Congenital malaria in Urabá, Colombia

Jiménez, Juan Gabriel Piñeros; Álvarez, Gonzalo; Tobón, Alberto; Arboleda, Margarita; Carrero, Sonia; Blair, Silvia

doi:10.1186/1475-2875-10-239

Cited by 29 publications

(25 citation statements)

References 31 publications

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“…As for congenital malaria, the current report confirmed previous observations made by other authors on the low frequency of infection in cord blood (2.5%) in relation with higher rates of gestational malaria (9.5%) [11]. Several factors might explain the relative protection of the foetus to acquisition of congenital malaria, namely the degree of previously acquired immunity of the mother [28], the proportion of foetal haemoglobin [28], and the higher frequency of P. vivax infection, which in theory, fails to sequester in placenta, among others.…”

Section: Discussionsupporting

confidence: 92%

Prevalence of gestational, placental and congenital malaria in north-west Colombia

Agudelo

Arango

Maestre

et al. 2013

Malar J

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BackgroundThe frequency of pregnancy-associated malaria is increasingly being documented in American countries. In Colombia, with higher frequency of Plasmodium vivax over Plasmodium falciparum infection, recent reports confirmed gestational malaria as a serious public health problem. Thick smear examination is the gold standard to diagnose malaria in endemic settings, but in recent years, molecular diagnostic methods have contributed to elucidate the dimension of the problem of gestational malaria. The study was aimed at exploring the prevalence of gestational, placental and congenital malaria in women who delivered at the local hospitals of north-west Colombia, between June 2008 and April 2011.MethodsA group of 129 parturient women was selected to explore the prevalence of gestational, placental and congenital malaria in a descriptive, prospective and transversal (prevalence) design. Diagnosis was based on the simultaneous application of two independent diagnostic tests: microscopy of thick blood smears and a polymerase chain reaction assay (PCR).ResultsThe prevalence of gestational malaria (thick smear /PCR) was 9.1%/14.0%; placental malaria was 3.3%/16.5% and congenital malaria was absent. A history of gestational malaria during the current pregnancy was significantly associated with gestational malaria at delivery. Plasmodium vivax caused 65% of cases of gestational malaria, whereas P. falciparum caused most cases of placental malaria.ConclusionsGestational and placental malaria are a serious problem in the region, but the risk of congenital malaria is low. A history of malaria during pregnancy may be a practical indicator of infection at delivery.

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Section: Discussionsupporting

confidence: 92%

Prevalence of gestational, placental and congenital malaria in north-west Colombia

Agudelo

Arango

Maestre

et al. 2013

Malar J

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“…These data contradict findings based on microscopy and nested PCR, where the majority of infections in pregnant women from Urabá were caused by P. vivax. 11,12,41,42 However, there are reports from the Brazilian and Peruvian Amazon that pregnant women are at higher risk of P. falciparum infection compared with the general population. [43][44][45] The Brazilian study showed that the ratio of P. falciparum to P. vivax changed in pregnant women from 1:5.6 to 1:2.3, 43 and in Peru, pregnant women were 2.3 times more likely to be infected with P. falciparum than non-pregnant women.…”

Section: Discussionmentioning

confidence: 99%

“…The few previous reports in Colombia on the frequency of malaria infection during pregnancy or at delivery were carried out in municipalities of Urabá ; according to microscopy, the frequency of malaria infection in maternal peripheral blood was 11-14%, the frequency of malaria infection in placental blood was 9-12%, and the frequency of malaria infection in cord blood was 2-4%. 11,12,41,42 One study used nested PCR in addition to microscopy to diagnose malaria infection in the three compartments, and the frequency of infection increased markedly from 13% to 32% in peripheral blood, from 9% to 26% in placenta, and from 2% to 13% in cord blood. 11 (3) 26 (12) 25 (3) 0.2691 Villitis percent (n)…”

Section: Discussionmentioning

confidence: 99%

Molecular Detection of Malaria at Delivery Reveals a High Frequency of Submicroscopic Infections and Associated Placental Damage in Pregnant Women from Northwest Colombia

Arango¹,

Samuel²,

Agudelo³

et al. 2013

The American Journal of Tropical Medicine and Hygiene

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Abstract. Plasmodium infection in pregnancy causes substantial maternal and infant morbidity and mortality. In Colombia, both P. falciparum and P. vivax are endemic, but the impact of either species on pregnancy is largely unknown in this country. A cross-sectional study was carried out with 96 pregnant women who delivered at their local hospital. Maternal, placental, and cord blood were tested for malaria infection by microscopy and real-time quantitative polymerase chain reaction (qPCR). A high frequency of infection was detected by qPCR (45%). These infections had low concentrations of parasite DNA, and 79% were submicroscopic. Submicroscopic infections were associated with placental villitis and intervillitis. In conclusion, the overall frequency of Plasmodium infection at delivery in Colombia is much higher than previously reported. These data prompt a re-examination of the local epidemiology of malaria using molecular diagnostics to establish the clinical relevance of submicroscopic infections during pregnancy as well as their consequences for mothers and newborns.

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“…Malaria is transmitted by the bite of the female Anopheles mosquito but also by congenital transmission and, rarely, by blood transfusion and the sharing of needles and syringes [5,6]. The history of transfusion-transmitted malaria dates back to 1882, when Gerhardt empirically demonstrated the transmission of malaria in humans by infected blood [7].…”

Section: Introductionmentioning

confidence: 99%

Real-time PCR diagnosis of Plasmodium vivax among blood donors

Batista-dos-Santos

Raiol

Santos

et al. 2012

Malar J

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BackgroundWhen selecting blood donors in transfusion centres, one important problem is to identify, during screening, individuals with infectious diseases that can be transmitted by blood, such as malaria, especially when the parasite densities are very low. This problem is particularly severe in endemic areas, such as the Brazilian Amazon. In the present study, molecular diagnostic (real-time PCR) of Plasmodium vivax was used to identify blood donors infected with malaria parasites.MethodsSamples from 595 blood donors were collected in seven haemotherapy centres in northern Brazil located in areas at risk for malaria transmission, and the analyses were performed by real-time PCR with TaqMan probes on 7500 Real-Time PCR Systems, to genotype the mitochondrial DNA region specific to P. vivax. The experiment was designed for hybridization of the cytochrome c oxidase genes of the mitochondrial genome (GenBank GI63022502). The serological data were obtained using enzyme-linked immunosorbent assay - ELISA (Anti-HIV, Anti-HTLV I-II; Anti-HVC, HBsAg, Anti-HBc, Chagas disease) and VDRL (Syphilis) from the Blood Bank System of the Haematology and Haemotherapy Centre of Pará.ResultsThe assay identified eight individuals in the sample (1.34%) infected with P. vivax at the time of blood donation. This percentage was higher than the altered serological results (reactive or inconclusive) of the prevalence of anti-HIV (0.67%), anti-hepatitis C virus (0.34%), anti-hepatitis B surface antigen (0.67%), anti-human T-lymphotropic virus I/II (1.18%), anti-Chagas disease (0.17%) and syphilis (VDRL) (0.50%), but not higher than anti-hepatitis B core antigen antibodies (4.37%). This result indicates the need to use more sensitive methods of diagnosing malaria in blood banks.ConclusionThe real-time PCR with TaqMan probes enabled the identification of P. vivax in a high proportion of clinically healthy donors, highlighting the potential risk for transfusion-transmitted malaria. Additionally, this molecular diagnostic tool can be adopted as a new laboratory screening method in haemotherapy centres, especially in malaria-endemic areas.

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Congenital malaria in Urabá, Colombia

Cited by 29 publications

References 31 publications

Prevalence of gestational, placental and congenital malaria in north-west Colombia

Prevalence of gestational, placental and congenital malaria in north-west Colombia

Molecular Detection of Malaria at Delivery Reveals a High Frequency of Submicroscopic Infections and Associated Placental Damage in Pregnant Women from Northwest Colombia

Real-time PCR diagnosis of Plasmodium vivax among blood donors

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