BackgroundMalaria during pregnancy remains a serious public health problem. The aim of this study was to determine the prevalence and possible risk factors for malaria in pregnant women attending antenatal clinic at two primary health facilities in Bobo-Dioulasso.MethodsWe conducted a cross sectional study from September to December 2010 in two primary health facilities located in the periurban area of Bobo-Dioulasso. Pregnant women attending antenatal clinic (ANC) were included in the study after signing informed consent. For each participant, the social-demographic profile, malaria and obstetric histories were investigated through a questionnaire. Peripheral blood was collected and thick and thin blood smears were prepared to check Plasmodium falciparum parasitaemia. Hemoglobin concentration was measured. The associations between age, parity, gestational age, schooling, number of ANC visits, use of IPTp-SP, use of insecticide-treated nets (ITN) and anemia with the occurrence of P. falciparum malaria infection during pregnancy were analyzed through logistic regression.ResultsDuring the period of study, 105 (18.1%) out of 579 pregnant women were infected by P. falciparum. The hemoglobin concentration mean was 10.5 ± 1.7/dL and was significantly lower in pregnant women with malaria infection (9.8 g/dL ±1.6) than in those who had no malaria infection (10.6 g/dL ±1.7) (P < 0.001). Multivariate analysis indicated that, education (AOR 1.9, 95% CI = [1.2-3.2]), parity [primigravidae (AOR 5.0, 95% CI = [2.5-9.8]) and secundigravidae (AOR 2.1, 95% CI = [1.2-3.8])], and anaemia (AOR 2.1, 95% CI = [1.3-3.5]) were significantly associated with P. falciparum malaria infection. The use of IPTp-SP was not associated with P. falciparum malaria infection.ConclusionsP. falciparum malaria infection is common in pregnant women attending antenatal clinic and anaemia is an important complication. The results show that the use of IPTp-SP does not reduce the risk of malaria incidence during pregnancy.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0631-z) contains supplementary material, which is available to authorized users.

SummaryWe investigated the relationship between the two main molecular markers for chloroquine resistance (Pfcrt T76 and Pfmdr-1 Y86) and the clinical efficacy of amodiaquine in Burkina Faso. Before treatment, the prevalence of Pfcrt T76, Pfmdr-1 Y86 or both mutations in the same infection was significantly higher in patients who experienced a recrudescence than in those who successfully responded to the treatment. Therefore, these two molecular markers could be useful in monitoring amodiaquine resistance, particularly in countries where this drug is used in combination with artesunate as first-or second-line treatment.keywords malaria, Plasmodium falciparum, drug resistance, amodiaquine, Pfcrt, Pfmdr-1Although chloroquine (CQ) and amodiaquine (AQ) are chemically similar; AQ might still be effective where CQ resistance is high (Gorissen et al. 2000;Staedke et al. 2001;Tinto et al. 2006). Nevertheless, several in vitro studies have shown cross-resistance between CQ and AQ or monodeshethyl-AQ, the active metabolite of AQ (Gonzalez et al. 2003;Tinto et al. 2006). This suggests that molecular markers linked to CQ resistance, such as Pfcrt T76 and Pfmdr-1 Y86, might be useful for monitoring AQ resistance (Ochong et al. 2003). We investigated the relationship between the two main CQ resistance markers (Pfcrt T76 and Pfmdr-1 Y86) and the clinical efficacy of AQ in children aged 6 months to 15 years. The study was conducted in Burkina Faso in two sites with differing intensity of malaria transmission; the north with an entomological inoculation rate (EIR) estimated at around 15-20 infecting bites ⁄ man ⁄ year and the centre with an EIR estimated to be around 50 to 60 infecting bites ⁄ man ⁄ year (T. Baldet, personal communication). Children were treated and followed up according to the World Health Organization (WHO) 28-day in vivo test (WHO 2003). Outcomes were defined according to the WHO classification for monitoring antimalarial drug resistance (World Health Organization 2003). Blood samples for the molecular analysis were collected on filter paper (Whatman 3; Maidstone, England) at day 0 before treatment and at the time of recurrent parasitaemia. DNA was extracted using the Chelex-100 method (Plowe et al. 1995). Detection of Pfcrt T76 and Pfmdr-1 Y86 mutations was done by using PCR followed by sequence-specific restriction enzyme digestion (Djimdé et al. 2001a). Nested PCR (Ranford-Cartwright et al. 1997) was adopted for the analysis of Msp1 and Msp2 to distinguish between recrudescence and new infection.Outcome at day 28 was known for most patients enrolled (90%, 195 ⁄ 217). The PCR-corrected total treatment failure (TTF) was 6% (12 ⁄ 195) with no difference between the two sites (P = 0.6) nor age groups [<5 years vs. >5 years (P = 0.11)].Before treatment, the prevalence of the Pfcrt T76, Pfmdr-1 Y86 or both mutations in the same infection was significantly higher among the TTF than among the adequate clinical and parasitological response (ACPR) samples (P = 0.03; P = 0.007; and P = 0.001, respectively) ( Table 1)...