Pregnancy-associated malaria

Pregnancy-associated malaria (PAM) is a presentation of the common illness that is particularly life threatening to both mother and developing fetus.[1] PAM is caused primarily by infection with Plasmodium falciparum,[1][2] the most dangerous of the four species of malaria-causing parasites that infect humans.[3] During her first pregnancy, a woman faces a much higher risk of contracting malaria and of associated complications.[4] Prevention and treatment of malaria are essential components of prenatal care in areas where the parasite is endemic.[5]

While the average adult citizen of an endemic region possesses some immunity to the parasite,[6] pregnancy causes complications that leave the woman and fetus extremely vulnerable.[1] The parasite interferes with transmission of vital substances through the fetal placenta,[1][7] often resulting in stillbirth, spontaneous abortion, or dangerously low birth weight.[1] The tragedy of malaria in developing countries receives abundant attention from the international health community, but until recently PAM and its unique complications were not adequately addressed.[8]

Contents

Signs and Symptoms

Women experiencing PAM may exhibit normal symptoms of malaria, but may also be asymptomatic or present with more mild symptoms, including a lack of the characteristic fever. This may prevent a woman from seeking treatment despite the danger to herself and her unborn child.[9][10]

Epidemiology

Globally, an estimated 125 million or more pregnant women per year risk contracting PAM.[11] Pregnancy-related malaria causes around 100,000 infant deaths each year, due in large part to low birth weight.[9]

References

  1. ^ a b c d e Srivastava, Anand; Gangnard, Stéphane; Round, Adam; Dechavanne, Sébastien; Juillerat, Alexandre; Raynal, Bertrand; Faure, Grazyna; Baron, Bruno et al. (2010). "Full-length extracellular region of the var2CSA variant of PfEMP1 is required for specific, high-affinity binding to CSA". Proceedings of the National Academy of Sciences 107 (11): 4884–9. doi:10.1073/pnas.1000951107. PMC 2841952. PMID 20194779. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2841952. Lay summary – ScienceDaily (March 12, 2010). 
  2. ^ "CDC-Malaria-Malaria Parasites". Centers for Disease Control and Prevention. http://www.cdc.gov/malaria/about/biology/parasites.html. 
  3. ^ Perlmann, P; Troye-Blomberg, M (2000). "Malaria blood-stage infection and its control by the immune system". Folia biologica 46 (6): 210–8. PMID 11140853. 
  4. ^ "Lives at Risk: Malaria in Pregnancy". WHO. http://who.int/features/2003/04b/en/. Retrieved March 30, 2011. 
  5. ^ Duffy, P. E.; M. Fried (2005). "Malaria in the Pregnant Woman". Current Topics in Microbiology and Immunology 295: 169–200. 
  6. ^ Doolan, Denise L.; Dobano, Carlota; Baird, J. Kevin (2009). "Acquired Immunity to Malaria". Clinical Microbiology Reviews 22 (1): 13–36, Table of Contents. doi:10.1128/CMR.00025-08. PMC 2620631. PMID 19136431. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2620631. 
  7. ^ Matteelli, BY; Caligaris, S; Castelli, F; Carosi, G (1997). "The placenta and malaria". Annals of Tropical Medicine and Parasitology 91 (7): 803–10. doi:10.1080/00034989760563. PMID 9625937. 
  8. ^ "Roll Back Malaria: Malaria in Pregnancy". WHO. http://www.rollbackmalaria.org/cmc_upload/0/000/015/369/RBMInfosheet_4.htm. Retrieved 18 April 2011. 
  9. ^ a b Desai, Meghna; et al. (22). "Epidemiology and burden of malaria in pregnancy". The Lancet 7 (2): 93–104. doi:10.1016/S1473-3099(07)70021-X. http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6W8X-4MWB62F-P&_user=655954&_coverDate=02%2F28%2F2007&_rdoc=1&_fmt=high&_orig=gateway&_origin=gateway&_sort=d&_docanchor=&view=c&_acct=C000035538&_version=1&_urlVersion=0&_userid=655954&md5=57b59fa469edb157b1d3e00e19e79a6b&searchtype=a. Retrieved April 14, 2011. 
  10. ^ "Burden of Malaria in Pregnancy in Latin America Not Known". Centers for Disease Control and Prevention. http://www.cdc.gov/malaria/malaria_worldwide/cdc_activities/activreg.html. Retrieved April 14, 2011. 
  11. ^ "New study finds 125 million pregnancies globally at risk from malaria every year". Malaria in Pregnancy Consortium. http://www.mip-consortium.org/resource_centre/press_releases/newstudyfinds125million.htm. Retrieved April 14, 2011. 

Further reading