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Polymerase chain reaction (PCR)–based methods were used to investigate malaria in pregnant women residing in Yaoundé, Cameroon. Microscopy and species-specific PCR-based diagnosis show that at delivery 82.4% of the women were infected with Plasmodium falciparum (27.5% blood-smear positive and 54.9% submicroscopic infections). The prevalence of P. malariae and P. ovale was 7.6% and 2.5%, respectively, with 9.4% infected with more than one species. Based on genotyping of the merozoite surface protein 1 (msp-1) and msp-2 alleles, the mean number of genetically different P. falciparum parasites in peripheral blood was 3.4 (range = 1–9) and 3.5 (range 1–8) in the placenta. Plasmodium falciparum detected by microscopy and PCR as well as mixed-species infections were significantly higher in women 
20 years old and paucigravidae, but maternal anemia was associated only with microscopic detection of parasites. Neither submicroscopic infections nor number of parasite genotypes decreased significantly with age or gravidity. Thus, pregnancy-associated immunity helps reduce malaria to submicroscopic levels, but does not reduce the number of circulating parasite genotypes.
Received April 17, 2004. Accepted for publication August 11, 2004.
Acknowledgments: We express our gratitude to the Cameroonian women who participated in this study. We are also indebted to all members of the Malaria Research Team at the Biotechnology Center in Yaoundé for conducting the field and microscopic studies reported herein.
Financial support: This project was funded by the National Institute of Allergy and Infectious Diseases, National Institutes of Health through the International Collaborations in Infectious Disease Research program UO1 AI-135839 and the Human Immune Resistance to Malaria in Endemic Areas Program UO1 AI-43888.
Authors’ addresses: Annie Walker-Abbey, Lucy H. Thuita, Eliza Beardslee, and Diane Wallace Taylor, Department of Biology, Room 406, Reiss Science Center, Georgetown University, 37th and O Streets, NW, Washington, DC, 20057, Telephone: 202-687-5972, E-mail: taylordw{at}georgetown.edu. Rosine R. T. Djokam, Anna Eno, Rose. F. G. Leke, Vincent P. K. Titanji, Josephine Fogako, and Grace Sama, Faculty of Medicine and Biomedical Sciences, Biotechnology Center, University of Yaoundé 1, Yaoundé, Cameroon, Telephone: 237-223-7479, E-mail: rl23{at}georgetown.edu. Georges Snounou, Unité de Parasitologie Biomédicale, Centre National de la Recherche Scientifique, Unité de Recherche Associée 2581, Institut Pasteur, 25 Rue du Dr. Roux, 75724 Paris Cedex 15, France, Telephone: 33-1-46-01-37-35, Fax: 33-1-45-68-860, E-mail: snounou{at}pasteur.fr. Ainong Zhou, AZ DataClinic, Inc., Rockville, MD, 20850, Telephone: 240-476-2148. E-mail: zhoua1{at}georgetown.edu.
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