Assessment of malaria in pregnancy using rapid diagnostic tests and its association with HIV infection and hematologic parameters in South-Eastern Nigeria

Abstract

Letters to the Editor haematologica | 2008; 93(1) | 143 | Assessment of malaria in pregnancy using rapid diagnostic tests and its association with HIV infection and hematologic parameters in South-Eastern Nigeria P. falciparum malaria in pregnancy was evaluated using histidine-rich proteins-2 RDT and related to HIV infection and hematologic parameters. Prevalence of malaria, HIV and anemia were 19.7%, 3.1% and 17.2% respectively. Primigravidae were significantly more infected with malaria. Malaria was not significantly associated with anemia, blood group, genotype and HIV infection. Haematologica. 2008 Jan; 93:(1) 143-144. DOI: 10.3324/haematol.11695 The enormous significance of malaria in pregnancy for public health makes early and accurate diagnosis of malaria absolutely imperative. Obtaining results quickly from the examination of blood samples from pregnant women with suspected malaria is now made possible by the use of rapid malaria diagnostic tests (RDTs). 1Although their use in developing countries has been limited by their high cost, RDTs have advantages over microscopy in their diagnostic precision and potential to help reduce drug costs due to over-prescription. In this study, we evaluated malaria in pregnancy using a P. falciparum RDT that detects histidine-rich proteins-2 (HRP-2) and its association with maternal HIV infection and hematologic parameters. This study was conducted in Abakaliki, south-eastern Nigeria, from June 2006 to December 2006 at the Ebonyi State University Teaching Hospital (EBSUTH). Approval was obtained from the Ethical Committee of the EBSUTH. Pregnant women at full term who were admitted at EBSUTH for childbirth and who fulfilled the following study inclusion criteria were enrolled: (i) attended the antenatal clinic at EBSUTH, (ii) had an uncomplicated singleton pregnancy ≥32 weeks' gestation (based on fundal height estimation), (iii) resident in Abakaliki or neighbouring local government areas, (iv) had no obvious clinical evidence of malaria (asymptomatic), and (v) had no known underlying chronic illness. After receiving informed consent, information about participants' age and parity were obtained from the case files of each individual and by interview. Shortly before child birth, about 5 mL of the maternal peripheral blood was obtained from each participant by venepuncture technique and placed in a sterile EDTA container for laboratory analysis.A rapid diagnostic test kit, the Smart Check Malaria P.f cassette (Globalemed, 1101 King St. Suite 370, Alexandria, VA 22314 USA) was used to assess malaria infection. The hemoglobin concentration (HbC) was determined using the cyanmethemoglobin method.2 The WHO definition of anemia in pregnancy, i.e., Hb<11g/dL, 3 was adopted. The hemoglobin genotype was determined by the Hemoglobin electrophoresis technique at alkaline pH using cellulose acetate membrane (CAM). 4 The ABO blood grouping test was performed using the slide method 2 with commercially available reagents (Murex Diagnostics, Inc. Dartford, UK). The HIV Tri Line Test ...

Prevalence of Malaria in Pregnant Women in Lagos, South-West Nigeria

“…The similar malaria prevalence rates in secundigravidas and multigravidas seen in this study suggest that there is no difference in the level of specific immunity to placental malaria and in line with existing data [20]. When this is considered, the reported high prevalence rates of malaria in pregnant women [9][10][11][12] seem to nullify the usefulness of this acquired immunity which has been shown to be able to prevent placental malaria by blocking parasite adhesion to placental circumsporozoite antigen (CSA) and opsonize malaria-infected erythrocytes for interaction with Fc receptors on phagocytic cells [19]. In this study, the highest malaria prevalence was seen in pregnant women < 20 year (20.5%) (Fig.…”

“…In Nigeria, 11% of maternal deaths are attributed to malaria [8]. To further buttress the worrisome malaria picture, many researchers have reported high prevalence rates of malaria in pregnancy in different parts of Nigeria, ranging from 19.7% to 72.0% [9][10][11][12]. Thus, pregnant women, who are known to be one of the groups at high risk of the effects of malaria infection, need special protective measures to ensure their survival and improve birth outcome.…”

Low prevalence of Plasmodium falciparum antigenaemia among asymptomatic HAART-treated adults in an urban cohort in Uganda

“…The findings of this study will contribute to the implementation of RDTs for PMD among PLHIV in areas where microscopy is not accessible [4]. Moreover, use of RDT results to guide anti-malarial therapy is likely to reduce anti-malarial drug costs due to over-prescription [6,17]. With the introduction of artemesinin-based combination therapy (ACT) [18] coupled with the high pill burden among HIV-infected individuals on HAART, cotrimoxazole and treatment for other co-morbidities, presumptive treatment of malaria is increasingly becoming clinically and economically inappropriate [1].…”

Placental Plasmodium falciparum malaria infection: Operational accuracy of HRP2 rapid diagnostic tests in a malaria endemic setting

“…However, malaria rapid diagnostic tests (RDTs) may provide a solution as emerging evidence suggests that RDTs are capable of detecting placental malaria better than microscopy and may detect sub-microscopic infections [12,13]. RDTs are lateral flow immuno-chromatographic dipstick assays that detect either histidine rich protein-2 (HRP-2) or Plasmodium lactate dehydrogenase (pLDH) produced by infected red blood cells.…”