Problem. Congenital plasmodial infection (CPI) is a rare event, which has been little studied in Colombia. Objective. To measure the frequency of CPI and to describe the immune and histological characteristics in maternal blood and placentas when CPI occurs. Methodology. A cross-sectional study was carried out in northwest Colombia. A sample size of 39 unit analysis (a unit of analysis corresponds to the cord, placenta, and peripheral blood of a pregnant woman) was calculated using epidemiological and statistical parameters. Thick blood smear (TBS) and quantitative real-time polymerase chain reaction (qPCR) were used as diagnostic tests. Results and Conclusions. A total of 137 parturient women were studied. All cases of CPI were submicroscopic (TBS negative and qPCR positive) and asymptomatic infections. If the definition of CPI considers only detection of parasites in umbilical cord blood, regardless of what was found in peripheral or placental blood, the frequency of CPI was 27%. However, if that definition is stricter and includes simultaneous detection of parasites in maternal or placental blood with the same species, the frequency of CPI in this study was 13%.
Objetivo: evaluar, con el protocolo de la Organización Mundial de la Salud (OMS) de 1998, la respuesta terapéutica antimalárica (RTA) y los eventos adversos (EA) en cuatro esquemas de tratamiento antiplasmodial en gestantes colombianas, con diagnóstico de malaria no complicada por P. vivax o por P. falcipaum, según gota gruesa. Materiales y métodos: experimento controlado aleatorizado en paralelo. Se calculó un tamaño muestral de 60 pacientes con P. vivax y 30 con P. falciparum. Se evaluaron cuatro tratamientos: malaria vivax en cualquier trimestre de gestación tratada con cloroquina o con amodiaquina; malaria falciparum en trimestres 2 y 3, terapia tratada con artesunatomefloquina o arteméter-lumefantrina. Se hizo seguimiento por 28 días. Se midió la proporción de falla terapéutica y de eventos adversos. Los grupos se comparan mediante análisis univariado. El protocolo Eficacia tErapéutica y EvEntOs advErsOs dE trataMiEntOs para MaLaria VIVAX y MaLaria FALCIPARUM En gEstantEs En Las rEgiOnEs dE urabá y aLtO san JOrgE, cOLOMbia, 2008-2011 therapeutic efficacy and adverse events of treatments for vivax and falciparum malaria in pregnant women in the regions of uraba and alto san Jorge, colombia,
Most research on placental malaria is focused on microscopic infection by Plasmodium falciparum; there are very few studies on submicroscopic infection. This study aimed to assess alterations of placental tissue associated with placental malaria, to describe the immune cell populations in the placental tissue, and to explore the relationships between the histopathological changes and cell infiltrates. A descriptive, prospective and cross-sectional study was carried out. Women were recruited at hospital obstetric facilities in three municipalities in Northwest Colombia. The histopathological analysis was performed in a total of 132 placentas including 66 placentas with submicroscopic plasmodial infection and 66 that were negatives. Immunohistochemistry was performed on a subset of 75 placentas to determine the distribution of immune cells. Based on histology, there were more immune cells in placentas with submicroscopic plasmodial infection compared with those without infection. The quantity of syncytial knots and calcifications was greater with submicroscopic plasmodial infection, but the quantity of abruption and thrombi was greater in placentas without infection. By immunohistochemistry, we observed a significant increase of CD56+ and CD68+ cells in the infected placentas. Submicroscopic plasmodial infection in the placenta causes tissue alterations and increased immune cell infiltrates. Submicroscopic plasmodial infection is very common in Colombia and can represent a serious threat to mothers and newborns.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.