Malaria Infection In Pregnancy Research Articles

Sub-microscopic Plasmodium falciparum infections and multiple drug resistant single nucleotide polymorphic alleles in pregnant women from southwestern Nigeria

ObjectivesThe study evaluated sub-microscopic malaria infections in pregnancy using two malaria Rapid Diagnostic Tests (mRDTs), microscopy and RT-PCR and characterized Plasmodium falciparum dihydrofolate reductase (Pfdhfr) and Plasmodium falciparum dihydropteroate synthase (Pfdhps) drug resistant markers in positive samples.MethodsThis was a cross sectional survey of 121 pregnant women. Participants were finger pricked, blood drops were collected for rapid diagnosis with P. falciparum histidine-rich protein 11 rapid diagnostic test kit and the ultra-sensitive Alere Pf malaria RDT, Blood smears for microscopy and dried blood spots on Whatman filter paper for molecular analysis were made. Real time PCR targeting the var acidic terminal sequence (varATS) gene of P. falciparum was carried out on a CFX 96 real time system thermocycler (BioRad) in discriminating malaria infections. For each run, laboratory strain of P. falciparum 3D7 and nuclease free water were used as positive and negative controls respectively. Additionally, High resolution melt analyses was employed for genotyping of the different drug resistance markers.ResultsOut of one hundred and twenty-one pregnant women sampled, the SD Bioline™ Malaria Ag P.f HRP2-based malaria rapid diagnostic test (mRDT) detected eight (0.06%) cases, the ultra-sensitive Alere™ malaria Ag P.f rapid diagnostic test mRDT had similar outcome in the same samples as detected by the HRP2-based mRDT. Microscopy and RT-PCR confirmed four out of the eight infections detected by both rapid diagnostic tests as true positive and RT-PCR further detected three false negative samples by the two mRDTs providing a sub-microscopic malaria prevalence of 3.3%. Single nucleotide polymorphism in Pfdhps gene associated with sulphadoxine resistance revealed the presence of S613 mutant genotypes in three of the seven positive isolates and isolates with mixed wild/mutant genotype at codon A613S. Furthermore, four mixed genotypes at the A581G codon were also recorded while the other Pfdhps codons (A436G, A437G and K540E) showed the presence of wild type alleles. In the Pfdhfr gene, there were mutations in 28.6%, 28.6%, and 85.7% at the I51, R59 and N108 codons respectively. Mixed wild and mutant type genotypes were also observed in 28.6% each of the N51I, and C59R codons. For the Pfcrt, two haplotypes CVMNK and CVIET were observed. The SVMNT was altogether absent. Triple mutant CVIET 1(14.3%) and triple mutant + wild genotype CVIET + CVMNK 1(14.3%) were observed. The Pfmdr1 haplotypes were single mutants YYND 1(14.3%); NFND 1(14.3%) and double mutants YFND 4(57.1%); YYDD 1(14.3%).

Prevalence of Malaria Infection in Pregnant Women Attending Antenatal Clinics in Southern Senegal.

Despite marked progress in Senegal, three regions in the southeast part continue to have a high burden of malaria, but there have been no recent studies assessing the prevalence of malaria associated with pregnancy. This study aimed to determine the prevalence of malaria infection in pregnant women attending antenatal clinics in Senegal. During the malaria transmission season of 2019, pregnant women attending 11 health care facilities for a scheduled visit and those presenting unwell with signs of malaria were invited to participate in a malaria screening study. A finger prick blood sample was taken for malaria diagnosis by rapid diagnosis test (RDT) and polymerase chain reaction (PCR). A total of 877 pregnant women were enrolled, 787 for a scheduled antenatal consultation and 90 for an unscheduled consultation with signs of malaria. The prevalence of Plasmodium falciparum among the first group was 48% by PCR and 20% by RDT, and that among the second group was 86% by PCR and 83% by RDT. RDT sensitivity in capturing asymptomatic, PCR-positive infections was 9.2% but ranged from 83% to 94% among febrile women. The prevalence of infection by PCR in women who reported having received at least three doses of sulfadoxine pyrimethamine (SP) was 41.9% compared with 58.9% in women who reported they had not received any SP doses (prevalence ratio adjusted for gravidity and gestational age, 0.54; 95% CI, 0.41-0.73). The burden of P. falciparum infections remains high among pregnant women, the majority of which are not captured by RDT. More effective measures to prevent malaria infection in pregnancy are needed.

Iron supplementation during malaria infection in pregnancy and childhood: A review

Malaria presents a significant global public health challenge, with severe malarial anaemia being a primary manifestation of the disease. The understanding of anaemia caused by malaria remains incomplete, making the treatment more complex. Iron is a crucial micronutrient essential for haemoglobin synthesis, oxygen delivery, and other vital metabolic functions in the body. It is indispensable for the growth of human beings, as well as bacteria, protozoa, and viruses in vitro and in vivo. Iron deficiency is among the most common nutritional deficiencies and can have detrimental effects during developmental stages of life. Malaria-induced iron deficiency occurs due to the hemolysis of erythrocytes and the suppression of erythropoiesis, leading to anaemia. Meeting iron requirements is particularly critical during pivotal life stages such as pregnancy, infancy, and childhood. Dietary intake alone may not suffice to meet adequate iron requirements, thus highlighting the vital role of iron supplementation. While iron supplementation can alleviate iron deficiency, it can exacerbate malaria infection by providing additional iron for the parasites. However, in the context of pregnancy and childhood, iron supplementation combined with malaria prevention and treatment has been shown to be beneficial in improving birth outcomes and ensuring proper growth and development, respectively. This review aims to identify the role and impact of iron supplementation in malaria infection during the life stages of pregnancy and childhood.

Utilization of Insecticide Treated Nets Among Pregnant Women Attending Antenatal Clinics in Selected Hospitals in Igbo-Eze North Local Government Area- Enugu State- South-East, Nigeria

Background: Malaria infection in pregnancy complicates about 32 million pregnancies each year in endemic areas in sub-Saharan Africa and can be life-threatening for both the mother and child (World Health Organization (WHO), 2017). The severe burden of disease has led to a global fight to control malaria. The World Malaria Report states that by the end of 2010, adequate insecticide-treated mosquito nets would have been delivered to sub-Saharan Africa to protect about 580 million people. This would protect 76% of the population at risk. More than 75 million people have received protection from indoor residual spray (WHO, 2017). Malaria increases the risk of adverse pregnancy outcomes for mothers, fetuses, and newborns. Aim: The study aimed to assess the utilization of insecticide treated nets among pregnant women attending antenatal clinics in some selected hospitals in Igbo-Eze North Local Government Area (LGA) of Enugu State. Method: This study adopted a cross sectional study design. The sample consists of Two hundred (200) pregnant women who attended antenatal clinics in the selected health centres of Igbo Eze North Local Government Area of Enugu State and were selected through a convenient sampling technique. The instruments for data collection were a self-structured questionnaire and an interview guide for those who could not read and write. Findings: Results showed high ownership of ITN with a poor level of utilization; no significant relationship between the pregnant women’s age, parity, and utilization of insecticide-treated net. Conclusions: The study concluded that high ownership of ITN does not translate to a good utilization level. It recommended a combination of subsidy and mass education campaigns to boost utilization.

Prevalence of Malaria Infection among Pregnant Women Attending Some Antenatal Clinics in Gombe State, Nigeria

Malaria continues to be a major health problem in endemic countries; it has been identified in many studies to worsen certain pregnancy outcomes, leading to an increase in morbidity and mortality. There are an estimated 100 million malaria cases with over 300,000 deaths per year in Nigeria. This study was aimed at assessing the prevalence of malaria among pregnant women living in Gombe State. A total of 725 Pregnant Women attending antenatal clinic from six selected general hospitals in Gombe State were examined, and blood samples collected from the subjects were analysed. Malaria diagnosis were carried out using standard parasitological techniques. The overall results showed that of the 725 samples examined, 31.9% were positive and 68.1% negative. The degree of parasitemia evealed mild in 78.4%, moderate in 17.3% and severe in 4.33%. Age group 21-25 (12.3%) had more infection, followed by age group 31-35 (7.31%), 26 30 (5.65%), 15-20 (4.00%), 36-40 (2.20%), 41-45(0.27%) and 46-50 (0.14%). More infections were recorded among pregnant women in their third trimester 19.7%(143) compared with those in second trimester 10.9%(79) and first trimester 1.24%(9) respectively. Malaria infection was also higher among multigravid 8.8%(136) pregnant women than among primigravid 8.41%(61) and secondigravid 4.68 (34) pregnant women. However, there was no significant difference (P > 0.05) between prevalence of infection with Age group, trimester and gravidity of the pregnant women. This research work has provided information at the local level on the spread of malaria parasites in pregnant women in Gombe State. There is therefore the need for increase sensitization and awareness on the effect of malaria infection in pregnancy which will in turn enhance prevention, management and control.

Fetal sex and risk of pregnancy-associated malaria in Plasmodium falciparum-endemic regions: a meta-analysis

In areas of moderate to intense Plasmodium falciparum transmission, malaria in pregnancy remains a significant cause of low birth weight, stillbirth, and severe anaemia. Previously, fetal sex has been identified to modify the risks of maternal asthma, pre-eclampsia, and gestational diabetes. One study demonstrated increased risk of placental malaria in women carrying a female fetus. We investigated the association between fetal sex and malaria in pregnancy in 11 pregnancy studies conducted in sub-Saharan African countries and Papua New Guinea through meta-analysis using log binomial regression fitted to a random-effects model. Malaria infection during pregnancy and delivery was assessed using light microscopy, polymerase chain reaction, and histology. Five studies were observational studies and six were randomised controlled trials. Studies varied in terms of gravidity, gestational age at antenatal enrolment and bed net use. Presence of a female fetus was associated with malaria infection at enrolment by light microscopy (risk ratio 1.14 [95% confidence interval 1.04, 1.24]; P = 0.003; n = 11,729). Fetal sex did not associate with malaria infection when other time points or diagnostic methods were used. There is limited evidence that fetal sex influences the risk of malaria infection in pregnancy.

Prevalence of and risk factors for microscopic and submicroscopic malaria infections in pregnancy: a systematic review and meta-analysis

Malaria infections during pregnancy can cause adverse birth outcomes, yet many infections are undetected by microscopy. We aimed to describe the epidemiology of submicroscopic malaria infections in pregnant women in Asia, the Americas, and Africa using aggregated and individual participant data (IPD). For this systematic review and meta-analysis, studies (published Jan 1, 1997 to Nov 10, 2021) with information on both microscopic and submicroscopic infections during pregnancy from Asia, the Americas, or Africa, identified in the Malaria-in-Pregnancy Library, were eligible. Studies (or subgroups or study groups) that selected participants on the basis of the presence of fever or a positive blood smear were excluded to avoid selection bias. We obtained IPD (when available) and aggregated data. Estimates of malaria transmission intensity and sulfadoxine-pyrimethamine resistance, matched by study location and year, were obtained using publicly available data. One-stage multivariable logit and multinomial models with random intercepts for study site were used in meta-analysis to assess prevalence of and risk factors for submicroscopic infections during pregnancy and at delivery. This study is registered with PROSPERO, number CRD42015027342. The search identified 87 eligible studies, 68 (78%) of which contributed to the analyses. Of these 68 studies, 45 (66%) studies contributed IPD (48 869 participants) and 23 (34%) studies contributed aggregated data (11 863 participants). During pregnancy, median prevalence estimates were 13·5% (range 0·0-55·9, 66 substudies) for submicroscopic and 8·0% (0·0-50·6, 66 substudies) for microscopic malaria. Among women with positive Plasmodium nucleic acid amplification tests (NAATs), the median proportion of submicroscopic infections was 58·7% (range 0·0-100); this proportion was highest in the Americas (73·3%, 0·0-100), followed by Asia (67·2%, 36·4-100) and Africa (56·5%, 20·5-97·7). In individual patient data analysis, compared with women with no malaria infections, those with submicroscopic infections were more likely to present with fever in Africa (adjusted odds ratio 1·32, 95% CI 1·02-1·72; p=0·038) but not in other regions. Among women with NAAT-positive infections in Asia and the Americas, Plasmodium vivax infections were more likely to be submicroscopic than Plasmodium falciparum infections (3·69, 2·45-5·54; p<0·0001). Risk factors for submicroscopic infections among women with NAAT-positive infections in Africa included older age (age ≥30 years), multigravidity, and no HIV infection. During pregnancy, submicroscopic infections are more common than microscopic infections and are associated with fever in Africa. Malaria control in pregnancy should target both microscopic and submicroscopic infections. Bill & Melinda Gates Foundation through the Worldwide Antimalarial Resistance Network.

Sub-microscopic Plasmodium falciparum parasitaemia, dihydropteroate synthase (dhps) resistance mutations to sulfadoxine–pyrimethamine, transmission intensity and risk of malaria infection in pregnancy in Mount Cameroon Region

BackgroundPlasmodium falciparum resistance to intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) continues to spread throughout sub-Saharan Africa. This study assessed the occurrence of microscopic and sub-microscopic P. falciparum parasitaemia, dihydropteroate synthase mutations associated with resistance to SP and maternal anaemia in the Mount Cameroon area.MethodsConsenting pregnant women living in semi-rural and semi-urban/urbanized settings were enrolled in this cross-sectional study. Socio-demographic, antenatal and clinical data were documented. Microscopic and sub-microscopic parasitaemia were diagnosed using peripheral blood microscopy and nested polymerase chain reaction (PCR) respectively. The dhps mutations were genotyped by restriction fragment length polymorphism analysis. The presence of A437G, K540E, and A581G was considered a marker for high-level resistance. Haemoglobin levels and anaemia status were determined.ResultsAmong the women, the prevalence of microscopic and sub-microscopic P. falciparum infection were 7.7% (67/874) and 18.6% (93/500) respectively. Predictors of microscopic infection were younger age (< 21 years) (AOR = 2.89; 95% CI 1.29–6.46) and semi-rural settings (AOR = 2.27; 95% CI 1.31–3.96). Determinants of sub-microscopic infection were the rainy season (AOR, 3.01; 95% CI 1.77–5.13), primigravidity (AOR = 0.45; 95% CI 0.21–0.94) and regular ITN usage (AOR = 0.49; 95% CI 0.27–0.90). Of the145 P. falciparum isolates genotyped, 66.9% (97) carried mutations associated with resistance to SP; 33.8% (49), 0%, 52.4% (76) and 19.3% (28) for A437G, K540E, A581G and A437G + A581G respectively. The A581G mutation was associated with ≥ 3 SP doses evident only among sub-microscopic parasitaemia (P = 0.027) and multigravidae (P = 0.009). Women with microscopic infection were more likely from semi-rural settings (AOR = 7.09; 95% CI 2.59–19.42), to report history of fever (AOR = 2.6; 95% CI 1.07–6.31), to harbour parasites with double resistant mutations (AOR = 6.65; 95% CI 1.85–23.96) and were less likely to have received 2 SP doses (AOR = 0.29; 95% CI 1.07–6.31). Microscopic infection decreased Hb levels more than sub-microscopic infection.ConclusionThe occurrence of sub-microscopic P. falciparum parasites resistant to SP and intense malaria transmission poses persistent risk of malaria infection during pregnancy in the area. ITN usage and monitoring spread of resistance are critical.

The association between maternal malaria infection and poor birth outcomes in a remote community in Papua, Indonesia

Background Sikari is a remote district in Papua, Indonesia, which is malaria-endemic. Malaria infection during pregnancy has been linked to poor birth outcomes.&#x0D; Objective To evaluate for an association between malaria infection in pregnancy and birth outcome.&#x0D; Methods This cohort study compared the outcomes of newborns from mothers infected with malaria during pregnancy vs. uninfected controls. We included clinical data of 82 pregnant women from January to December 2020 at the Batavia Public Health Center, Sikari District, Mamberamo Raya, Papua. Malaria diagnosis was established based on the World Health Organization (WHO) criteria and positive rapid diagnostic tests. The maternal and infant characteristics analyzed were years of formal education, antenatal care (ANC) visits, gestational age, obstetric history, diagnosis of malaria, birth weight, APGAR score, and newborn mortality.&#x0D; Results Forty-six mothers (56.1%) were diagnosed with malaria during pregnancy, of whom 33 (71.7%) had tropical malaria, 7 (15.2%) had tertian malaria, and 6 (13.0%) had mixed malaria. Malaria infections of any type were associated with an increased risk of preterm birth (OR 5.34; 95%CI 1.10 to 25.91; P=0.04), low birth weight (LBW) (OR 49.00; 95%CI 28.62 to 838.89; P=0.00), newborn mortality (OR 13.86; 95%CI 0.76 to 251.37; P=0.04), and low 5-minute APGAR score (OR 23.65; 95%CI 1.34 to 416.61; P=0.03). Tropical malaria was associated with a higher risk of preterm birth (OR 5.44; 95%CI 1.06 to 27.86; P=0.04), LBW (OR 15.22; 95%CI 1.82 to 127.02; P=0.01), newborn mortality (OR 14.09; 95%CI 0.75 to 265.48; P=0.04), and low APGAR (OR 24.33; 95%CI 1.34 to 440.77; P=0.03). Mixed malaria was associated with a higher risk of LBW (OR 35.00; 95%CI 2.73 to 449.10; P=0.01) and low APGAR score (OR 40.56; 95%CI 1.67 to 985.39; P=0.02).&#x0D; Conclusion Malaria infections are associated with an increased risk of preterm birth, low birth weight, newborn mortality, and low 5-minute APGAR scores.

Systematic Review: Prevalensi dan Dampak Infeksi Malaria pada Wanita Hamil dan Neonatal

Globally, malaria cases in the world reached 241 million cases in 2020 and increase from the previous year. Malaria infection in pregnant women was reported in 33 countries, and the cases were estimated at 11.6 million (34%). Malaria infection can increase maternal and fetal morbidity and mortality, including anemia in pregnancy, low birth weight, premature birth, stillbirth, and small gestation age, and congenital malaria. This article discusses pregnant women's malaria infection prevalence and maternal and neonatal outcomes. This paper is a systematic review by searching for articles using electronic databases from Pubmed and ScienceDirect using keywords “Malaria” and “Pregnancy” or “Pregnant Women” and “Outcome” or “Impact” and “Maternal” or “Neonatal”. The selection of articles used the PRISMA guidelines which were then analyzed in a narrative manner. Based on the article search results obtained 10 articles that meet the criteria for analysis. The prevalence of malaria infection in pregnancy is still high. Reported outcomes in pregnancy, birth, and neonates include preterm birth, low birth weight, small gestation age, maternal anemia, and maternal and neonatal mortality. The role of health workers is very important to prevent malaria infection in pregnancy so that it does not result in adverse health impacts for maternal and neonatal.

Determinants of utilization of malaria preventive measures during pregnancy among women aged 15 to 49 years in Kenya: an analysis of the Malaria Indicator Survey 2020

BackgroundMalaria is a significant cause of morbidity and mortality. Malaria infection in pregnancy can have severe consequences for the fetus and the mother. To fight against malaria infection in pregnancy, Kenya integrated the issuance of an insecticide-treated net (ITN) and intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTpSP) with antenatal care (ANC) for pregnant women. However, the uptake of the ITN and IPTpSP is still low. Individual, social, or structural factors may influence the low uptake. It is, therefore, important to identify the determinants associated with the uptake of ITN and IPTpSP during pregnancy in Kenya.MethodsData were from the 2020 Kenya Malaria Indicator Survey (MIS). A total of 1779 women between the ages of 15 to 49 years who had a history of either being pregnant or having given birth within 5 years before the MIS survey were included. Survey-adjusted multinomial logistic regression was used in the analysis.ResultsDuring pregnancy, ITN use was more than half (54.9%). The use of at least one dose of IPTpSP was 43.5%, three or more doses of IPTpSP was 27.2%, and only 28.2% of the participants used both ITN and IPTpSP during pregnancy. The significant determinants of combined use of ITN and IPTpSP during pregnancy were maternal age (RR 3.57, CI 1.80–7.08; p=<0.001), maternal education (RRR 2.84, CI 1.33–6.06; p=0.007), wealth index (RR 2.14, CI 1.19–3.84; p=0.011) and living in the different malaria epidemiological zones: lake endemic (RRR 10.57 CI 5.65–19.76; p=<0.001), coastal endemic area (RRR 4.86 CI 1.86–12.67; p=0.001), seasonal (RRR 0.21 CI 0.10–0.39; p=<0.001) and low risk (RRR 0.07, CI 0.03–0.17; p=<0.001).ConclusionThe uptake of malaria preventive measures is still below 80% for both ITN and IPTpSP during pregnancy in Kenya. The significant results on determinants of the use of ITN and IPTpSP could be considered in implementing malaria prevention programmes during pregnancy. For example, sensitizing the community on the importance of antenatal care visits will provide a platform to teach the importance of malaria prevention in pregnancy. Moreover, the pregnant mothers receive an ITN and IPTpSP during the ANC visit.

Malaria Parasite Infection is associated with Inflammatory and Endothelial Dysregulation in Preeclampsia

Abstract Introduction/Objective Previous Studies have associated Preeclampsia with alterations in inflammation and endothelial dysfunction . However the relationship between the pathway of this alteration and the Malaria infection in pregnancy remains underexplored, especially in malaria endemic regions like Nigeria where there is high incidence of preeclampsia. Methods/Case Report A comparative cross-sectional study was carried out among 260 pregnant women at term (18-45 years); comprising 100 preeclamptic with Malaria (PEM), 80 preeclamptic without Malaria (PE2) and 80 Normotensive, Non Malaria (Control), at Federal Medical Center Owerri, Nigeria. The groups were matched for maternal age, gestational age, gravidity and body mass index. Fasting serum lipids were analyzed by Enzymatic colorimetric method. Some Inflammatory and anti-angiogenic markers; Vascular Endothelial growth factor (VEGF), Plasminogen Activator inhibitor 1, Intracellular adhesion molecule, CRP. IL 6 and IL 8 were tested by Magnetic multiplex ELISA. Results (if a Case Study enter NA) There were significantly higher levels of Total Cholesterol, LDL and triglyceride among the 2 pre-eclamptic groups (PEM,PE2) compared to the normotensive nonmalaria group; P&amp;lt; 0.001, p=0.001, p=0.003 respectively, while HDL was decreased in the pre-eclamptic groups against the normotensive nonmalaria group (P = 0.024). PAI-1 and VEGF expressed significantly higher levels in the pre- eclamptic groups (PEM,PE2) compared to the normotensive nonmalaria group (P &amp;lt; 0.0001, P=0.000). Based on Malaria exposure, PAI-1, and IL8 were significantly elevated in PEM group (P &amp;lt; 0.0001) compared to the PE2 and normotensive nonmalaria group. There was no significant difference in the CRP and ICAM-I between the 2 preeclamptic groups (PEM and PE2). Conclusion These findings demonstrated that Malaria is associated with dysregulated inflammation and endothelia function, which may enhance the pathogenesis of Preeclampsia. Further studies on the predictive role of PAI-I in the pathophysiology and diagnosis of Malaria and preeclampsia is hence suggested.

Prevention of malaria in pregnancy: The threat of sulfadoxine-pyrimethamine resistance.

Malaria infection in pregnancy can lead to adverse outcomes for both the pregnant person and fetus. The administration of intermittent preventative therapy (IPTp) with sulfadoxine-pyrimethamine (SP) during pregnancy (IPTp-SP) improves outcomes, including severe maternal anemia, placental malaria infection, and low infant birth weight. The WHO recommends IPTp-SP for pregnant individuals living in areas of moderate or high malaria transmission in Africa. The current regimen consists of two or more doses of SP starting as early as possible in the second trimester, at least 1 month apart. Unfortunately, rising Plasmodium falciparum SP resistance throughout Africa threatens to erode the benefits of SP. Recent studies have shown a decrease in IPTp-SP efficacy in areas with high SP resistance. Thus, there is an urgent need to identify new drug regimens that can be used for intermittent preventative therapy in pregnancy. In this review, we discuss recent data on P. falciparum SP resistance in Africa, the effect of resistance on IPTp-SP, and studies of alternative IPTp regimens. Finally, we present a framework for the ideal pharmacokinetic and pharmacodynamic properties for future IPTp regimens.

Can platelet indices be of value in pregnant women with malaria?

Malaria infection in pregnancy is a serious disease with feto-maternal adverse outcomes. In this study we evaluated and compared the haematologic parameters of pregnant women with and without malarial infection. This case-control study included a total of 145 participants (59 pregnant women with malaria and 86 aparasitemic pregnant women). Haematological parameters were evaluated using an automated hemo-analyser. Haemoglobin, platelet, white blood cell and platelet distribution width (PDW) of pregnant women with malaria were found to be significantly lower than pregnant without malaria. However, the mean platelet volume (MPV) of pregnant women with malaria was significantly higher than those without infection. Impact Statement What is already known on this subject? Malaria infection in pregnancy is a serious disease and may affect haematological parameters. What do the results of this study add? Platelet indices were significantly changed in malaria. Especially mean platelet volume (MPV) with malaria was significantly higher than those without infection. What are the implications of these findings for clinical practice and/or further research? Among the expected differences in haematologic parameters of pregnant women with malaria, the increase in MPV has been a novel finding. The increase in MPV level of pregnant with malaria should be investigated further to address the value of MPV as a prognostic factor.

HIV and malaria prevalence among pregnant women with and without pre-eclampsia at the Atua Government Hospital in Ghana's eastern region.

To evaluate the association of malaria and HIV with pre-eclampsia by evaluating their prevalence among pregnant women. Using a case-control study design, we randomly sampled the antenatal records of 125 pregnant women with clinician-diagnosed pre-eclampsia (cases) and 125 others without pre-eclampsia (controls) who visited Atua Government Hospital in the eastern region of Ghana between June 2014 and January 2017. All selected records had available routine HIV and malaria test results and were analyzed statistically. In all 250 records, 122 (48.8%) were HIV positive and 35 (14.0%) had malaria. Of the 122 HIV-positive pregnant women, 29 (23.8%) were cases and 93 (76.2%) were controls; of the 35 women with malaria, one was in the case group (1/35, 2.9%) and the other 34 (97.1%) were in the control. Group. Pregnant women with pre-eclampsia had lower odds of HIV infection (odds ratio [OR] 0.10, 95% confidence interval [CI] 0.06-0.19: adjusted AOR 0.07, 95% CI 0.04-0.13, P< 0.001). Similarly, pregnant women with pre-eclampsia had lower odds of having malaria infection (OR 0.02, 95% CI 0.00-0.17, P= 0.025; adjusted OR 0.00, 95% CI 0.00-0.01, P< 0.001). Women with pre-eclampsia had lower odds of HIV and malaria infection in pregnancy.

Risk Factors For Malaria Incidence In Pregnant Women In Puskemas Bosnik And Marau Regency Biak Numfor

Malaria infection in pregnancy is very detrimental to both the mother and the fetus it contains, because it can increase the morbidity and mortality of the mother and fetus. The prevalence of malaria in Papua Province with Annual Parasite Incendence in 2016 amounted to 208.95 per thousand population, the prevalence of malaria in pregnant women in Papua Province as much as (3.09%). The prevalence of malaria in pregnant women in Biak Numfor Regency in 2017 was 4.11%. The purpose of this study was to determine the risk factors for the incidence of malaria in pregnant women at the Bosnik and Marau Health Centers, Biak Numfor Regency in 2018.This study is an observational study with case control design in pregnant women in the Bosnik Health Center and Marauw Health Center area of Biak Numfor Regency. The study sample with simple random sampling was 27 pregnant women as cases and 27 pregnant women as control.data analised with chi square test. From the results of a multivariate analysis found 2 (two) variables associated with malaria incidence in pregnant women, namely sleeping not using mosquito nets (OR = 3,768 p = 0.024 95% CI 1,158-12,270) and Hb anemia &lt; 9 gr% (OR = 5,500 p = 0.013 95% CI 1,323-22,862) while 3 (three) variables namely low economic status, first parity and ≥ 4 and nutritional status is not associated with malaria incidence. Risk factors for malaria incidence in pregnant women are related to sleep habits not using mosquito nets and anemia Hb &lt; 9gr%.

Berghei model of gestational is associated with decreased locomotion and increased maternal anxiety.

Gestational Malaria has adverse health effects on the mother and the neonate. It results in severe anemia, spontaneous abortion, stillbirths, cerebral malaria, and acute renal failure. At least 6 million worldwide are at risk of malaria infection in pregnancy, with at least 10,000 maternal deaths and 200,000 newborn deaths annually. It has been known as an obstetric, medical, and social problem requiring both multidisciplinary and multidimensional intervention; for this reason, this study investigated the effect of Gestational malaria on the cerebellum of adult female mice&#x0D; The study was performed on twenty-one mice (male and female) of almost the same age range and weighed about 16g to 22g, and they were divided into groups (infected and control group). The female mice were mated in the ratio of two to one male per cage. Pregnant mice were inoculated with Plasmodium berghei intraperitoneally. Bodyweight was taken regularly, and the animals went through neurobehavioral tests to measure fear, anxiety, locomotion, and balance. The mice were sacrificed after delivery, and the cerebellum was excised, weighed, and processed for histological analysis and stained with Hematoxylin &amp; Eosin stain and Nissl stain&#x0D; The study revealed significant (p&lt;0.05) alteration in body weight, fear, anxiety, balance, and locomotion. Histologically, there was a substantial decrease in the neuronal density and cell size of the cerebellum of the infected mice group compared with the control group&#x0D; Plasmodium berghei model of gestational malaria showed a reduction in locomotion and body weight and an increase in anxiety which was mediated via the morphological and functional derangement of the cerebellum&#x0D; &#x0D; Keywords: Gestational malaria, plasmodium Berghei, Anxiety, cerebellum, Locomotion.&#x0D;

Malaria in the First Trimester of Pregnancy and Fetal Growth: Results from a Beninese Preconceptional Cohort.

Malaria in early pregnancy occurs at a time when the placenta is developing, with possible consequences for placental function and fetal growth. We assessed the association between first trimester malaria and fetal growth documented through repeated ultrasound scans. The RECIPAL preconceptional cohort included 411 Beninese pregnant women followed from 7 weeks' gestation (wg) until delivery. Among them, 218 had 4 scans for fetal monitoring at 16, 22, 28, and 34 wg. Multivariate seemingly unrelated regression models were used to assess association of microscopic malaria in the first trimester (<15 wg) with abdominal circumference, head circumference, biparietal diameter, and femur length throughout pregnancy. Of 39% (86/218) of women with at least 1 microscopic malarial infection during pregnancy, 52.3% (45/86) were infected in the first trimester. Most women (88.5%) were multiparous. There was no association between adjusted z-scores for fetal growth parameters and first trimester malaria. Parity, newborn sex, socioeconomic level, and maternal body mass index significantly influenced fetal growth. In a context where malaria infections in pregnancy are well detected and treated, their adverse effect on fetal growth may be limited. Our results argue in favor of preventing and treating infections as early as the first trimester.

Trends of malaria infection in pregnancy in Ghana over the past two decades: a review

BackgroundThere has been a global decline in malaria transmission over the past decade. However, not much is known of the impact of this observation on the burden of malaria infection in pregnancy in endemic regions including Ghana. A narrative review was undertaken to help describe trends in malaria infection in pregnancy in Ghana. Among others, such information is important in showing any progress made in malaria in pregnancy control.MethodsTo describe trends in pregnancy-associated malaria infection in Ghana, a search and review of literature reporting data on the prevalence of asymptomatic Plasmodium falciparum infection in pregnancy was conducted.ResultsThirty-six (36) studies, conducted over 1994–2019, were included in the review. In the northern savannah zone with largely seasonal malaria transmission, prevalence appeared to reduce from about 50–60% in 1994–2010 to 13–26% by 2019. In the middle transitional/forest zone, where transmission is perennial with peaks in the rainy season, prevalence apparently reduced from 60% in the late 1990 s to about 5–20% by 2018. In the coastal savannah area, there was apparent reduction from 28 to 35% in 2003–2010 to 5–11% by 2018–2019. The burden of malaria infection in pregnancy continues to be highest among teenagers and younger-aged pregnant women and paucigravidae.ConclusionsThere appears to be a decline in asymptomatic parasite prevalence in pregnancy in Ghana though this has not been uniform across the different transmission zones. The greatest declines were noticeably in urban settings. Submicroscopic parasitaemia remains a challenge for control efforts. Further studies are needed to evaluate the impact of the reduced parasite prevalence on maternal anaemia and low birthweight and to assess the local burden of submicroscopic parasitaemia in relation to pregnancy outcomes.

Distance matters: barriers to antenatal care and safe childbirth in a migrant population on the Thailand-Myanmar border from 2007 to 2015, a pregnancy cohort study

BackgroundAntenatal care and skilled childbirth services are important interventions to improve maternal health and lower the risk of poor pregnancy outcomes and mortality. A growing body of literature has shown that geographic distance to clinics can be a disincentive towards seeking care during pregnancy. On the Thailand-Myanmar border antenatal clinics serving migrant populations have found high rates of loss to follow-up of 17.4%, but decades of civil conflict have made the underlying factors difficult to investigate. Here we perform a comprehensive study examining the geographic, demographic, and health-related factors contributing to loss to follow-up.MethodsUsing patient records we conducted a spatial and epidemiological analysis looking for predictors of loss to follow-up and pregnancy outcomes between 2007 and 2015. We used multivariable negative binomial regressions to assess for associations between distance travelled to the clinic and birth outcomes (loss to follow-up, pregnancy complications, and time of first presentation for antenatal care.)ResultsWe found distance travelled to clinic strongly predicts loss to follow-up, miscarriage, malaria infections in pregnancy, and presentation for antenatal care after the first trimester. People lost to follow-up travelled 50% farther than people who had a normal singleton childbirth (a ratio of distances (DR) 1.5; 95% confidence interval (CI): 1.4 – 1.5). People with pregnancies complicated by miscarriage travelled 20% farther than those who did not have miscarriages (DR: 1.2; CI 1.1–1.3), and those with Plasmodium falciparum malaria in pregnancy travelled 60% farther than those without P. falciparum (DR: 1.6; CI: 1.6 – 1.8). People who delayed antenatal care until the third trimester travelled 50% farther compared to people who attended in the first trimester (DR: 1.5; CI: 1.4 – 1.5).ConclusionsThis analysis provides the first evidence of the complex impact of geography on access to antenatal services and pregnancy outcomes in the rural, remote, and politically complex Thailand-Myanmar border region. These findings can be used to help guide evidence-based interventions to increase uptake of maternal healthcare both in the Thailand-Myanmar region and in other rural, remote, and politically complicated environments.