Effect of IPTp on Plasmodium falciparum antibody levels among pregnant women and their babies in a sub-urban coastal area in Ghana

Abstract Background Women exposed to Plasmodium infection develop antibodies and become semi-immune. This immunity is suppressed during pregnancy making both the pregnant woman and the foetus vulnerable to the adverse effects of malaria, particularly by Plasmodium falciparum. Intermittent preventive...

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Main Authors: Judith K. Stephens, Eric Kyei-Baafour, Emmanuel K. Dickson, Jones K. Ofori, Michael F. Ofori, Mark L. Wilson, Isabella A. Quakyi, Bartholomew D. Akanmori
Format: Article
Language:English
Published: BMC 2017-05-01
Series:Malaria Journal
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12936-017-1857-1
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author Judith K. Stephens
Eric Kyei-Baafour
Emmanuel K. Dickson
Jones K. Ofori
Michael F. Ofori
Mark L. Wilson
Isabella A. Quakyi
Bartholomew D. Akanmori
author_facet Judith K. Stephens
Eric Kyei-Baafour
Emmanuel K. Dickson
Jones K. Ofori
Michael F. Ofori
Mark L. Wilson
Isabella A. Quakyi
Bartholomew D. Akanmori
author_sort Judith K. Stephens
collection DOAJ
description Abstract Background Women exposed to Plasmodium infection develop antibodies and become semi-immune. This immunity is suppressed during pregnancy making both the pregnant woman and the foetus vulnerable to the adverse effects of malaria, particularly by Plasmodium falciparum. Intermittent preventive treatment of malaria in pregnancy (IPTp) with Sulfadoxine–pyrimethamine (SP) tablets is one of the current interventions to mitigate the effects of malaria on both the pregnant woman and the unborn child. The extent to which IPTp may interfere with the acquisition of protective immunity against pregnancy-associated malaria (PAM) is undefined in Ghana. Methods Three-hundred-and-twenty pregnant women were randomly enrolled at the antenatal clinic (ANC) in Madina, Accra. Venous blood samples were obtained at first ANC registration and at 4-week intervals (post-IPTp administration). Placental and cord blood samples were obtained at delivery and the infants were followed monthly for 6 months after birth. Anti-IgG and IgM antibodies against a crude antigen preparation and the glutamate-rich protein (GLURP) of P. falciparum were quantified by the enzyme-linked immunosorbent assay (ELISA). Results There was a general decline in the trend of mean concentrations of all the antibodies from enrolment to delivery. The levels of antibodies in cord blood and placenta were well correlated. Children did not show clinical signs of malaria at 6 months after birth. Conclusions IgG against both crude antigen and GLURP were present in placenta and cord blood and it is therefore concluded that there is a trend of declining antibody from enrolment to delivery and IPTp-SP may have reduced malaria exposure, however, this does not impact on the transfer of antibodies to the foetus in utero. The levels of maternal and cord blood antibodies at delivery showed no adverse implications on malaria among the children at 6 months. However, the quantum and quality of the antibody transferred needs further investigation to ensure that the infants are protected from severe episodes of malaria.
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spelling doaj.art-cb93951445c54ca897b88b76711f47942022-12-21T22:49:35ZengBMCMalaria Journal1475-28752017-05-0116111010.1186/s12936-017-1857-1Effect of IPTp on Plasmodium falciparum antibody levels among pregnant women and their babies in a sub-urban coastal area in GhanaJudith K. Stephens0Eric Kyei-Baafour1Emmanuel K. Dickson2Jones K. Ofori3Michael F. Ofori4Mark L. Wilson5Isabella A. Quakyi6Bartholomew D. Akanmori7Biological, Environmental and Occupational and Health Sciences Department, School of Public Health, College of Health Sciences, University of GhanaImmunology Department Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of GhanaImmunology Department Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of GhanaBiological, Environmental and Occupational and Health Sciences Department, School of Public Health, College of Health Sciences, University of GhanaImmunology Department Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of GhanaDepartment of Epidemiology, School of Public Health, The University of MichiganBiological, Environmental and Occupational and Health Sciences Department, School of Public Health, College of Health Sciences, University of GhanaImmunology Department Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of GhanaAbstract Background Women exposed to Plasmodium infection develop antibodies and become semi-immune. This immunity is suppressed during pregnancy making both the pregnant woman and the foetus vulnerable to the adverse effects of malaria, particularly by Plasmodium falciparum. Intermittent preventive treatment of malaria in pregnancy (IPTp) with Sulfadoxine–pyrimethamine (SP) tablets is one of the current interventions to mitigate the effects of malaria on both the pregnant woman and the unborn child. The extent to which IPTp may interfere with the acquisition of protective immunity against pregnancy-associated malaria (PAM) is undefined in Ghana. Methods Three-hundred-and-twenty pregnant women were randomly enrolled at the antenatal clinic (ANC) in Madina, Accra. Venous blood samples were obtained at first ANC registration and at 4-week intervals (post-IPTp administration). Placental and cord blood samples were obtained at delivery and the infants were followed monthly for 6 months after birth. Anti-IgG and IgM antibodies against a crude antigen preparation and the glutamate-rich protein (GLURP) of P. falciparum were quantified by the enzyme-linked immunosorbent assay (ELISA). Results There was a general decline in the trend of mean concentrations of all the antibodies from enrolment to delivery. The levels of antibodies in cord blood and placenta were well correlated. Children did not show clinical signs of malaria at 6 months after birth. Conclusions IgG against both crude antigen and GLURP were present in placenta and cord blood and it is therefore concluded that there is a trend of declining antibody from enrolment to delivery and IPTp-SP may have reduced malaria exposure, however, this does not impact on the transfer of antibodies to the foetus in utero. The levels of maternal and cord blood antibodies at delivery showed no adverse implications on malaria among the children at 6 months. However, the quantum and quality of the antibody transferred needs further investigation to ensure that the infants are protected from severe episodes of malaria.http://link.springer.com/article/10.1186/s12936-017-1857-1MalariaPregnancyAntibodiesIPTpPlacentaCord blood
spellingShingle Judith K. Stephens
Eric Kyei-Baafour
Emmanuel K. Dickson
Jones K. Ofori
Michael F. Ofori
Mark L. Wilson
Isabella A. Quakyi
Bartholomew D. Akanmori
Effect of IPTp on Plasmodium falciparum antibody levels among pregnant women and their babies in a sub-urban coastal area in Ghana
Malaria Journal
Malaria
Pregnancy
Antibodies
IPTp
Placenta
Cord blood
title Effect of IPTp on Plasmodium falciparum antibody levels among pregnant women and their babies in a sub-urban coastal area in Ghana
title_full Effect of IPTp on Plasmodium falciparum antibody levels among pregnant women and their babies in a sub-urban coastal area in Ghana
title_fullStr Effect of IPTp on Plasmodium falciparum antibody levels among pregnant women and their babies in a sub-urban coastal area in Ghana
title_full_unstemmed Effect of IPTp on Plasmodium falciparum antibody levels among pregnant women and their babies in a sub-urban coastal area in Ghana
title_short Effect of IPTp on Plasmodium falciparum antibody levels among pregnant women and their babies in a sub-urban coastal area in Ghana
title_sort effect of iptp on plasmodium falciparum antibody levels among pregnant women and their babies in a sub urban coastal area in ghana
topic Malaria
Pregnancy
Antibodies
IPTp
Placenta
Cord blood
url http://link.springer.com/article/10.1186/s12936-017-1857-1
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