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Burden and impact of Plasmodium vivax in pregnancy: A multi-centre prospective observational study

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Podeu consultar dades primàries associades a l'article a: http://hdl.handle.net/2445/111582

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BACKGROUND: Despite that over 90 million pregnancies are at risk
                of Plasmodium vivax infection annually, little is known about
                the epidemiology and impact of the infection in pregnancy.
                METHODOLOGY AND PRINCIPAL FINDINGS: We undertook a health
                facility-based prospective observational study in pregnant women
                from Guatemala (GT), Colombia (CO), Brazil (BR), India (IN) and
                Papua New Guinea PNG). Malaria and anemia were determined during
                pregnancy and fetal outcomes assessed at delivery. A total of
                9388 women were enrolled at antennal care (ANC), of whom 53%
                (4957) were followed until delivery. Prevalence of P. vivax
                monoinfection in maternal blood at delivery was 0.4% (20/4461)
                by microscopy [GT 0.1%, CO 0.5%, BR 0.1%, IN 0.2%, PNG 1.2%] and
                7% (104/1488) by PCR. P. falciparum monoinfection was found in
                0.5% (22/4463) of women by microscopy [GT 0%, CO 0.5%, BR 0%, IN
                0%, PNG 2%]. P. vivax infection was observed in 0.4% (14/3725)
                of placentas examined by microscopy and in 3.7% (19/508) by PCR.
                P. vivax in newborn blood was detected in 0.02% (1/4302) of
                samples examined by microscopy [in cord blood; 0.05% (2/4040) by
                microscopy, and 2.6% (13/497) by PCR]. Clinical P. vivax
                infection was associated with increased risk of maternal anemia
                (Odds Ratio-OR, 5.48, [95% CI 1.83-16.41]; p = 0.009), while
                submicroscopic vivax infection was not associated with increased
                risk of moderate-severe anemia (Hb<8g/dL) (OR, 1.16, [95% CI
                0.52-2.59]; p = 0.717), or low birth weight (<2500g) (OR,
                0.52, [95% CI, 0.23-1.16]; p = 0.110). CONCLUSIONS: In this
                multicenter study, the prevalence of P. vivax infection in
                pregnancy by microscopy was overall low across all endemic study
                sites; however, molecular methods revealed a significant number
                of submicroscopic infections. Clinical vivax infection in
                pregnancy was associated with maternal anemia, which may be
                deleterious for infant's health. These results may help to guide
                maternal health programs in settings where vivax malaria is
                endemic; they also highlight the need of addressing a vulnerable
                population such as pregnant women while embracing malaria
                elimination in endemic countries.

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PLoS Neglected Tropical Diseases, 2017, vol. 11, num. 6, p. e0005606

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Articles publicats en revistes (ISGlobal)

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Burden and impact of Plasmodium vivax in pregnancy: A multi-centre prospective observational study