnancy outcomes in Papua Indonesia. Of 50 million pregnancies occurring each year in countries where malaria is endemic approximately one-half occur in areas where P. vivax malaria is endemic. P. falciparum malaria during pregnancy is a well-known cause of maternal and fetal morbidity and mortality. Each year an estimated 10000 maternal deaths result from malarial anemia and 60-200000 infant deaths result from malaria-associated low birth weight in Africa. In areas of low transmission such as in many areas of Latin America and the Asia-Pacific region (and where adults migrate from malaria-free areas to areas of endemicity) pregnant women may have limited prepregnancy immunity and may be susceptible to symptomatic and severe disease. Symptomatic malaria may lead to preterm delivery and fetal loss and neonates of nonimmune mothers may be at a particular risk of congenital malaria resulting from transplacental passage of parasites. (excerpt)