Prevalence of <i>Plasmodium falciparum</i> Submicroscopic Infection and Pregnancy Outcomes in Congolese Women at Delivery

Abstract

Suphodoxine-Pyrimethamine (SP) acts by inhibiting <i>P. falciparum</i> replication, therefore, long term use of SP in malarial endemic sittings as intermittent preventive treatment (IPT) during pregnancy might lead to increased risk of submicroscopic parasitaemia. The present study aimed to determine the prevalence of submicroscopic <i>P. falciparum</i> infection in women at delivery from southern Brazzaville, where IPT-SP has been implemented since 2004, and investigate the relationship between the submicroscopic parasitaemia and pregnancy outcomes. This descriptive cross-sectional study was carried out from March 2014 to April 2015 with 281 women randomly recruited at delivery at a Health Centre in southern Brazzaville, Republic of Congo. Matched peripheral, placental, and cord blood collected from each women with malaria negative thick smears, were used for the diagnostic of <i>P.falciparum</i> submicroscopic infection by nested-polymerase chain reaction (nPCR) targeting the multi-copy 18 S ribosomal ARN gene. The prevalence of <i>P.falciparum</i> submicroscopic infection was 31.7%, 36.37%, and 12.9%, when using the peripheral, placental, and cord blood respectively. The submicroscopic <i>P. falciparum</i> was slightly associated with increased risk of maternal anaemia (adjusted odds ratio [OR] 1.33, 95% CI 0.82-2.17). No significant association was found between the submicroscopic parasitaemia and low birth weight, or preterm delivery. The data suggest that the prevalence of submicroscopic <i>P. falciparum</i> infection is high in women at delivery in Brazzaville; and might increase the risk for maternal anaemia. The infection had no impact on the prevalence of low birth weight and preterm delivery in this study sitting.