Abstract
BackgroundMaternal immunity is thought to play a major role in the increased susceptibility of pregnant women to Plasmodium falciparum malaria. Few studies exist on immunohistochemical characterization of the placental inflammatory infiltrate. The current study was conducted in Gadarif hospital in an area characterized by unstable malaria transmission in eastern Sudan.MethodNinety three placentae were investigated for malaria histological changes and immunohistochemical study for monocytes and macrophages (CD68).ResultsWhile 1(1.1%), 2(2.2%) and 20(21.5%) of the 93 placentae had acute, chronic and past malaria infections, 70(75.2%) had no malaria infections. Monocytes and macrophage (CD 68) were detected in 29 (31.2%) of these 93 placentae. Significantly higher rate of monocytes and macrophage were detected in placentae with malaria infections [11/23 (47.8%) vs. 18/70 (25.7%); P = 0.047] especially in placentae with past malaria infections. Placental malaria infections and monocytes and macrophages cells infiltration were not different between primiparae and multiparae. There was no significant difference in the birth weight between the women with placental malaria infections/monocytes and macrophages cells infiltration and those who had no placental malaria infections/cellular infiltrations.ConclusionSignificantly higher rate of monocytes and macrophage were detected in placentae with malaria infections. Neither placental malaria infections nor cellular infiltrates were associated with parity or lead to reduction of birth weight.
Highlights
Malaria during pregnancy is a major public health problem in tropical and subtropical regions; each year 25 million African women become pregnant in malaria endemic areas [1]
Higher rate of monocytes and macrophage were detected in placentae with malaria infections [11/23 (47.8%) vs. 18/70 (25.7%); P = 0.047] especially in placentae with past malaria infections
There was no significant difference in the birth weight between the women with placental malaria infections/monocytes and macrophages cells infiltration and those who had no placental malaria infections/cellular infiltrations
Summary
Malaria during pregnancy is a major public health problem in tropical and subtropical regions; each year 25 million African women become pregnant in malaria endemic areas [1]. Malaria during pregnancy is a huge burden in Sudan [3,5] and it is one of the leading causes of maternal mortality [6]. P. falciparum-infected placentae are characterized by an increase in inflammatory cells in the intervillous space [13,14]. We identified monocytes and macrophages in the placenta immunohistochemically, using monoclonal antibodies to CD68, in samples from women in Gadarif hospital which is located in an area characterized by unstable malaria transmission in eastern Sudan [19]. Maternal immunity is thought to play a major role in the increased susceptibility of pregnant women to Plasmodium falciparum malaria.
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