Gestational malaria associated to Plasmodium vivax and Plasmodium falciparum placental mixed-infection followed by foetal loss: a case report from an unstable transmission area in Brazil

Carvalho, Bruna O.; Matsuda, Joycenéa S; Luz, Sérgio L.B.; Martínez-Espinosa, Flor Ernestina; Leite, Juliana Almeida; Franzin, Fernanda Maria; Orlandi, Patrícia Puccinelli; Gregoracci, Gustavo Bueno; Lacerda, Marcus Vinícius Guimarães; Nogueira, Paulo Afonso; Costa, Fábio T. M.

doi:10.1186/1475-2875-10-178

Cited by 14 publications

(6 citation statements)

References 19 publications

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“…Studies on gestational placental or congenital malaria are scarce in America in comparison to Africa [ 4 - 6 , 26 , 27 ] and most recent reports come from Colombia [ 7 , 9 - 12 ] and Brazil [ 4 , 26 ]. In the Brazilian Amazon, among 1,699 women with malaria, the prevalence of gestational malaria was 11.7% and P. vivax was confirmed in 83% of cases [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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

Agudelo

Arango

Maestre

et al. 2013

Malar J

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“… 114 , 116 , 120 , 121 Placental malaria is quite common during P. falciparum infection, less common in P. vivax malaria; P. falciparum and P. vivax placental mixed-infection can occur. 122 P. vivax placental malaria may lead to the same adverse events as P. falciparum infection, even if with milder consequences. 121 – 124 …”

Section: Specific Complications Of Severe Malaria Infectionmentioning

confidence: 99%

Pathogenesis of Malaria in Tissues and Blood

Autino¹,

Corbett²,

Castelli

et al. 2012

Mediterr J Hematol Infect Dis

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The clinical manifestations of severe malaria are several and occur in different anatomical sites. Both parasite- and host-related factors contribute to the pathogenicity of the severe forms of the disease. Cytoadherence of infected red blood cells to the vascular endothelium of different organs and rosetting are unique features of malaria parasites which are likely to contribute to the vascular damage and the consequent excessive inflammatory/immune response of the host. In addition to cerebral malaria or severe anaemia, which are quite common manifestation of severe malaria, clinical evidences of thrombocytopenia, acute respiratory distress syndrome (ARDS), liver and kidney disease, are reported. In primigravidae from endemic areas, life threatening placental malaria may also be present.In the following pages, some of the pathogenetic aspects will be briefly reviewed and then data on selected and less frequent manifestation of severe malaria, such as liver or renal failure or ARDS will be discussed.

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“…A virulência de P. falciparum deve-se, em grande parte, à capacidade de hemácias parasitadas com formas maduras desse parasito serem sequestradas da circulação para os órgãos do hospedeiro, em um processo de evasão do sistema imune que pode provocar malária cerebral e placentária (MILLER et al, 2002;CARVALHO et al, 2010). A malária placentária caracteriza-se por processo inflamatório, deposição de pigmento malárico (hemozoína), e modificações nos tecidos placentários, que colocam em risco os desfechos gestacionais (ISMAIL et al, 2000;UMBERS et al, 2011 CARVALHO et al, 2011;MAYOR et al, 2012;BRUTUS et al, 2013;BARDAJÍ et al, 2017). Além disso, em ensaios in vitro, a citoaderência de P. vivax, ainda que em níveis bastante menores do que de P. falciparum, acontece (CARVALHO et al, 2010;CHOTIVANICH et al, 2012).…”

Section: Malária Na Gestaçãounclassified

Malária na gestação na Amazônia Ocidental Brasileira: fatores associados e implicações para a saúde materno-fetal.

Cintra¹

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We measured the prevalence of malaria in pregnancy and estimated its impact on birth weight and length and maternal hemoglobin in 1,180 women from Juruá Valley, the main malaria hotspot in Brazil. Antenatal malaria episodes, 74.6% of them due to Plasmodium vivax, were microscopically diagnosed in 8.0% of the women and were associated with an average reduction in birth weight z-scores of 0.35 (95% confidence interval [CI] = 0.14-0.57) and in birth length z-scores of 0.31 (95% CI = 0.08-0.54), compared with malaria-free pregnancies. Affected mothers had a mean decrease in hemoglobin concentration at delivery of 0.33 g/100 mL (95% CI = 0.05-0.62 g/100 mL); 51.6% were anemic. The timing and frequency of antenatal infections influenced pregnancy outcomes and first-or secondtrimester infections were not associated with decreased birth weight and length and maternal hemoglobin at delivery. Although repeated antenatal vivax infections were associated with poorer birth outcomes, even a single vivax malaria episode was associated with a significant reduction in birth weight and length and maternal hemoglobin. Overall, 7.5% women had the parasite's DNA found in peripheral blood at delivery. Most (83.1%) of these 89 perinatal infections were due to P. vivax and only 7.9% of them progressed to symptomatic disease after delivery. Plasmodium vivax and Plasmodium falciparum DNA was found in 0.6% and 0.3% of 637 cord blood samples examined, respectively, but only one newborn developed clinical neonatal malaria. Our results further challenge the notion that vivax malaria is relatively benign during pregnancy and call for better strategies for its prevention.

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Gestational malaria associated to Plasmodium vivax and Plasmodium falciparum placental mixed-infection followed by foetal loss: a case report from an unstable transmission area in Brazil

Cited by 14 publications

References 19 publications

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

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

Pathogenesis of Malaria in Tissues and Blood

Malária na gestação na Amazônia Ocidental Brasileira: fatores associados e implicações para a saúde materno-fetal.

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