1921
Volume 91, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Zanzibar has transitioned from malaria control to the pre-elimination phase, and the continued need for intermittent preventive treatment during pregnancy (IPTp) has been questioned. We conducted a prospective observational study to estimate placental malaria positivity rate among women who did not receive IPTp with sulfadoxine-pyrimethamine. A convenience sample of pregnant women was enrolled from six clinics on the day of delivery from August of 2011 to September of 2012. Dried placental blood spot specimens were analyzed by polymerase chain reaction (PCR); 9 of 1,349 specimens (0.7%; precision estimate = 0.2–1.1%) were PCR-positive for . Placental infection was detected on both Pemba ( = 3) and Unguja ( = 6). Placental malaria positivity in Zanzibar was low, even in the absence of IPTp. It may be reasonable for the Ministry of Health to consider discontinuing IPTp, intensifying surveillance efforts, and promoting insecticide-treated nets and effective case management of malaria in pregnancy.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.13-0586
2014-08-06
2017-09-23
Loading full text...

Full text loading...

/deliver/fulltext/14761645/91/2/367.html?itemId=/content/journals/10.4269/ajtmh.13-0586&mimeType=html&fmt=ahah

References

  1. Brabin B, Romagosa C, Abdelgalil S, Menéndez C, Verhoeff FH, McGready R, Fletcher KA, Owens S, D'Alessandro U, Nosten F, Fischer PR, Ordi J, , 2004. The sick placenta—the role of malaria. Placenta 25: 359378.[Crossref]
  2. Steketee RW, Nahlen BL, Parise ME, Menendez C, , 2001. The burden of malaira in pregnancy in malaria-endemic areas. Am J Trop Med Hyg 64 (Suppl): 2835.
  3. Nosten F, Ter Kuile F, Maelankirri I, Decludt B, White NJ, , 1991. Malaria during pregnancy in an area of unstable endemicity. Trans R Soc Trop Med Hyg 85: 424429.[Crossref]
  4. Newman R, Hailemariam A, Jimma D, , 2003. Burden of malaria during pregnancy in areas of stable and unstable transmission in Ethiopica during a nonepidemic year. J Infect Dis 187: 17651772.[Crossref]
  5. Brabin B, Verhoeff F, Maclean AB, , 2002. The contribution of malaria. , ed. Maternal Morbidity and Mortality. London, United Kingdom: Royal College of Obstetricians and Gynaecologists, 6578.
  6. Brabin B, Hakimi M, Pelletier D, , 2001. An analysis of anemia and pregnancy-related maternal mortality. J Nutr 131 (Suppl 2): 604615.
  7. De Beaudrap P, Turyakira E, White L, Nabasumba C, Tumwebaze B, Muehlenbachs A, Guérin P, Boum Y, McGready R, Piola P, , 2013. Impact of malaria during pregnancy on pregnancy outcomes in a Ugandan prospective cohort with intensive malaria screening and prompt treatment. Malar J 12: 139.[Crossref]
  8. Guyatt H, Snow RW, , 2004. Impact of malaria during pregnancy on low birth weigh in Sub-Saharan Africa. Clin Microbiol Rev 17: 760769.[Crossref]
  9. Van Geertruyden J, Thomas F, Erhart A, D'Alessandro U, , 2004. The contribution of malaria in pregnancy to perinatal mortality. Am J Trop Med Hyg 71 (Suppl): 3540.
  10. World Health Organisation, 2012. Updated WHO Policy Recomendations: Intermittent Preventive Treatment of Malaria in Pregnancy Using Sulfadoxine-Pyrimethamine (IPTp-SP). Geneva: World Health Organization.
  11. World Health Organisation, 2004. A Strategic Framework for Malaria Prevention and Control during Pregnancy in the African Region: Brazzaville: WHO Regional Office for Africa. Geneva: World Health Organization.
  12. World Health Organization, 2013. WHO Policy Brief for the Implementation of Intermittent Preventive Treatment of Malaria in Pregnancy Using Sulfadoxine-Pyrimethamine. Available at: http://www.who.int/malaria/publications/atoz/Policy_brief_IPTp-SP_implementation_11april2013.pdf.pdf. Accessed June 1, 2013.
  13. Aregawi M, Ali SA, Al-mafazy A, Molteni F, Katikiti S, Warsame M, Njau R, Komatsu R, Korenromp E, Hosseini M, Low-Beer D, Bjokman A, D'Alessandro U, Coosemans M, Otten M, , 2011. Reduction in malaria and anaemia case and death burden at hospitals following scale-up of malaria control in Zanzibar, 1999–2008. Malar J 10: 46.[Crossref]
  14. National Bureau of Statistics, 2012. HIVAIDS and Malaria Indicator Survey 2011/12. Dar es Salaam, Tanzania: National Bureau of Statistics.
  15. National Bureau of Statistics and Ministry of Finance, 2010. Tanzania in Figures 2010, Dar es Salaam, Tanzania: National Bureau of Statistics.
  16. National Bureau of Statistics and Ministry of Finance Dar es Salaam; Office of Chief Goverment Statistician President Office Finance Economy and Development Planning Zanzibar, 2012. Population and Housing Census. Dar es Salaam, Tanzania: National Bureau of Statistics.
  17. National Bureau of Statistics (NBS) Tanzania and ICF Macro, 2011. 2010 Tanzania Demographic and Health Survey. Dar es Salaam, Tanzania: National Bureau of Statistics and ICF Macro.
  18. Zanzibar Malaria Control Program and Ministry of Health, 2011. Malaria Epidemic Early Detection System Biannual Report Year - End 2011. Zanzibar: Zanzibar Ministry of Health.
  19. Othoro C, Moore JM, Wannemuehler K, Nahlen BL, Otieno J, Slutsker L, Lal AA, Shi YP, , 2006. Evaluation of various methods of maternal placenta blood collection for immunology studies. Clin Vaccine Immunol 13: 568574.[Crossref]
  20. Newman P, Wanzira H, Tumwine G, Arinaitwe E, Waldman S, Achan J, Havlir D, Rosenthal PJ, Dorsey G, Clark TD, Cohan D, , 2009. Placental malaria among HIV- infected and uninfected women receiving anti-folates in a high transmission area of Uganda. Malar J 8: 254.[Crossref]
  21. Snounow G, Viryakosol S, Zhu XP, Jarra W, Pinheiro L, do Rosairio VE, Thaithong S, Brown KN, , 1993. High sensitivity of detection of human parasites by the use of nested polymerase chain reaction. Mol Biochem Parasitol 61: 315320.[Crossref]
  22. Zanzibar Malaria Control Program and Ministry of Health, 2012. ZMCP Annual Report.
  23. Zanzibar Malaria Control Program and Ministry of Health, 2011. ZMCP Annual Report.
  24. WHO Malaria Policy Advisory Committee and Secretariat, 2012. Malaria Policy Advisory Committee to the WHO: conclusions and recommendations of September 2012 meeting. Malar J 11: 424.[Crossref]
  25. Institut National de la Statistique du Rwanda (INSR) and ICF Macro, 2009. Enquête intermédiaire sur les indicateurs démographiques et de santé Rwanda 2007–2008 Ministere de la Sante (MINISANTE).
  26. WHO Evidence Review Group on Intermittent Preventive Treatment (IPT) of Malaria in Pregnancy, 2013. Draft Recommendations on Intermittent Preventive Treatment in Pregnancy (IPTp). Available at: http://www.who.int/malaria/mpac/mpac_sep13_erg_ipt_malaria_pregnancy_report.pdf. Accessed October 4, 2013.
  27. Smith DL, Cohen JM, Moonen B, Tatem AJ, Sabot OJ, Ali A, Mugheiry SM, , 2011. Infectious disease. Solving the Sisyphean problem of malaria in Zanzibar. Science 332: 13841385.[Crossref]
  28. Al-mafazy A, McElroy P, Msellem M, Molteni F, Ramsan M, Kakuko J, Murugasampillay S, Njau R, Jiddawi M, Ali AS, , 2012. Examination of surveillance data milestones as Zanzibar transitions to the malaria pre-elimination phase, 2008–2012. Proceedings of the 61st American Society of Tropical Medicine and Hygiene Annual Meeting, November 11–15, 2012, Atlanta, GA.
  29. Tagbor H, Jane B, Mitchel A, Brian G, Daniel C, , 2010. Intermittent screening and treatment versus intermittent preventive treatment of malaria in pregnancy: a randomised controlled non-inferiority trial. PLoS ONE 5: e14425.[Crossref]
  30. Njau J, Kabanywanyi A, Goodman C, Macarthur JR, Kapella BK, Gimnig JE, Kahigwa E, Bloland PB, Abdulla SM, Kachur SP, , 2013. Adverse drug events resulting from use of drugs with sulphonamide-containing anti-malarials and artemisinin-based ingredients: findings on incidence and household costs from three districts with routine demographic surveillance systems in rural Tanzania. Malar J 12: 236.[Crossref]
  31. Lengeler C, , 2004. Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev 2: CD000363.
  32. Hawley W, Phillips-Howard PA, ter Kuile FO, Terlouw DJ, Vulule JM, Ombok M, Nahlen BL, Gimnig JE, Kariuki SK, Kolczak MS, Hightower AW, , 2003. Community-wide effects of permethrin-treated bed nets on child mortality and malaria morbidity in western Kenya. Am J Trop Med Hyg 68 (Suppl): 121127.
  33. Ndyomugyenyi R, Clarke SE, Hutchison CL, Hansen KS, Magnussen P, , 2011. Efficacy of malaria prevention during pregnancy in an area of low and unstable transmission: an individually-randomised placebo-controlled trial using intermittent preventive treatment and insecticide-treated nets in the Kabale Highlands, southwestern Uganda. Trans R Soc Trop Med Hyg 105: 607616.[Crossref]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.13-0586
Loading
/content/journals/10.4269/ajtmh.13-0586
Loading

Data & Media loading...

  • Received : 11 Oct 2013
  • Accepted : 26 Mar 2014

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error