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

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• 作者：Violeta Moya-Alvarez (18) (19) (20)
  Rosa Abellana (21)
  Michel Cot (18) (19)
  
  18. Institut de Recherche pour le D茅veloppement ; UMR 216 M猫re et enfant face aux infections tropicales ; Facult茅 de Pharmacie Paris Descartes ; 4 Avenue de l鈥橭bservatoire ; 75270 ; Paris ; France
  19. Centre Biom茅dical des Cordeliers ; Universit茅 Pierre et Marie Curie (Paris 6) ; 15 ; rue de l鈥橢cole de M茅decine ; 75006 ; Paris ; France
  20. R茅seau doctoral de l鈥橢cole des Hautes Etudes en Sant茅 Publique ; Avenue du Professeur L茅on-Bernard ; CS 74312-35043 ; Rennes ; France
  21. Departament de Salut P煤blica ; Facultat de Medicina ; Casanova 143 ; 08036 ; Barcelona ; Spain
  
• 关键词：Pregnancy ; associated malaria ; Immune tolerance ; Intermittent preventive treatment in pregnancy ; Parasitaemia ; Infancy ; Sulphadoxine ; pyrimethamine
• 刊名：Malaria Journal
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：13
• 期：1
• 全文大小：887 KB
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• 刊物主题：Parasitology; Infectious Diseases; Tropical Medicine;
• 出版者：BioMed Central
• ISSN：1475-2875

文摘

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.