Article
Malaria during Pregnancy in a Reference Centre from the Brazilian Amazon: Unexpected Increase in the Frequency of Plasmodium falciparum Infections
Registro en:
MARTINEZ-ESPINOZA, Flor Ernestina; RIBEIRO, Cláudio Tadeu Daniel; ALECRIM, Wilson Duarte. Malaria during Pregnancy in a Reference Centre from the Brazilian Amazon: Unexpected Increase in the Frequency of Plasmodium falciparum Infections. Memórias do Instituto Oswaldo Cruz, Rio de Janeiro, v. 99, n. 1, p. 19-21, Feb. 2004.
0074-0206
10.1590/S0074-02762004000100003
1678-8060
Autor
Martínez-Espinosa, Flor Ernestina
Ribeiro, Cláudio Tadeu Daniel
Alecrim, Wilson Duarte
Resumen
Malaria remains globally the most important parasitic disease of man. Data on its deleterious effects during
pregnancy have been extensively documented in hyperendemic, holoendemic, and mesoendemic areas – from Africa
and Asia – where Plasmodium falciparum is responsible for almost all infections. However, knowledge about malaria
during pregnancy in areas where transmission is unstable and P. vivax is the most prevalent species, such as the
Brazilian Amazon, is scarce. Here, we report a preliminary cross sectional descriptive study, carried out at the
Fundação de Medicina Tropical do Amazonas, a reference centre for diagnosis and treatment of tropical diseases in
the west-Amazon (Manaus, Brazil). A total of 1699 febrile childbearing age women had positive thick blood smears
to Plasmodium species, between January and November 1997: 1401 (82.5%) were positive for P. vivax, 286 (16.8%)
for P. falciparum and 12 (0.07%) carried mixed infections. From the malarious patients, 195 were pregnant. The ratio
of P. falciparum to P. vivax infections in the group of non-pregnant infected women was 1:5.6 while it was 1:2.3 in that
of pregnant infected ones. Similar rates or even proportionally more vivax infections during pregnancy were
expected to occur, in function of the contraindication of primaquine with the resulting increased P. vivax relapse
rates. Such an observation suggests that the mechanism of resistance/susceptibility to infection and/or malaria
pathogenesis in pregnant women may differ according to Plasmodium species and that the extensively described
increase in the frequencies of malaria infection during pregnancy may be specifically due to P. falciparum infection.
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