Molecular Detection of Malaria at Delivery Reveals a High Frequency of Submicroscopic Infections and Associated Placental Damage in Pregnant Women from Northwest Colombia

Eliana M. Arango Grupo Salud y Comunidad, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Provincial Laboratory for Public Health, Edmonton, Canada; School of Public Health, University of Alberta, Alberta, Canada

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Roshini Samuel Grupo Salud y Comunidad, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Provincial Laboratory for Public Health, Edmonton, Canada; School of Public Health, University of Alberta, Alberta, Canada

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Olga M. Agudelo Grupo Salud y Comunidad, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Provincial Laboratory for Public Health, Edmonton, Canada; School of Public Health, University of Alberta, Alberta, Canada

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Jaime Carmona-Fonseca Grupo Salud y Comunidad, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Provincial Laboratory for Public Health, Edmonton, Canada; School of Public Health, University of Alberta, Alberta, Canada

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Amanda Maestre Grupo Salud y Comunidad, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Provincial Laboratory for Public Health, Edmonton, Canada; School of Public Health, University of Alberta, Alberta, Canada

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Stephanie K. Yanow Grupo Salud y Comunidad, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Provincial Laboratory for Public Health, Edmonton, Canada; School of Public Health, University of Alberta, Alberta, Canada

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Plasmodium infection in pregnancy causes substantial maternal and infant morbidity and mortality. In Colombia, both P. falciparum and P. vivax are endemic, but the impact of either species on pregnancy is largely unknown in this country. A cross-sectional study was carried out with 96 pregnant women who delivered at their local hospital. Maternal, placental, and cord blood were tested for malaria infection by microscopy and real-time quantitative polymerase chain reaction (qPCR). A high frequency of infection was detected by qPCR (45%). These infections had low concentrations of parasite DNA, and 79% were submicroscopic. Submicroscopic infections were associated with placental villitis and intervillitis. In conclusion, the overall frequency of Plasmodium infection at delivery in Colombia is much higher than previously reported. These data prompt a re-examination of the local epidemiology of malaria using molecular diagnostics to establish the clinical relevance of submicroscopic infections during pregnancy as well as their consequences for mothers and newborns.

Author Notes

* Address correspondence to Stephanie K. Yanow, School of Public Health, University of Alberta, Alberta, Canada and Provincial Laboratory for Public Health, Edmonton, Canada. E-mail: stephanie.yanow@albertahealthservices.ca

Financial support: This work was supported by the Departamento Administrativo de Ciencia, Tecnología e Inovación Colciencias (Project Codes 111540820495 and 111549326134), the Universidad de Antioquia (Project Codes IIM 8764-2530 and IIM 8764-2557; Estrategia de Sostenibilidad 2013–2014), and the Canadian Institutes of Health Research (Catalyst Grant in Maternal Health: FRN 115440).

Authors' addresses: Eliana M. Arango, Olga M. Agudelo, Jaime Carmona-Fonseca, and Amanda Maestre, Grupo Salud y Comunidad, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia, E-mails: emarango@gmail.com, momag204@gmail.com, jaimecarmonaf@hotmail.com, and aemaestre@gmail.com. Roshini Samuel, Provincial Laboratory for Public Health, Edmonton, Canada, E-mail: roshini@ualberta.ca. Stephanie K. Yanow, School of Public Health, University of Alberta, Alberta, Canada and Provincial Laboratory for Public Health, Edmonton, Canada, E-mail: stephanie.yanow@albertahealthservices.ca.

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