Prevalence of Plasmodium falciparum infection among pregnant women at first antenatal visit in post-Ebola Monrovia, Liberia
Abstract Background Disruption of malaria control strategies during the West African 2014–2016 Ebola epidemic led to an increase in malaria-attributable mortality. However, recent data on malaria infection in vulnerable groups, such as pregnant women, are lacking in this post-Ebola scenario. This cr...
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| Format: | Article |
| Language: | English |
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BMC
2018-10-01
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| Series: | Malaria Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12936-018-2506-z |
| _version_ | 1831774727023099904 |
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| author | Guillermo Martínez-Pérez Dawoh Peter Lansana Senga Omeonga Himanshu Gupta Bondey Breeze-Barry Raquel González Azucena Bardají Adelaida Sarukhan James D. K. Goteh Edith Tody Pau Cisteró Benard Benda Juwe D. Kercula Fanta D. Kibungu Ana Meyer García-Sípido Quique Bassat Christine K. Tarr-Attia Alfredo Mayor |
| author_facet | Guillermo Martínez-Pérez Dawoh Peter Lansana Senga Omeonga Himanshu Gupta Bondey Breeze-Barry Raquel González Azucena Bardají Adelaida Sarukhan James D. K. Goteh Edith Tody Pau Cisteró Benard Benda Juwe D. Kercula Fanta D. Kibungu Ana Meyer García-Sípido Quique Bassat Christine K. Tarr-Attia Alfredo Mayor |
| author_sort | Guillermo Martínez-Pérez |
| collection | DOAJ |
| description | Abstract Background Disruption of malaria control strategies during the West African 2014–2016 Ebola epidemic led to an increase in malaria-attributable mortality. However, recent data on malaria infection in vulnerable groups, such as pregnant women, are lacking in this post-Ebola scenario. This cross-sectional study aimed to assess the prevalence of Plasmodium falciparum infection and of molecular markers of drug resistance among pregnant women attending antenatal care in Monrovia, capital of Liberia. Methods From October 2016 to June 2017, all pregnant women attending their first antenatal care visit at the Saint Joseph’s Catholic Hospital, Monrovia, were invited to participate in the study. In addition to their routine antenatal care tests, capillary blood spotted onto filter papers were collected from all consenting participants to determine presence of P. falciparum by real-time quantitative PCR. Molecular markers of anti-malarial drug resistance were assessed through Sanger sequencing and quantitative PCR in specimens positive for P. falciparum analysis. Results Of the 195 women participants, 24 (12.3%) were P. falciparum-positive by qPCR. Infected women tended to be more commonly primigravidae and younger than uninfected ones. Parasite densities were higher in primigravidae. Fever was more frequently detected among the infected women. No statistically significant association between P. falciparum infection and haemoglobin levels or insecticide-treated net use was found. While high prevalence of genetic polymorphisms associated with chloroquine and amodiaquine resistance were detected, no molecular markers of artemisinin resistance were observed. Conclusion Plasmodium falciparum infections are expected to occur in at least one in every eight women attending first ANC at private clinics in Monrovia and outside the peak of the rainy season. Young primigravidae are at increased risk of P. falciparum infection. Molecular analyses did not provide evidence of resistance to artemisinins among the P. falciparum isolates tested. Further epidemiological studies involving pregnant women are necessary to describe the risk of malaria in this highly susceptible group outside Monrovia, as well as to closely monitor the emergence of resistance to anti-malarials, as recommended by the Liberian National Malaria Control Programme. |
| first_indexed | 2024-12-22T08:59:45Z |
| format | Article |
| id | doaj.art-af25a19c7148429e94291df0311f3fa1 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-22T08:59:45Z |
| publishDate | 2018-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-af25a19c7148429e94291df0311f3fa12022-12-21T18:31:45ZengBMCMalaria Journal1475-28752018-10-0117111010.1186/s12936-018-2506-zPrevalence of Plasmodium falciparum infection among pregnant women at first antenatal visit in post-Ebola Monrovia, LiberiaGuillermo Martínez-Pérez0Dawoh Peter Lansana1Senga Omeonga2Himanshu Gupta3Bondey Breeze-Barry4Raquel González5Azucena Bardají6Adelaida Sarukhan7James D. K. Goteh8Edith Tody9Pau Cisteró10Benard Benda11Juwe D. Kercula12Fanta D. Kibungu13Ana Meyer García-Sípido14Quique Bassat15Christine K. Tarr-Attia16Alfredo Mayor17ISGlobal, Hospital Clínic-Universitat de BarcelonaSaint Joseph’s Catholic HospitalSaint Joseph’s Catholic HospitalISGlobal, Hospital Clínic-Universitat de BarcelonaSaint Joseph’s Catholic HospitalISGlobal, Hospital Clínic-Universitat de BarcelonaISGlobal, Hospital Clínic-Universitat de BarcelonaISGlobal, Hospital Clínic-Universitat de BarcelonaLiberia Medicines and Health Products Regulatory AuthoritySaint Joseph’s Catholic HospitalISGlobal, Hospital Clínic-Universitat de BarcelonaSaint Joseph’s Catholic HospitalLiberia Medicines and Health Products Regulatory AuthoritySaint Joseph’s Catholic HospitalNGO Juan Ciudad FoundationISGlobal, Hospital Clínic-Universitat de BarcelonaSaint Joseph’s Catholic HospitalISGlobal, Hospital Clínic-Universitat de BarcelonaAbstract Background Disruption of malaria control strategies during the West African 2014–2016 Ebola epidemic led to an increase in malaria-attributable mortality. However, recent data on malaria infection in vulnerable groups, such as pregnant women, are lacking in this post-Ebola scenario. This cross-sectional study aimed to assess the prevalence of Plasmodium falciparum infection and of molecular markers of drug resistance among pregnant women attending antenatal care in Monrovia, capital of Liberia. Methods From October 2016 to June 2017, all pregnant women attending their first antenatal care visit at the Saint Joseph’s Catholic Hospital, Monrovia, were invited to participate in the study. In addition to their routine antenatal care tests, capillary blood spotted onto filter papers were collected from all consenting participants to determine presence of P. falciparum by real-time quantitative PCR. Molecular markers of anti-malarial drug resistance were assessed through Sanger sequencing and quantitative PCR in specimens positive for P. falciparum analysis. Results Of the 195 women participants, 24 (12.3%) were P. falciparum-positive by qPCR. Infected women tended to be more commonly primigravidae and younger than uninfected ones. Parasite densities were higher in primigravidae. Fever was more frequently detected among the infected women. No statistically significant association between P. falciparum infection and haemoglobin levels or insecticide-treated net use was found. While high prevalence of genetic polymorphisms associated with chloroquine and amodiaquine resistance were detected, no molecular markers of artemisinin resistance were observed. Conclusion Plasmodium falciparum infections are expected to occur in at least one in every eight women attending first ANC at private clinics in Monrovia and outside the peak of the rainy season. Young primigravidae are at increased risk of P. falciparum infection. Molecular analyses did not provide evidence of resistance to artemisinins among the P. falciparum isolates tested. Further epidemiological studies involving pregnant women are necessary to describe the risk of malaria in this highly susceptible group outside Monrovia, as well as to closely monitor the emergence of resistance to anti-malarials, as recommended by the Liberian National Malaria Control Programme.http://link.springer.com/article/10.1186/s12936-018-2506-zMalariaPregnancyPrevalenceAntenatalLiberiaParasite resistance |
| spellingShingle | Guillermo Martínez-Pérez Dawoh Peter Lansana Senga Omeonga Himanshu Gupta Bondey Breeze-Barry Raquel González Azucena Bardají Adelaida Sarukhan James D. K. Goteh Edith Tody Pau Cisteró Benard Benda Juwe D. Kercula Fanta D. Kibungu Ana Meyer García-Sípido Quique Bassat Christine K. Tarr-Attia Alfredo Mayor Prevalence of Plasmodium falciparum infection among pregnant women at first antenatal visit in post-Ebola Monrovia, Liberia Malaria Journal Malaria Pregnancy Prevalence Antenatal Liberia Parasite resistance |
| title | Prevalence of Plasmodium falciparum infection among pregnant women at first antenatal visit in post-Ebola Monrovia, Liberia |
| title_full | Prevalence of Plasmodium falciparum infection among pregnant women at first antenatal visit in post-Ebola Monrovia, Liberia |
| title_fullStr | Prevalence of Plasmodium falciparum infection among pregnant women at first antenatal visit in post-Ebola Monrovia, Liberia |
| title_full_unstemmed | Prevalence of Plasmodium falciparum infection among pregnant women at first antenatal visit in post-Ebola Monrovia, Liberia |
| title_short | Prevalence of Plasmodium falciparum infection among pregnant women at first antenatal visit in post-Ebola Monrovia, Liberia |
| title_sort | prevalence of plasmodium falciparum infection among pregnant women at first antenatal visit in post ebola monrovia liberia |
| topic | Malaria Pregnancy Prevalence Antenatal Liberia Parasite resistance |
| url | http://link.springer.com/article/10.1186/s12936-018-2506-z |
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