| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Placental histopathology was studied in a cohort of 204 women living in an area of low Plasmodium falciparum and P. vivax malaria transmission. Detection of malaria antenatally was active, by weekly peripheral blood smears, and all infections were treated. Significant histopathologic placental malaria changes (increased malaria pigment, cytotrophoblastic prominence, and presence of parasites) were found only in a minority of women who had P. falciparum infections in pregnancy. These changes were significantly more frequent in women with evidence of peripheral blood infection close to delivery and only in these cases were placental inflammatory cells increased. Antenatal P. vivax infection was associated only with the presence of malaria pigment in the placenta. All placental infections diagnosed by blood smear and 32.4% (12 of 37) diagnosed by histopathology were associated with patent peripheral parasitemia. This study indicates that prompt treatment of peripheral parasitemias during pregnancy limits placental pathology. The effect on birth weight reduction may not result from irreversible placental changes but from the acute insult of infection. These findings emphasize the importance of treating malaria in pregnancy promptly with effective antimalarial drugs.
Received August 14, 2003. Accepted for publication December 15, 2003.
Acknowledgments: We thank the pregnant women who attended the Shoklo Malaria Research Unit antenatal clinics, the Karen midwives, and the laboratory staff, and expatriate doctors (Christine Luxemburger, Michele van Vugt, Leopoldo Villegas, Elizabetta Leonardi, Robert Hutagalung, and Elizabeth Ashley) working at Shoklo and Maela Refugee camps for their support; Renee Grow, Carol Coyne, and Maurice Duplantis for their excellent technical support in preparation of the slides for histopathology; Associate Professor Lilly Dubowitz for training and quality control of gestational age assessment; Khun Patchari Prakongpan, Tip Rutchaitrakul, and Cherise Rohr for their friendly logistical support; and Professor Bernard Brabin for his review of the manuscript.
Financial support; This work was supported by the National Institutes of Health (NIH) Public Health Service Grant P51RR00164 to the Tulane National Primate Research Center and NIH (National Institute of Allergy and Infectious Diseases) grant 5 RO1 AI-42400. The Shoklo Malaria Research Unit is part of the Wellcome-Mahidol University-Oxford Tropical Medicine Research Program funded by the Wellcome Trust of Great Britain. Part of this work was supported by PREMA-EU (Contract no PREMA-EU- ICA4-CT-2001-10012)
Authors’ addresses: Rose McGready, Thein Cho, Htee Shee, Alan Brockman, and François Nosten, Shoklo Malaria Research Unit, PO Box 46, Mae Sot, Thailand, 63110, Telephone: 66-55-531-531, Fax: 66-55-525-440, E-mail: shoklo{at}cscoms.com. Billie B. Davison, Division of Comparative Pathology, Tulane National Primate Research Center, 18703 Three Rivers Road, Covington, LA. 70433, Telephone: 985-871-6307, Fax: 985-871-6271, E-mail: billie{at}tpc.tulane.edu. Kasia Stepniewska, Sornchai Looareesuwan, and Nicholas J. White, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand, Telephone: 66-2246-0832, Fax: 66-2246-7795, E-mail: tmwu{at}diamond.mahidol.ac.th. Rachanee Udomsangpetch, Faculty of Science, Mahidol University, Bangkok, 10400 Thailand, E-mail: scrud{at}mucc.mahidol.ac.th. Steve R. Meshnick, Department of Epidemiology and Microbiology and Immunology, University of North Caro-lina, Chapel Hill, NC 27599-7435, Telephone: 919-966-7414, Fax: 919-966-2089, E-mail: meshnick{at}unc.edu.
This article has been cited by other articles:
|
|
 |
|
  S. J. Rogerson, V. Mwapasa, and S. R. Meshnick Malaria in Pregnancy: Linking Immunity and Pathogenesis to Prevention Am J Trop Med Hyg, December 1, 2007; 77(6_Suppl): 14 - 22. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. N. Price, E. Tjitra, C. A. Guerra, S. Yeung, N. J. White, and N. M. Anstey Vivax Malaria: Neglected and Not Benign Am J Trop Med Hyg, December 1, 2007; 77(6_Suppl): 79 - 87. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. Coldren, K. Jongsakul, S. Vayakornvichit, H. Noedl, and M. M. Fukudas Apparent Relapse of Imported Plasmodium ovale Malaria in a Pregnant Woman Am J Trop Med Hyg, November 1, 2007; 77(5): 992 - 994. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. COTTRELL, J.-Y. MARY, D. BARRO, and M. COT THE IMPORTANCE OF THE PERIOD OF MALARIAL INFECTION DURING PREGNANCY ON BIRTH WEIGHT IN TROPICAL AFRICA Am J Trop Med Hyg, May 1, 2007; 76(5): 849 - 854. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. SARR, L. MARRAMA, A. GAYE, J. M. DANGOU, M. NIANG, O. MERCEREAU-PUIJALON, J. Y. LEHESRAN, and R. JAMBOU High prevalence of placental malaria and low birth weight in sahelian periurban area. Am J Trop Med Hyg, July 1, 2006; 75(1): 171 - 177. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. COTTRELL, J.-Y. MARY, D. BARRO, and M. COT IS MALARIAL PLACENTAL INFECTION RELATED TO PERIPHERAL INFECTION AT ANY TIME OF PREGNANCY? Am J Trop Med Hyg, December 1, 2005; 73(6): 1112 - 1118. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
