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HIGH PREVALENCE OF PLACENTAL MALARIA AND LOW BIRTH WEIGHT IN SAHELIAN PERIURBAN AREA

The impact of placental malaria in African urban areas is poorly documented. We therefore conducted a study during the rainy season in Dakar, an area with low malaria transmission. Two groups of delivering women were enrolled according to the detection of PfHRP2 in placental blood. Ten percent of the women were positive for parasites in the placenta, and microscopic examination showed, respectively, 17%, 22%, and 44% of past, acute, and chronic infection. The mean birth weight decreased drastically with the infection of the placenta (2,684 ± 67 versus 3,085 ± 66 g for controls), particularly with chronic infection. Chronic infection was not linked with parasiteamia in maternal venous blood. Seventy-six percent of positive women were anemic (46% of the controls). Severe anemia was also associated with chronic infection. Long-lasting infections are the most deleterious to mother and infant and are most likely associated with drug resistance of parasites.

Received August 12, 2005. Accepted for publication January 17, 2006.

Acknowledgments: We thank the members of the study team, the medical staff of the Health Centre Roi Baudoin for technical support, and the women who participated in this program. Without their cooperation, this study would not have been possible.

Financial support: This program was funded by the Louis D. Foundation, the French National Academy of Sciences (Paris).

^* Address correspondence to Ronan Jambou, Institut Pasteur de Dakar, Laboratoire d’Immunologie Clinique et Parasitaire, BP220 Dakar, Senegal. E-mail: rjambou{at}pasteur.sn

Authors’ addresses: Demba Sarr, Institut Pasteur de Dakar, BP220 Dakar, Senegal. Laurence Marrama, Institut Pasteur de Dakar, BP220 Dakar, Senegal. Alioune Gaye, Centre de Santé Roi Baudoin de Guediawaye, Dakar, Senegal. Jean M. Dangou, Institut Pasteur de Dakar, BP220 Dakar, Senegal. Makhtar Niang, Institut Pasteur de Dakar, BP220 Dakar, Senegal. Odile Mercereau-Puijalon, Institut Pasteur, 25 rue Dr Roux, 75015 Paris, France. Jean Yves Lehesran, IRD UR10, Faculté de Pharmacie Paris V, 75014 Paris, France. Ronan Jambou, Institut Pasteur de Dakar, Laboratoire d’Immunologie Clinique et Parasitaire, BP220 Dakar, Senegal, E-mail: rmanbou{at}pasteur.sn.

Reprint requests: Dr. Ronan Jambou, Institut Pasteur de Dakar, Laboratoire d’Immunologie Clinique et Parasitaire, BP220 Dakar, Senegal, E-mail: rjambou{at}pasteur.sn.

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