Volume 75, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


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.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Brabin BJ, 1983. An analysis of malaria in pregnancy in Africa. Bull WHO 61 : 1005–1016. [Google Scholar]
  2. Fried M, Duffy PE, 1998. Maternal malaria and parasite adhesion. J Mol Med 76 : 162–171. [Google Scholar]
  3. Flick K, Scholander C, Chen Q, Fernandez V, Pouvelle B, Gysin J, Wahlgren M, 2001. Role of nonimmune IgG bound to PfEMP1 in placental malaria. Science 293 : 2098–2100. [Google Scholar]
  4. Beeson JG, Brown GV, 2004. Plasmodium falciparum-infected erythrocytes demonstrate dual specificity for adhesion to hyaluronic acid and chondroitin sulfate A and have distinct adhesive properties. J Infect Dis 189 : 169–179. [Google Scholar]
  5. Cot M, Le Hesran JY, Mailhes P, Esveld M, Etya’ale D, Breart G, 1995. Increase of birth weight following chloroquine chemoprophylaxis during the first pregnancy: results of a randomized trial in Cameroon. Am J Trop Med Hyg 53 : 581–585. [Google Scholar]
  6. Diagne N, Rogier C, Sokhna CS, Tall A, Fontenille D, Roussilhon C, Spiegel A, Trape JF, 2000. Increased susceptibility to malaria during the early postpartum period. N Engl J Med 343 : 598–603. [Google Scholar]
  7. Trape JF, Lefebvre-Zante E, Legros F, Ndiaye G, Bouganali H, Druilhe P, Salem G, 1992. Vector density gradients and the epidemiology of urban malaria in Dakar, Senegal. Am J Trop Med Hyg 47 : 181–189. [Google Scholar]
  8. Ndao CT, Ndiaye JL, Gaye A, Lehesran JY, 2003. Infection du placenta par Plasmodium falciparum en zone urbaine au Sénégal. Bull Soc Pathol Exot 96 : 161–164. [Google Scholar]
  9. Bulmer JN, Rasheed FN, Francis N, Morrison L, Greenwood BM, 1993. Placental malaria. I. Pathological classification of placental malaria. Histopathol 22 : 211–218. [Google Scholar]
  10. Ismail MR, Ordi J, Menendez C, Ventura PJ, Aponte JJ, Kahigwa E, Hirt R, Cardesa A, Alonso PL, 2000. Placental pathology in malaria: a histological, immunohistochemical, and quantitative study. Hum Pathol 31 : 85–93. [Google Scholar]
  11. Contamin H, Fandeur T, Bonnefoy S, Skouri F, Ntoumi F, Mercereau-Puijalon O, 1995. PCR typing of field isolates of Plasmodium falciparum. J Clin Microbiol 33 : 944–951. [Google Scholar]
  12. Fidock DA, Nomura T, Talley AK, Cooper RA, Dzekunov SM, Ferdig MT, Ursos LM, Sidhu AB, Naude B, Deitsch KW, Su XZ, Wootton JC, Roepe PD, Wellems TE, 2000. Mutations in the P. falciparum digestive vacuole transmembrane protein PfCRT and evidence for their role in chloroquine resistance. Mol Cell 6 : 861–871. [Google Scholar]
  13. Newman RD, Hailemariam A, Jimma D, Degifie A, Kebede D, Rietveld AE, Nahlen BL, Barnwell JW, Steketee RW, Parise ME, 2003. Burden of malaria during pregnancy in areas of stable and unstable transmission in Ethiopia during a nonepidemic year. J Infect Dis 187 : 1765–1772. [Google Scholar]
  14. Feresu SA, Harlow SD, Woelk GB, 2004. Risk factors for prematurity at Harare Maternity Hospital, Zimbabwe. Int J Epidemiol 33 : 1194–1201. [Google Scholar]
  15. Sirima SB, Sawadogo R, Moran AC, Konate A, Diarra A, Yameogo M, Parise ME, Newman RD, 2003. Failure of a chloroquine chemoprophylaxis program to adequately prevent malaria during pregnancy in Koupela District, Burkina Faso. Clin Infect Dis 36 : 1374–1382. [Google Scholar]
  16. McGready R, Davison BB, Stepniewska K, Cho T, Shee H, Brockman A, Udomsangpetch R, Looareesuwan S, White NJ, Meshnick SR, Nosten F, 2004. The effects of Plasmodium falciparum and P. vivax infections on placental histopathology in an area of low malaria transmission. Am J Trop Med Hyg 70 : 398–407. [Google Scholar]
  17. Tuikue Ndam NG, Salanti A, Bertin G, Dahlback M, Fievet N, Turner L, Gaye A, Theander T, Deloron P, 2005. High level of var2csa transcription by Plasmodium falciparum isolated from the placenta. J Infect Dis 192 : 331–335. [Google Scholar]
  18. Beeson JG, Amin N, Kanjala M, Rogerson SJ, 2002. Selective accumulation of mature asexual stages of Plasmodium falciparum-infected erythrocytes in the placenta. Infect Immun 70 : 5412–5415. [Google Scholar]
  19. McGready R, Brockman A, Cho T, Levesque MA, Tkachuk AN, Meshnick SR, Nosten F, 2002. Haemozoin as a marker of placental parasitization. Trans R Soc Trop Med Hyg 96 : 644–646. [Google Scholar]
  20. Balla G, Vercellotti GM, Muller-Eberhard U, Eaton J, Jacob HS, 1991. Exposure of endothelial cells to free heme potentiates damage mediated by granulocytes and toxic oxygen species. Lab Invest 64 : 648–655. [Google Scholar]
  21. Diouf I, Fievet N, Doucoure S, Ngom M, Gaye A, Dumont A, Ndao CT, Le Hesran JY, Chaouat G, Deloron P, 2004. Monocyte activation and T cell inhibition in Plasmodium falciparum-infected placenta. J Infect Dis 189 : 2235–2242. [Google Scholar]
  22. Fried M, Muga RO, Misore AO, Duffy PE, 1998. Malaria elicits type 1 cytokines in the human placenta: IFN-gamma and TNF-alpha associated with pregnancy outcomes. J Immunol 160 : 2523–2530. [Google Scholar]
  23. Guyatt HL, Snow RW, 2004. Impact of malaria during pregnancy on low birth weight in sub-Saharan Africa. Clin Microbiol Rev 17 : 760–769. [Google Scholar]
  24. Brabin BJ, Romagosa C, Abdelgalil S, Menendez 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 : 359–378. [Google Scholar]
  25. Bertin G, Ndam NT, Jafari-Guemouri S, Fievet N, Renart E, Sow S, Le Hesran JY, Deloron P, 2005. High prevalence of Plasmodium falciparum pfcrt K76T mutation in pregnant women taking chloroquine prophylaxis in Senegal. J Antimicrob Chemother 55 : 788–791. [Google Scholar]
  26. Sarr O, Myrick A, Daily J, Diop BM, Dieng T, Ndir O, Sow PS, Mboup S, Wirth DF, 2005. In vivo and in vitro analysis of chloroquine resistance in Plasmodium falciparum isolates from Senegal. Parasitol Res 97 : 136–140. [Google Scholar]
  27. Shulman CE, Dorman EK, Cutts F, Kawuondo K, Bulmer JN, Peshu N, Marsh K, 1999. Intermittent sulphadoxine-pyrimethamine to prevent severe anaemia secondary to malaria in pregnancy: a randomised placebo-controlled trial. The Lancet 353 : 632–636. [Google Scholar]
  28. Parise ME, Ayisi JG, Nahlen BL, Schultz LJ, Roberts JM, Misore A, Muga R, Oloo AJ, Steketee RW, 1998. Efficacy of sulfa-doxine-pyrimethamine for prevention of malaria and human immunodeficiency virus infection. Am J Trop Med Hyg 59 : 813–822. [Google Scholar]

Data & Media loading...

  • Received : 12 Aug 2005
  • Accepted : 17 Jan 2006

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