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Longitudinal Studies of Plasmodium falciparum Malaria in Pregnant Women Living in a Rural Cameroonian Village with High Perennial Transmission

Abstract

Rose F. G. Leke, Jude D. Bioga, James Zhou, Genevieve G. Fouda, Robert J. I. Leke, Viviane Tchinda, Rosette Megnekou, Josephine Fogako, Grace Sama, Philomina Gwanmesia, Germaine Bomback, Charles Nama, Ababacar Diouf, Naveen Bobbili, and Diane Wallace Taylor

A prospective longitudinal study of Plasmodium falciparum in pregnant women was conducted in the rural village of Ngali II, where malaria is hyperendemic and individuals receive ~0.7 infectious mosquito bites/person/day throughout the year. Pregnant women (N = 60; 19 primigravidae, 41 multigravidae) were enrolled early in pregnancy (median 14 wk) and were followed monthly, with 38 women followed through term (5.7 ± 1.1 prenatal visits and delivery). The total number of times primigravidae were slide-positive during pregnancy was higher than multigravidae (3.3 ± 1.1 versus 1.3 ± 1.3 times; P  0.001), but no difference in the number of polymerase chain reactionpositive cases (4.6 ± 1.7 and 3.4 ± 1.7 times, P = 0.106) or total genotypes they harbored (8.9 ± 3.2 and 7.0 ± 2.9) was found. Only 7.9% women developed symptomatic infections. All primigravidae and 38% multigravidae were placental malaria-positive at delivery (P = 0.009). Genotyping showed that 77% of placental parasites were acquired ≥ 30 wks in pregnancy. These results help identify the extent of malaria-associated changes women experience during pregnancy

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