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A prospective longitudinal study of Plasmodium falciparum in pregnant women was conducted in the rural village of Ngali II, where malaria is hyperendemic and individuals receive ~0.7 infectious mosquito bites/person/day throughout the year. Pregnant women (N = 60; 19 primigravidae, 41 multigravidae) were enrolled early in pregnancy (median 14 wk) and were followed monthly, with 38 women followed through term (5.7 ± 1.1 prenatal visits and delivery). The total number of times primigravidae were slide-positive during pregnancy was higher than multigravidae (3.3 ± 1.1 versus 1.3 ± 1.3 times; P < 0.001), but no difference in the number of polymerase chain reaction-positive cases (4.6 ± 1.7 and 3.4 ± 1.7 times, P = 0.106) or total genotypes they harbored (8.9 ± 3.2 and 7.0 ± 2.9) was found. Only 7.9% women developed symptomatic infections. All primigravidae and 38% multigravidae were placental malaria-positive at delivery (P = 0.009). Genotyping showed that 77% of placental parasites were acquired ≥ 30 wks in pregnancy. These results help identify the extent of malaria-associated changes women experience during pregnancy.
Financial support: This study was supported by the NIAID grant no. UO1 AI43888.
Authors' addresses: Rose F. G. Leke, Faculty of Medicine and Biomedical Research, Jude D. Bigoga, Faculty of Science, Department of Biochemistry, Robert J. I. Leke, Department of Obstetrics and Gynecology, Yaoundé Central Hospital, University of Yaoundé 1, Yaoundé, Cameroon, E-mails: roseleke@yahoo.com, judebigoga@yahoo.com, and robertjleker@yahoo.fr. Viviane Tchinda, Rosette Megnekou, Josephine Fogako, Grace Sama, Philomina Gwanmesia, and Germaine Bomback, The Biotechnology Center, University of Yaoundé 1, Yaoundé, Cameroon, E-mails: vtchinda1@yahoo.com, megnekor@yahoo.com, fogakoj@yahoo.com, menyensg@yahoo.com, and wanp2003@yahoo.com. James Zhou, AZ DataClinic, Inc., Rockville, MD, E-mail: jameszhou7@gmail.com. Genevieve G. Fouda, Laboratory for AIDS Vaccine and Development, Duke University Medical Center, Durham, NC, E-mail: ginyfouda@yahoo.com. Ababacar Diouf, Malaria Immunology Section, Laboratory of Malaria and Vector Research, NIAID, NIH, Rockville, MD, E-mail: dioufa@niaid.nih.gov. Naveen Bobbili and Diane Wallace Taylor, Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, E-mails: bobbili@hawaii and dwtaylor@hawaii.edu.edu.