Decreasing Malaria Prevalence and Its Potential Consequences for Immunity in Pregnant Women

Teo, Andrew; Hasang, Wina; Randall, Louise M.; Feng, Gaoqian; Bell, Lauren; Unger, Holger W.; Langer, Christine; Beeson, James G.; Siba, Peter; Müeller, Ivo; Molyneux, Malcolm E.; Brown, Graham V.; Rogerson, Stephen J.

doi:10.1093/infdis/jiu264

Cited by 24 publications

(36 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The concentrations of both antibodies showed a decline with IPTp uptake probably as a result of decay in antibodies or as a result of the clearance of parasitaemia by treatment with SP. This is consistent with other studies [43, 48, 55, 56], which also found a decline in the levels of antibodies against several antigens during pregnancy and after delivery. The decrease in antibody levels is believed to be linked with pregnancy-specific malaria immunity rather than to non-pregnancy associated malaria antigens [48] as speculated elsewhere [50] or possibly to short-lived responses in the absence of infection [43, 55].…”

Section: Discussionsupporting

confidence: 93%

“…Regardless of these benefits, there is concern that “any exposure-reducing interventions could result in the loss of or failure to acquire protective (PAM) immunity” [41–43] which would increase the overall, long-term disease burden [44] by increasing morbidity and mortality [45, 46]. The use of IPTp with Sulfadoxine–pyrimethamine (SP) treatment of primigravidae has also been shown to reduce levels of plasma IgG, which protects against pregnancy-associated falciparum malaria [47, 48] and severe malaria among children [49]. However, the extent to which IPTp may interfere with acquisition of protective immunity against PAM is largely undefined, particularly in Ghana.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of IPTp on Plasmodium falciparum antibody levels among pregnant women and their babies in a sub-urban coastal area in Ghana

Stephens

Kyei-Baafour

Dickson

et al. 2017

Malar J

View full text Add to dashboard Cite

BackgroundWomen exposed to Plasmodium infection develop antibodies and become semi-immune. This immunity is suppressed during pregnancy making both the pregnant woman and the foetus vulnerable to the adverse effects of malaria, particularly by Plasmodium falciparum. Intermittent preventive treatment of malaria in pregnancy (IPTp) with Sulfadoxine–pyrimethamine (SP) tablets is one of the current interventions to mitigate the effects of malaria on both the pregnant woman and the unborn child. The extent to which IPTp may interfere with the acquisition of protective immunity against pregnancy-associated malaria (PAM) is undefined in Ghana.MethodsThree-hundred-and-twenty pregnant women were randomly enrolled at the antenatal clinic (ANC) in Madina, Accra. Venous blood samples were obtained at first ANC registration and at 4-week intervals (post-IPTp administration). Placental and cord blood samples were obtained at delivery and the infants were followed monthly for 6 months after birth. Anti-IgG and IgM antibodies against a crude antigen preparation and the glutamate-rich protein (GLURP) of P. falciparum were quantified by the enzyme-linked immunosorbent assay (ELISA).ResultsThere was a general decline in the trend of mean concentrations of all the antibodies from enrolment to delivery. The levels of antibodies in cord blood and placenta were well correlated. Children did not show clinical signs of malaria at 6 months after birth.ConclusionsIgG against both crude antigen and GLURP were present in placenta and cord blood and it is therefore concluded that there is a trend of declining antibody from enrolment to delivery and IPTp-SP may have reduced malaria exposure, however, this does not impact on the transfer of antibodies to the foetus in utero. The levels of maternal and cord blood antibodies at delivery showed no adverse implications on malaria among the children at 6 months. However, the quantum and quality of the antibody transferred needs further investigation to ensure that the infants are protected from severe episodes of malaria.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Effect of IPTp on Plasmodium falciparum antibody levels among pregnant women and their babies in a sub-urban coastal area in Ghana

Stephens

Kyei-Baafour

Dickson

et al. 2017

Malar J

View full text Add to dashboard Cite

show abstract

“…As well as having pharmacokinetic determinants, the duration of protection will depend on the degree of malarial immunity. Where there has been a reduction in exposure to malaria through strategies, including ITNs (including PNG), immunity may decline as a result (60), and pregnant women may therefore have a shorter period of protection after the same DHA-PQ dose. There is a clear need for monitoring the incidence of malaria in pregnancy where IPTp is used, as part of in vitro and other in vivo measures of local parasite resistance.…”

Section: Discussionmentioning

confidence: 99%

Population Pharmacokinetics, Tolerability, and Safety of Dihydroartemisinin-Piperaquine and Sulfadoxine-Pyrimethamine-Piperaquine in Pregnant and Nonpregnant Papua New Guinean Women

Benjamin

Moore

Salman

et al. 2015

Antimicrob Agents Chemother

View full text Add to dashboard Cite

The tolerability, safety, and disposition of dihydroartemisinin (DHA) and piperaquine (PQ) were assessed in 32 pregnant (second/third trimester) and 33 nonpregnant Papua New Guinean women randomized to adult treatment courses of DHA-PQ (three daily doses) or sulfadoxine-pyrimethamine (SP)-PQ (three daily PQ doses, single dose of SP). All dose adminstrations were observed, and subjects fasted for 2 h postdose. Plasma PQ was assayed by using high-performance liquid chromatography, and DHA was assessed by using liquid chromatography-mass spectrometry. Compartmental pharmacokinetic models were developed using a population-based approach. Both regimens were well tolerated. There was an expected increase in the rate-corrected electrocardiographic QT interval which was independent of pregnancy and treatment. Two pregnant and two nonpregnant women had Plasmodium falciparum parasitemia which cleared within 48 h, and no other subject became slide positive for malaria during 42 days of follow-up. Of 30 pregnant women followed to delivery, 27 (90%) delivered healthy babies and 3 (10%) had stillbirths; these obstetric outcomes are consistent with those in the general population. The apparent pharmacokinetic differences between the present study and results from other studies of women with uncomplicated malaria that showed no effect of pregnancy on the AUC 0 -ؕ of PQ and greater bioavailability may reflect differences in postdose fat intake, proportions of women with malaria, and/or racial differences in drug disposition.

show abstract

“…, see [20; 36; 74; 81; 82; 83; 84; 85; 86; 87; 88]). Because the parasite is threatened by the immune system, it has evolved escape strategies, including the intriguing use of antigenic variation mechanisms [89; 90; 91].…”

Section: Malaria As the Paradigm Infectious Diseasementioning

confidence: 99%

From within host dynamics to the epidemiology of infectious disease: Scientific overview and challenges

Gutiérrez

Galinski

Cantrell

et al. 2015

Mathematical Biosciences

View full text Add to dashboard Cite

Since their earliest days, humans have been struggling with infectious diseases. Caused by viruses, bacteria, protozoa, or even higher organisms like worms, these diseases depend critically on numerous intricate interactions between parasites and hosts, and while we have learned much about these interactions, many details are still obscure. It is evident that the combined host-parasite dynamics constitutes a complex system that involves components and processes at multiple scales of time, space, and biological organization. At one end of this hierarchy we know of individual molecules that play crucial roles for the survival of a parasite or for the response and survival of its host. At the other end, one realizes that the spread of infectious diseases by far exceeds specific locales and, due to today's easy travel of hosts carrying a multitude of organisms, can quickly reach global proportions. The community of mathematical modelers has been addressing specific aspects of infectious diseases for a long time. Most of these efforts have focused on one or two select scales of a multi-level disease and used quite different computational approaches. This restriction to a molecular, physiological, or epidemiological level was prudent, as it has produced solid pillars of a foundation from which it might eventually be possible to launch comprehensive, multi-scale modeling efforts that make full use of the recent advances in biology and, in particular, the various high-throughput methodologies accompanying the emerging –omics revolution. This special issue contains contributions from biologists and modelers, most of whom presented and discussed their work at the workshop From within Host Dynamics to the Epidemiology of Infectious Disease, which was held at the Mathematical Biosciences Institute at Ohio State University in April 2014. These contributions highlight some of the forays into a deeper understanding of the dynamics between parasites and their hosts, and the consequences of this dynamics for the spread and treatment of infectious diseases.

show abstract

Decreasing Malaria Prevalence and Its Potential Consequences for Immunity in Pregnant Women

Cited by 24 publications

References 43 publications

Effect of IPTp on Plasmodium falciparum antibody levels among pregnant women and their babies in a sub-urban coastal area in Ghana

Effect of IPTp on Plasmodium falciparum antibody levels among pregnant women and their babies in a sub-urban coastal area in Ghana

Population Pharmacokinetics, Tolerability, and Safety of Dihydroartemisinin-Piperaquine and Sulfadoxine-Pyrimethamine-Piperaquine in Pregnant and Nonpregnant Papua New Guinean Women

From within host dynamics to the epidemiology of infectious disease: Scientific overview and challenges

Contact Info

Product

Resources

About