Maternal Clinical Findings in Malaria in Pregnancy in a Region of Northwestern Colombia

Juan Gabriel Piñeros Malaria Group, Universidad de Antioquia, Medellín, Colombia

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Alberto Tobon-Castaño Malaria Group, Universidad de Antioquia, Medellín, Colombia

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Gonzalo Álvarez Malaria Group, Universidad de Antioquia, Medellín, Colombia

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Carmencita Portilla Malaria Group, Universidad de Antioquia, Medellín, Colombia

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Silvia Blair Malaria Group, Universidad de Antioquia, Medellín, Colombia

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In malaria-endemic regions of Latin America, little is known about malaria in pregnancy. To characterize the clinical and laboratory findings of maternal infection, we evaluated 166 cases of pregnant women infected with Plasmodium spp. in a prospective study conducted in northwestern Colombia during 2005–2006. A total of 89.8% (149 of 166) had fever or a history of fever in the past 48 hours, 9.0% (15 of 166) had severe malaria, of which 66.7% was caused by Plasmodium vivax and 33.3% by P. falciparum. Hepatic dysfunction was the main complication (9 of 15) observed. The proportion of severe cases was similar for both species (P = 0.41). In malaria-endemic areas of Colombia, malaria in pregnancy has a broad clinical spectrum. In pregnant women, P. vivax infection frequently leads to organ-specific complications.

Author Notes

* Address correspondence to Juan Gabriel Piñeros, Malaria Group, Universidad de Antioquia, Calle 62#52–59, Laboratorio 610, Medellín 050010, Colombia. E-mail: jgpinerosj@gmail.com

Financial support: This study was supported by the Colombian Science, Technology and Innovation Department within the framework of the Gestational and Congenital Malaria in Urabá project (1115-04-17041), the Antioquia District Health Department, and Estrategia de Sotenbilidad 2013-2014, Malaria Group, universidad de Antioquia.

Authors' addresses: Juan Gabriel Piñeros, Malaria Group, Universidad de Antioquia, Calle 62#52–59, Laboratorio 610, Medellín 050010, Colombia, E-mail: jgpinerosj@gmail.com. Alberto Tobon-Castaño, Gonzalo Álvarez, Carmencita Portilla, and Silvia Blair, Sede de Investigaciones Universitarias, Universidad de Antioquia, Medellín, Antioquia, Colombia, E-mails: albertobon@yahoo.com, lgonzalvarez@gmail.com, malaria@quimbaya.udea.edu.co, and silviablairt@gmail.com.

  • 1.

    Dellicour S, Tatem AJ, Guerra CA, Snow RW, ter Kuile FO, 2010. Quantifying the number of pregnancies at risk of malaria in 2007: a demographic study. PLoS Med 7: e1000221.

  • 2.

    Steketee RW, Nahlen BL, Parise ME, Menendez C, 2001. The burden of malaria in pregnancy in malaria-endemic areas. Am J Trop Med 64 (Suppl 1–2): 2835.

  • 3.

    Okoko BJ, Enwere G, Ota MO, 2003. The epidemiology and consequences of maternal malaria: A review of immunological basis. Acta Trop 87: 193205.

  • 4.

    Rogerson SJ, Hviid L, Duffy PE, Leke RF, Taylor DW, 2007. Malaria in pregnancy: pathogenesis and immunity. Lancet Infect Dis 7: 105117.

  • 5.

    Nosten F, Rogerson SJ, Beeson JG, McGready R, Mutabingwa TK, Brabin B, 2004. Malaria in pregnancy and the endemicity spectrum: What can we learn? Trends Parasitol 20: 425432.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    World Health Organization, 2010. Guidelines for the treatment of malaria, Second edition. NLM classification: WC 770. Available at: http://whqlibdoc.who.int/publications/2010/9789241547925_eng.pdf. Accessed August 2012.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Arevalo-Herrera M, Quiñones ML, Guerra C, Céspedes N, Giron S, Ahumada M, Piñeros JG, Padilla N, Terrientes Z, Rosas A, Padilla JC, Escalante AA, Beier JC, Herreia S, 2012. Malaria in selected non-Amazonian countries of Latin America. Acta Trop 121: 303314.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Fernández RD, García Y, Alger J, 2001. Malaria y embarazo: observaciones clínico-epidemiológicas en dos zonas geográficas de Honduras. Rev Med Hondur 69: 818.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Gómez E, López E, Ache A, 2009. Malaria y embarazo. Parroquia San Isidro, municipio Sifontes, estado Bolívar, Venezuela, años 2005–2006. Invest Clin 50: 455464.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Jarude R, Trindade R, Tavares-Neto J, 2003. Malária em grávidas de uma maternidade pública de Rio Branco (Acre, Brasil). Rev Bras Ginecol Obstet 25: 149154.

  • 11.

    Rodriguez-Morales AJ, Sanchez E, Vargas M, Piccolo C, Colina R, Arria M, Franco-Paredes C, 2006. Pregnancy outcomes associated with Plasmodium vivax malaria in northeastern Venezuela. Am J Trop Med Hyg 74: 755757.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Dirección Seccional de Salud de Antioquia, 2010. Eventos de Salud Pública: Enfermedades Transmitidas por Vectores a 2010. Available at: http://www.dssa.gov.co/index.php/estadisticas/eventos-de-salud-publica. Accessed July 2012.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    República de Colombia, Ministerio de Salud, Dirección General de Promoción y Prevención. Guía de Atención de Malaria, 2000. Norma Técnica 31/03/2000. Bogotá, Colombia: Diario Oficial 43.956.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Tobón A, 2009. Signos de peligro en el paciente con malaria. Biomedica 29: 320329.

  • 15.

    Tobón-Castaño A, Piñeros-Jiménez JG, Blair-Trujillo S, Carmona-Fonseca J, 2009. Clínica de la malaria complicada debida a P. falciparum. Estudio de casos y controles en Tumaco y Turbo (Colombia). Iatreia 19: 339355.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Tobón-Castaño A, Cortina A, Miranda AF, Blair-Trujillo S, 2010. Orina oscura e ictericia como signos de peligro en malaria por Plasmodium falciparum en Colombia. Rev Cubana Med Trop 62: 2835.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    World Health Organization, 2009. Methods for Surveillance of Antimalarial Drug Efficacy. NLM classification: QV 256. Available at: http://whqlibdoc.who.int/publications/2009/9789241597531_eng.pdf. Accessed August 2012.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    López-Antuñano FJ, Schmunis G, 1988. Diagnóstico de Malaria. Series Técnicas 143. Washington, DC: Organización Panamericana de la Salud.

  • 19.

    Osorio L, Todd J, Bradley D, 2004. Ausencia de malaria asintomática en escolares de Quibdo, Choco. Biomedica 24: 1319.

  • 20.

    Greenwood B, Alonso P, ter Kuile FO, Hill J, Steketee RW, 2007. Malaria in pregnancy: Priorities for research. Lancet Infect Dis 7: 169174.

  • 21.

    Shulman CE, Dorman EK, 2003. Importance and prevention of malaria in pregnancy. Trans R Soc Trop Med Hyg 97: 3035.

  • 22.

    Davies HD, Keystone J, Lester ML, Gold R, 1992. Congenital malaria in infants of asymptomatic women. CMAJ 146: 17551756.

  • 23.

    Schantz-Dunn J, Nour NM, 2009. Malaria and pregnancy: a global health perspective. Rev Obstet Gynecol. 2: 186192.

  • 24.

    Baird JK, 2007. Neglect of Plasmodium vivax malaria. Trends Parasitol 23: 533539.

  • 25.

    Anstey NM, Handojo T, Pain MC, Kenangalem E, Tjitra E, Price RN, Macguire GP, 2007. Lung injury in vivax malaria: pathophysiological evidence for pulmonary vascular sequestration and posttreatment alveolar-capillary inflammation. J Infect Dis 195: 589596.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Carvalho BO, Lopes SC, Nogueira PA, Orlandi PP, Bargieri DY, Blanco YC, Mamoni R, Leite JA, Rodrigues MM, Soares IS, Oliveira TR, Wunderlich G, Lacerda MV, del Portillo HA, Araújo MO, Russell B, Suwanarusk R, Snounou G, Rénia L, Costa FT, 2010. On the cytoadhesion of Plasmodium vivax-infected erythrocytes. J Infect Dis 202: 638647.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Jayavanth S, Park BC, 2007. Microrheologic dysfunctions in blood during malaria. Indian J Exp Biol 45: 111120.

  • 28.

    Andrade BB, Reis-Filho A, Souza-Neto SM, Clarêncio J, Camargo LM, Barral A, Barral-Netto M, 2010. Severe Plasmodium vivax malaria exhibits marked inflammatory imbalance. Malar J 9: 13.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Nosten F, McGready R, Simpson JA, Thwai KL, Balkan S, Cho T, Hkirijaroen L, Looaresuwan S, White NJ, 1999. Effects of Plasmodium vivax malaria in pregnancy. Lancet 354: 546549.

  • 30.

    Agudelo-Jaramillo B, Cadavid-Jaramillo AP, Bueno-Mendoza JC, Fisiología de la gestación. En: Botero J, Júbiz A, Henao G, eds. Obstetricia y Ginecología. Texto Integrado. Octava Edición. Medellín: Editorial CIB, 2008, 8591.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    World Health Organization, 2000. Severe falciparum malaria. Trans R Soc Trop Med Hyg 94 (Suppl): 190.

  • 32.

    Shulman CE, Levene M, Morison L, Dorman E, Peshu N, Marsh K, 2001. Screening for severe anaemia in pregnancy in Kenya, using pallor examination and self-reported morbidity. Trans R Soc Trop Med Hyg 95: 250255.

    • PubMed
    • Search Google Scholar
    • Export Citation
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