Malaria continues to cause devastation during pregnancy. Unfortunately, there is still no clear strategy to effectively protect pregnant women and countless mothers living in malaria endemic countries are dying every year.
The molecular basis of sulfadoxine-pyrimethamine (SP) resistance lies in a combination of single-nucleotide polymorphisms (SNPs) in two genes coding for Plasmodium falciparum dihydrofolate reductase (Pfdhfr) and P. falciparum dihydropteroate synthase (Pfdhps), targeted by pyrimethamine and sulfadoxine, respectively.
Prolonged time to recrudescence may occur in pregnancy, regardless of anti-malarial treatment.
In 2014, a global ‘Call to Action’ seminar for the scale-up of intermittent preventive treatment of malaria in pregnancy was held during the 63rd Annual Meeting of the American Society of Tropical Medicine and Hygiene.
In the current cohort nutrient supplementation did not affect anti-malarial antibody responses, but poor and undernourished mothers should be a priority group in future trials.
Use of SP for malaria treatment is common during pregnancy.
Malaria parasites in human Madagascan highland populations trigger immunity but could also be a reservoir for malaria epidemics.
The placental thickness changes were significant but caused no foetal repercussions at birth.
Gametocytaemia is present in 5% of pregnant women at their first antenatal visit and associated with placental malaria. SP-IPTp does not alter the risk of gametocytaemia.
This study provides valuable data for the evaluation of effectiveness and factors affecting MCI.