Abstract
BackgroundThe frequency of pregnancy-associated malaria is increasingly being documented in American countries. In Colombia, with higher frequency of Plasmodium vivax over Plasmodium falciparum infection, recent reports confirmed gestational malaria as a serious public health problem. Thick smear examination is the gold standard to diagnose malaria in endemic settings, but in recent years, molecular diagnostic methods have contributed to elucidate the dimension of the problem of gestational malaria. The study was aimed at exploring the prevalence of gestational, placental and congenital malaria in women who delivered at the local hospitals of north-west Colombia, between June 2008 and April 2011.MethodsA group of 129 parturient women was selected to explore the prevalence of gestational, placental and congenital malaria in a descriptive, prospective and transversal (prevalence) design. Diagnosis was based on the simultaneous application of two independent diagnostic tests: microscopy of thick blood smears and a polymerase chain reaction assay (PCR).ResultsThe prevalence of gestational malaria (thick smear /PCR) was 9.1%/14.0%; placental malaria was 3.3%/16.5% and congenital malaria was absent. A history of gestational malaria during the current pregnancy was significantly associated with gestational malaria at delivery. Plasmodium vivax caused 65% of cases of gestational malaria, whereas P. falciparum caused most cases of placental malaria.ConclusionsGestational and placental malaria are a serious problem in the region, but the risk of congenital malaria is low. A history of malaria during pregnancy may be a practical indicator of infection at delivery.
Highlights
The frequency of pregnancy-associated malaria is increasingly being documented in American countries
A report based on samples from the same region (2004–2006) found a prevalence of gestational malaria of 14.0% and placental malaria of 10.5% [8]
Another study on Plasmodium infection at the time of delivery, reported a prevalence of gestational malaria of 13% with microscopy, but the frequency increased to 32% with a polymerase chain reaction (PCR) assay [9]
Summary
The frequency of pregnancy-associated malaria is increasingly being documented in American countries. In regions of high stable transmission, they might acquire significant clinical immunity before pregnancy, and placental malaria is often asymptomatic, but it can produce severe maternal anaemia and foetal growth restriction [1]. In such regions, placental malaria is common in first-time mothers, and women develop specific immunity against placental infection over successive pregnancies. Another study on Plasmodium infection at the time of delivery, reported a prevalence of gestational malaria of 13% with microscopy, but the frequency increased to 32% with a polymerase chain reaction (PCR) assay [9]. The diagnostic capacity of histopathology was superior to that of microscopy and PCR, mainly because the basis of the histopathology diagnosis is the observation of the parasite and/or the malarial pigment
Sign-in/Register to view highlights & summary 
Published Version (
Free)
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 call