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Review
. 2014 Jul 11:13:271.
doi: 10.1186/1475-2875-13-271.

Pregnancy-associated malaria and malaria in infants: an old problem with present consequences

Violeta Moya-Alvarez  1 , Rosa Abellana, Michel Cot
Affiliations
Review

Pregnancy-associated malaria and malaria in infants: an old problem with present consequences

Violeta Moya-Alvarez et al. Malar J. .

Abstract

Albeit pregnancy-associated malaria (PAM) poses a potential risk for over 125 million women each year, an accurate review assessing the impact on malaria in infants has yet to be conducted. In addition to an effect on low birth weight (LBW) and prematurity, PAM determines foetal exposure to Plasmodium falciparum in utero and is correlated to congenital malaria and early development of clinical episodes during infancy. This interaction plausibly results from an ongoing immune tolerance process to antigens in utero, however, a complete explanation of this immune process remains a question for further research, as does the precise role of protective maternal antibodies. Preventive interventions against PAM modify foetal exposure to P. falciparum in utero, and have thus an effect on perinatal malaria outcomes. Effective intermittent preventive treatment in pregnancy (IPTp) diminishes placental malaria (PM) and its subsequent malaria-associated morbidity. However, emerging resistance to sulphadoxine-pyrimethamine (SP) is currently hindering the efficacy of IPTp regimes and the efficacy of alternative strategies, such as intermittent screening and treatment (IST), has not been accurately evaluated in different transmission settings. Due to the increased risk of clinical malaria for offspring of malaria infected mothers, PAM preventive interventions should ideally start during the preconceptual period. Innovative research examining the effect of PAM on the neurocognitive development of the infant, as well as examining the potential influence of HLA-G polymorphisms on malaria symptoms, is urged to contribute to a better understanding of PAM and infant health.

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Figures

Figure 1
Figure 1
Intermittent Preventive Treatment in pregnancy in Africa. Source: World Malaria report 2013. WHO publications 2013. A. Implementation of intermittent preventive treatment in pregnancy in Africa. B. The percentages of women having received at least 2 doses of IPTp are approximated data issue of the latest demographic surveys of the countries represented.
See this image and copyright information in PMC

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