期刊
CLINICAL INFECTIOUS DISEASES
卷 73, 期 2, 页码 E355-E361出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciaa841
关键词
malaria; pregnancy; Africa; genotyping techniques; polymerase chain reaction
资金
- Bill and Melinda Gates Foundation [OPP1169555]
- French Agence Nationale de la Recherche [ANR-13-JSV1-0004]
- Fondation Simone Beer under the auspices of the Fondation de France [00074147]
- Bill and Melinda Gates Foundation [OPP1169555] Funding Source: Bill and Melinda Gates Foundation
The study found that almost half of the P. falciparum infections detected in early pregnancy were already present before pregnancy. Protecting young women from malaria infection before pregnancy could reduce the prevalence of malaria in early pregnancy and improve maternal and birth outcomes.
Background. Malaria infections in the first trimester of pregnancy are frequent and deleterious for both mother and child health. To investigate if these early infections are newly acquired or already present in the host, we assessed whether parasites detected before pregnancy and those detected in early pregnancy are the same infection. Methods. We used data from the preconceptional RECIPAL study (Benin, 2014-2017). Sixty-three pregnant women of 411 included who had a malaria infection detected by quantitative polymerase chain reaction both before pregnancy and at the first antenatal care (ANC) visit were selected for this study. Two highly polymorphic markers, msp-2 and glurp, and a fragment-analysis method were used to enumerate the Plasmodium falciparum genotypes and to quantify their proportions within isolates. An infection was considered as persistent when identical rasp-2 and glurp genotypes were found in the corresponding prepregnancy and early-pregnancy samples. Results. The median time between the 2 malaria screenings was 3 months. The median gestational age at the first ANC visit was 6.4 weeks. Most infections before pregnancy were submicroscopic infections. Based on both msp-2 and glurp genotyping, the infection was similar before and in early pregnancy in 46% (29/63) of cases. Conclusions. Almost half of P. falciparum infections detected in the first trimester originate before pregnancy. Protecting young women from malaria infection before pregnancy might reduce the prevalence of malaria in early pregnancy and its related poor maternal and birth outcomes.
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