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Gemechu T, Dedecha W, Gelchu M, Husen O, Jarso H. Asymptomatic Malaria During Pregnancy: Prevalence, Influence on Anemia and Associated Factors in West Guji Zone, Ethiopia - A Community-Based Study. Infect Drug Resist 2023; 16:6747-6755. [PMID: 37876858 PMCID: PMC10591643 DOI: 10.2147/idr.s431877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/14/2023] [Indexed: 10/26/2023] Open
Abstract
Background Pregnant women with asymptomatic malaria parasitemia are at increased risk of anaemia, stillbirth, miscarriage, and preterm delivery. The asymptomatic nature of the population makes diagnosis difficult, and there is generally a lack of urgency to address this specific outcome. Objective This study aimed to determine the prevalence of asymptomatic malaria and associated factors among pregnant women in West Guji Zone, Oromia, Ethiopia. Methods A community-based cross-sectional study was conducted among randomly selected 557 asymptomatic pregnant women in the West Guji Zone from February to March 2022. A standardized questionnaire was used to collect information on socio-demographic and obstetric characteristics. Approximately 2 milliliters of peripheral blood was collected for microscopy to identify species and parasite density. Epi-Data and SPSS were used for data entry and analysis respectively. Binary logistic regression was used to identify risk factors. Results The prevalence of malaria among asymptomatic pregnant women was 24.10% (95% CI: 20.55%-27.65%). The prevalence of Plasmodium vivax and falciparum prevalence was 73 (54.5%) and 61 (45.5%), respectively. Of the study subjects, 105 (78.4%) had mild parasitemia and 29 (21.6%) had moderate parasitemia. Pregnant women with Plasmodium infection were anaemic in two-thirds (66.5%) of cases. Living near standing water (AOR=2.6, 95% CI: 1.74-3.96), having a history of Plasmodium species infection (AOR=2.12, 95% CI: 1.36-3.31), not using indoor residual spraying (AOR=2.0, 95% CI: 1.32-3.14), and not using insecticide-treated bed nets (AOR=1.62, 95% CI: 1.02-2.55) were all factors that were significantly associated with asymptomatic infection. Pregnant women with Plasmodium infection had a significantly higher rate of anaemia than those who were not infected (OR = 6.31, p = 0.000). Conclusion Pregnant women had a significant prevalence of asymptomatic Plasmodium infection. Regular screening, appropriate treatment for those who test positive, and health education for pregnant women should be provided by the West Guji Zone Health Bureau.
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Affiliation(s)
- Tibeso Gemechu
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Wako Dedecha
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Miesa Gelchu
- Department of Public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Oliyad Husen
- Department of Medical Laboratory Science, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Habtemu Jarso
- Department of Public Health, School of Health Science, Madda Walabu University Shashemene Campus, Shashemene, Ethiopia
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Carrión-Nessi FS, Mendoza-Millán DL, Omaña-Ávila ÓD, Romero SR, Moncada-Ortega A, Lopez-Perez M, Torres JR, Noya-González Ó, Forero-Peña DA. Plasmodium vivax and SARS-CoV-2 co-infection in Venezuelan pregnant women: a case series. Malar J 2023; 22:11. [PMID: 36611189 PMCID: PMC9825080 DOI: 10.1186/s12936-023-04442-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/04/2023] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Malaria-endemic areas are not spared from the impact of coronavirus disease 2019 (COVID-19), leading to co-infection scenarios where overlapping symptoms impose serious diagnostic challenges. Current knowledge on Plasmodium spp. and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co-infection in pregnant women remains limited, especially in Latin America, where Plasmodium vivax infection is highly prevalent. METHODS This is a case series of five pregnant women with P. vivax and SARS-CoV-2 co-infection hospitalized in two main malaria referral centers of the Capital District and Bolivar state, Venezuela between March 13, 2020 and December 31, 2021. RESULTS Clinical and laboratory data from five pregnant women with a mean age of 22 years were analyzed; three of them were in the third trimester of pregnancy. Comorbidities included obesity in two cases, hypertension in one, and asthma in one. Three out of five patients had severe to critical COVID-19 disease. Dry cough, fever, chills, and headache were the most frequent symptoms reported. Laboratory analyses showed elevated aspartate/alanine aminotransferase and creatinine levels, thrombocytopenia, and severe anemia as the most relevant abnormalities. The mean period between symptom onset and a positive molecular test for SARS-CoV-2 infection or positive microscopy for Plasmodium spp. was 4.8 ± 2.5 days and 2.8 ± 1.6 days, respectively. The mean hospital stay was 5.4 ± 7 days. Three women recovered and were discharged from the hospital. Two women died, one from cerebral malaria and one from respiratory failure. Three adverse fetal outcomes were registered, two miscarriages and one stillbirth. CONCLUSION This study documented a predominance of severe/critical COVID-19 disease and a high proportion of adverse maternal-fetal outcomes among pregnant women with malaria and COVID-19 co-infection. More comprehensive prospective cohort studies are warranted to explore the risk factors, management challenges, and clinical outcomes of pregnant women with this co-infection.
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Affiliation(s)
- Fhabián S. Carrión-Nessi
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela ,“Dr. Francisco Battistini Casalta” Health Sciences School, University of Oriente – Bolivar Nucleus, Ciudad Bolivar, Venezuela
| | - Daniela L. Mendoza-Millán
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela ,grid.8171.f0000 0001 2155 0982“Luis Razetti” School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - Óscar D. Omaña-Ávila
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela ,grid.8171.f0000 0001 2155 0982“Luis Razetti” School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - Sinibaldo R. Romero
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela ,grid.17635.360000000419368657Medical Scientist Training Program (MD/PhD), University of Minnesota Medical School, Minneapolis, USA
| | - Augusto Moncada-Ortega
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela ,grid.8171.f0000 0001 2155 0982“José María Vargas” School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - Mary Lopez-Perez
- grid.5254.60000 0001 0674 042XCentre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jaime R. Torres
- grid.8171.f0000 0001 2155 0982Infectious Diseases Section, “Dr. Félix Pifano” Tropical Medicine Institute, Central University of Venezuela, Caracas, Venezuela
| | - Óscar Noya-González
- grid.8171.f0000 0001 2155 0982Infectious Diseases Section, “Dr. Félix Pifano” Tropical Medicine Institute, Central University of Venezuela, Caracas, Venezuela ,Centro Para Estudios Sobre Malaria, “Dr. Arnoldo Gabaldón” High Studies Institute, Caracas, Venezuela
| | - David A. Forero-Peña
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela ,grid.411226.2Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
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Abstract
PURPOSE OF REVIEW This is a review of Plasmodium vivax epidemiology, pathogenesis, disease presentation, treatment and innovations in control and elimination. Here, we examine the recent literature and summarize new advances and ongoing challenges in the management of P. vivax . RECENT FINDINGS P. vivax has a complex life cycle in the human host which impacts disease severity and treatment regimens. There is increasing data for the presence of cryptic reservoirs in the spleen and bone marrow which may contribute to chronic vivax infections and possibly disease severity. Methods to map the geospatial epidemiology of P. vivax chloroquine resistance are advancing, and they will inform local treatment guidelines. P. vivax treatment requires an 8-aminoquinoline to eradicate the dormant liver stage. Evidence suggests that higher doses of 8-aminoquinolines may be needed for radical cure of tropical frequent-relapsing strains. SUMMARY P. vivax is a significant global health problem. There have been recent developments in understanding the complexity of P. vivax biology and optimization of antimalarial therapy. Studies toward the development of best practices for P. vivax control and elimination programs are ongoing.
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Affiliation(s)
- Nazia Khan
- Department of Medicine (Infectious Diseases), Albert Einstein College of Medicine, Bronx, New York
| | - Johanna P. Daily
- Department of Medicine (Infectious Diseases), Albert Einstein College of Medicine, Bronx, New York
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Mtalimanja M, Abasse KS, Abbas M, Mtalimanja JL, Zhengyuan X, DuWenwen, Cote A, Xu W. Tracking malaria health disbursements by source in Zambia, 2009-2018: an economic modelling study. Cost Eff Resour Alloc 2022; 20:34. [PMID: 35864530 PMCID: PMC9306103 DOI: 10.1186/s12962-022-00371-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 07/05/2022] [Indexed: 12/02/2022] Open
Abstract
Background Zambia has made profound strides in reducing both the incidence and prevalence of malaria followed by reducing malaria related deaths between 2009 and 2018. The number of partners providing malaria funding has significantly increased in the same period. The increasing number of partners and the subsequent reduction of the number of reported malaria cases in the Ministry of Health main data repository Health Management Information System (HMIS) stimulated this research. The study aimed at (1) identifying major sources of malaria funding in Zambia; (2) describe malaria funding per targeted interventions and (3) relating malaria funding with malaria disease burden. Methods Data was collected using extensive literature review of institutional strategic document between the year 2009 to 2018, assuming one-year time lag between investment and the health outcome across all interventions. The National’s Health Management Information System (HMIS) provided information on annual malaria admission cases and outpatient clinic record. The statistical package for social sciences (SPSS) alongside Microsoft excel was used to analyze data in the year 2019. Results The investigation observed that about 30% of the funding came from PMI/USAID, 26% from the global funds, the government of Zambia contributed 17% and other partners sharing the remaining 27%. Multivariate regression analysis suggests a positive correlation between reducing reported malaria disease burden in HMIS 2009–2018 and concurrent increasing program/intervention funding towards ITNs, IRS, MDA, and Case Management with r2 = 77% (r2 > 0.77; 95% CI: 0.72–0.81). Furthermore, IRS showed a p-value 0.018 while ITNs, Case Management and MDA having 0.029, 0.030 and 0.040 respectively. Conclusion Our findings highlight annual funding towards specific malaria intervention reduced the number of malaria admission cases. Supplementary Information The online version contains supplementary material available at 10.1186/s12962-022-00371-2.
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Affiliation(s)
- Michael Mtalimanja
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, Jiangsu, China
| | - Kassim Said Abasse
- Centre de Recherche en Gestion Des Services de Sante, Faculté Des Sciences de L'administration (FSA), Université Laval (UL), Centre Hospitalière Universitaire (CHU) de Québec UL-IUCPQ-UL, Québec, QC, Canada
| | - Muhammad Abbas
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Islamabad, Pakistan
| | - James Lamon Mtalimanja
- Department of Monitoring and Evaluation, Ministry of Health, P.O Box, 30205, Lusaka, Zambia
| | - Xu Zhengyuan
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, Jiangsu, China
| | - DuWenwen
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, Jiangsu, China
| | - Andre Cote
- Centre de Recherche en Gestion Des Services de Sante, Faculté Des Sciences de L'administration (FSA), Université Laval (UL), Centre Hospitalière Universitaire (CHU) de Québec UL-IUCPQ-UL, Québec, QC, Canada
| | - Wei Xu
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, 211198, Jiangsu, China. .,Riphah Institute of Pharmaceutical Sciences, Riphah International University, Islamabad, Pakistan.
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Kumar M, Saadaoui M, Al Khodor S. Infections and Pregnancy: Effects on Maternal and Child Health. Front Cell Infect Microbiol 2022; 12:873253. [PMID: 35755838 PMCID: PMC9217740 DOI: 10.3389/fcimb.2022.873253] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/04/2022] [Indexed: 12/22/2022] Open
Abstract
Pregnancy causes physiological and immunological adaptations that allow the mother and fetus to communicate with precision in order to promote a healthy pregnancy. At the same time, these adaptations may make pregnant women more susceptible to infections, resulting in a variety of pregnancy complications; those pathogens may also be vertically transmitted to the fetus, resulting in adverse pregnancy outcomes. Even though the placenta has developed a robust microbial defense to restrict vertical microbial transmission, certain microbial pathogens have evolved mechanisms to avoid the placental barrier and cause congenital diseases. Recent mechanistic studies have begun to uncover the striking role of the maternal microbiota in pregnancy outcomes. In this review, we discuss how microbial pathogens overcome the placental barrier to cause congenital diseases. A better understanding of the placental control of fetal infection should provide new insights into future translational research.
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Affiliation(s)
- Manoj Kumar
- Research Department, Sidra Medicine, Doha, Qatar
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Kumar R, Farzeen M, Ahmed J, Lal M, Somrongthong R. Predictors of knowledge and use of long-lasting insecticidal nets for the prevention of malaria among the pregnant women in Pakistan. Malar J 2021; 20:347. [PMID: 34425857 PMCID: PMC8381575 DOI: 10.1186/s12936-021-03878-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/15/2021] [Indexed: 11/30/2022] Open
Abstract
Background Malaria is endemic to Pakistan with high prevalence among pregnant women and linked with maternal anaemia, intrauterine growth retardation, preterm birth, and low birth weight. The use of long-lasting insecticidal nets (LLINs) is a proven and cost-effective intervention preventing malaria among pregnant women. The present study aimed to explore predictors of knowledge and use of LLINs among pregnant women in Pakistan. Methods This was part of a quasi-experimental study of 200 pregnant women conducted in a rural district of Sindh province in Pakistan. Data were collected using Malaria Indicator Survey questionnaires developed by Roll Back Malaria Partnership to end Malaria Monitoring and Evaluation Reference Group. Pregnant women and mothers with newborns of six months of age were interviewed in their homes. Results The age of the women was from 18 to 45, two thirds of the respondents (72.5%) were uneducated and married (77%). Majority (92%) of the women had received antenatal care during pregnancy, and 29.5% women had received counseling on malaria during their antenatal care visits. Multiple linear regression showed that the type of latrine was the most significant (β = 0.285, p < 0.001) determinant of knowledge about malaria among pregnant women followed by the death of a newborn (β = 0.271, p < 0.001). The use of mobile phone was the most significant (β = 0.247, p < 0.001) predictor of usage of LLINs among pregnant women followed by the death of a newborn (β = 0.232, p < 0.05). Conclusions Maternal education, type of latrine, use of mobile phone, malaria during previous pregnancy and newborn death were strong predictors of knowledge and use of LLINs in pregnant women in Pakistan. There is a need to scale-up programmes that aim to create awareness regarding malaria among pregnant women. Mobile phone technology can be used to implement awareness programmes focusing on malaria prevention among women.
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Affiliation(s)
- Ramesh Kumar
- Health Services Academy, Ministry of National Health Services Regulation and Coordination, Government of Pakistan, Islamabad, Pakistan. .,College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand.
| | - Midhat Farzeen
- Health Services Academy, Ministry of National Health Services Regulation and Coordination, Government of Pakistan, Islamabad, Pakistan
| | - Jamil Ahmed
- Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Manohar Lal
- Health Services Academy, Ministry of National Health Services Regulation and Coordination, Government of Pakistan, Islamabad, Pakistan
| | - Ratana Somrongthong
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
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