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Seasonal Dynamics of Malaria in Pregnancy in West Africa: Evidence for Carriage of Infections Acquired Before Pregnancy Until First Contact with Antenatal Care

In malaria-endemic areas, Plasmodium falciparum prevalence is often high in young women because of 1) low use of insecticide-treated nets before their first pregnancy and 2) acquired immunity, meaning infections are asymptomatic and thus untreated. Consequently, a common source of malaria in pregnan...

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Detalles Bibliográficos
Autores principales: Berry, Isha, Walker, Patrick, Tagbor, Harry, Bojang, Kalifa, Coulibaly, Sheick Oumar, Kayentao, Kassoum, Williams, John, Oduro, Abraham, Milligan, Paul, Chandramohan, Daniel, Greenwood, Brian, Cairns, Matthew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The American Society of Tropical Medicine and Hygiene 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5929207/
https://www.ncbi.nlm.nih.gov/pubmed/29210351
http://dx.doi.org/10.4269/ajtmh.17-0620
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author Berry, Isha
Walker, Patrick
Tagbor, Harry
Bojang, Kalifa
Coulibaly, Sheick Oumar
Kayentao, Kassoum
Williams, John
Oduro, Abraham
Milligan, Paul
Chandramohan, Daniel
Greenwood, Brian
Cairns, Matthew
author_facet Berry, Isha
Walker, Patrick
Tagbor, Harry
Bojang, Kalifa
Coulibaly, Sheick Oumar
Kayentao, Kassoum
Williams, John
Oduro, Abraham
Milligan, Paul
Chandramohan, Daniel
Greenwood, Brian
Cairns, Matthew
author_sort Berry, Isha
collection PubMed
description In malaria-endemic areas, Plasmodium falciparum prevalence is often high in young women because of 1) low use of insecticide-treated nets before their first pregnancy and 2) acquired immunity, meaning infections are asymptomatic and thus untreated. Consequently, a common source of malaria in pregnancy (MiP) may be infected women becoming pregnant, rather than pregnant women becoming infected. In this study, prevalence of infection was determined by microscopy at first antenatal care (ANC) visit in primigravidae and secundigravidae in Ghana, Burkina Faso, Mali, and The Gambia, four countries with strong seasonal variations in transmission. Duration of pregnancy spent in the rainy season and other risk factors for infection were evaluated using multivariable Poisson regression. We found that the overall prevalence of malaria at first ANC was generally high and increased with time spent pregnant during the rainy season: prevalence among those with the longest exposure was 59.7% in Ghana, 56.7% in Burkina Faso, 42.2% in Mali, and 16.8% in Gambia. However, the prevalence was substantial even among women whose entire pregnancy before first ANC had occurred in the dry season: 41.3%, 34.4%, 11.5%, and 7.8%, respectively, in the four countries. In multivariable analysis, risk of infection was also higher among primigravidae, younger women, and those of lower socioeconomic status, independent of seasonality. High prevalence among women without exposure to high transmission during their pregnancy suggests that part of the MiP burden results from long-duration infections, including those acquired preconception. Prevention of malaria before pregnancy is needed to reduce the MiP burden.
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spelling pubmed-59292072018-05-08 Seasonal Dynamics of Malaria in Pregnancy in West Africa: Evidence for Carriage of Infections Acquired Before Pregnancy Until First Contact with Antenatal Care Berry, Isha Walker, Patrick Tagbor, Harry Bojang, Kalifa Coulibaly, Sheick Oumar Kayentao, Kassoum Williams, John Oduro, Abraham Milligan, Paul Chandramohan, Daniel Greenwood, Brian Cairns, Matthew Am J Trop Med Hyg Articles In malaria-endemic areas, Plasmodium falciparum prevalence is often high in young women because of 1) low use of insecticide-treated nets before their first pregnancy and 2) acquired immunity, meaning infections are asymptomatic and thus untreated. Consequently, a common source of malaria in pregnancy (MiP) may be infected women becoming pregnant, rather than pregnant women becoming infected. In this study, prevalence of infection was determined by microscopy at first antenatal care (ANC) visit in primigravidae and secundigravidae in Ghana, Burkina Faso, Mali, and The Gambia, four countries with strong seasonal variations in transmission. Duration of pregnancy spent in the rainy season and other risk factors for infection were evaluated using multivariable Poisson regression. We found that the overall prevalence of malaria at first ANC was generally high and increased with time spent pregnant during the rainy season: prevalence among those with the longest exposure was 59.7% in Ghana, 56.7% in Burkina Faso, 42.2% in Mali, and 16.8% in Gambia. However, the prevalence was substantial even among women whose entire pregnancy before first ANC had occurred in the dry season: 41.3%, 34.4%, 11.5%, and 7.8%, respectively, in the four countries. In multivariable analysis, risk of infection was also higher among primigravidae, younger women, and those of lower socioeconomic status, independent of seasonality. High prevalence among women without exposure to high transmission during their pregnancy suggests that part of the MiP burden results from long-duration infections, including those acquired preconception. Prevention of malaria before pregnancy is needed to reduce the MiP burden. The American Society of Tropical Medicine and Hygiene 2018-02 2017-12-04 /pmc/articles/PMC5929207/ /pubmed/29210351 http://dx.doi.org/10.4269/ajtmh.17-0620 Text en © The American Society of Tropical Medicine and Hygiene This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Articles
Berry, Isha
Walker, Patrick
Tagbor, Harry
Bojang, Kalifa
Coulibaly, Sheick Oumar
Kayentao, Kassoum
Williams, John
Oduro, Abraham
Milligan, Paul
Chandramohan, Daniel
Greenwood, Brian
Cairns, Matthew
Seasonal Dynamics of Malaria in Pregnancy in West Africa: Evidence for Carriage of Infections Acquired Before Pregnancy Until First Contact with Antenatal Care
title Seasonal Dynamics of Malaria in Pregnancy in West Africa: Evidence for Carriage of Infections Acquired Before Pregnancy Until First Contact with Antenatal Care
title_full Seasonal Dynamics of Malaria in Pregnancy in West Africa: Evidence for Carriage of Infections Acquired Before Pregnancy Until First Contact with Antenatal Care
title_fullStr Seasonal Dynamics of Malaria in Pregnancy in West Africa: Evidence for Carriage of Infections Acquired Before Pregnancy Until First Contact with Antenatal Care
title_full_unstemmed Seasonal Dynamics of Malaria in Pregnancy in West Africa: Evidence for Carriage of Infections Acquired Before Pregnancy Until First Contact with Antenatal Care
title_short Seasonal Dynamics of Malaria in Pregnancy in West Africa: Evidence for Carriage of Infections Acquired Before Pregnancy Until First Contact with Antenatal Care
title_sort seasonal dynamics of malaria in pregnancy in west africa: evidence for carriage of infections acquired before pregnancy until first contact with antenatal care
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5929207/
https://www.ncbi.nlm.nih.gov/pubmed/29210351
http://dx.doi.org/10.4269/ajtmh.17-0620
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