Abstract
BackgroundIn areas of stable transmission, malaria during pregnancy is associated with severe maternal and foetal outcomes, especially low birth weight (LBW). To prevent these complications, weekly chloroquine (CQ) chemoprophylaxis is now being replaced by intermittent preventive treatment with sulfadoxine-pyrimethamine in West Africa. The prevalence of placental malaria and its burden on LBW were assessed in Benin to evaluate the efficacy of weekly CQ chemoprophylaxis, prior to its replacement by intermittent preventive treatment.MethodsIn two maternity clinics in Ouidah, an observational study was conducted between April 2004 and April 2005. At each delivery, placental blood smears were examined for malaria infection and women were interviewed on their pregnancy history including CQ intake and dosage. CQ was measured in the urine of a sub-sample (n = 166). Multiple logistic and linear regression were used to assess factors associated with LBW and placental malaria.ResultsAmong 1090 singleton live births, prevalence of placental malaria and LBW were 16% and 17% respectively. After adjustment, there was a non-significant association between placental malaria and LBW (adjusted OR = 1.43; P = 0.10). Multiple linear regression showed a positive association between placental malaria and decreased birth weight in primigravidae. More than 98% of the women reported regular chemoprophylaxis and CQ was detectable in 99% of urine samples. Protection from LBW was high in women reporting regular CQ prophylaxis, with a strong duration-effect relationship (test for linear trend: P < 0,001).ConclusionDespite high parasite resistance and limited effect on placental malaria, a CQ chemoprophylaxis taken at adequate doses showed to be still effective in reducing LBW in Benin.
Highlights
In areas of stable transmission, malaria during pregnancy is associated with severe maternal and foetal outcomes, especially low birth weight (LBW)
Pregnant women are at increased risk of Plasmodium falciparum infection [1,2] which leads to increased morbidity and mortality for the mother and her child
In areas of stable transmission, where women have developed acquired malaria immunity, malaria during pregnancy often does not cause symptomatic infection, it increases the risk for maternal anaemia or death, and low birth weight (LBW) [3,4]
Summary
In areas of stable transmission, malaria during pregnancy is associated with severe maternal and foetal outcomes, especially low birth weight (LBW) To prevent these complications, weekly chloroquine (CQ) chemoprophylaxis is being replaced by intermittent preventive treatment with sulfadoxine-pyrimethamine in West Africa. It was estimated that around 100,000 infant deaths occur annually in malaria endemic areas in Africa due to pregnancy associated malaria [6] In these areas, primigravidae have higher prevalence of placental malaria and its associated complications [7,8]. Primigravidae have higher prevalence of placental malaria and its associated complications [7,8] This relates to the property of parasitized erythrocytes to adhere to chondroitin sulphate A (CSA) by means of parasite variant surface antigens (VSA) expressed on the surface of infected erythrocytes. These induce cytoadherence inhibiting VSACSAspecific antibodies which increase in prevalence with increasing parity [9,10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
