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Placental malaria is rare among Zanzibari pregnant women who did not receive intermittent preventive treatment in pregnancy.

Plotkin M, Said K, Msellem MI, Chase RP, Hendler N, Khamis AR, Roman E, Kitojo C, Schwartz AC, Gutman J, McElroy PD - Am. J. Trop. Med. Hyg. (2014)

Bottom Line: Dried placental blood spot specimens were analyzed by polymerase chain reaction (PCR); 9 of 1,349 specimens (0.7%; precision estimate = 0.2-1.1%) were PCR-positive for Plasmodium falciparum.Placental infection was detected on both Pemba (N = 3) and Unguja (N = 6).It may be reasonable for the Ministry of Health to consider discontinuing IPTp, intensifying surveillance efforts, and promoting insecticide-treated nets and effective case management of malaria in pregnancy.

View Article: PubMed Central - PubMed

Affiliation: Jhpiego Tanzania, Dar es Salaam, Tanzania; Zanzibar Malaria Elimination Programme Zanzibar Ministry of Health, Tanzania; Jhpiego Baltimore, Baltimore, Maryland; Department of International Health, John Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Medicine, University of California, San Francisco, California; US President's Malaria Initiative and Centers for Disease Control and Prevention Tanzania, Dar es Salaam, Tanzania; Centers for Disease Control and Prevention, Atlanta, Georgia Marya.Plotkin@jhpiego.org.

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Placental specimens collected by month in Pemba and Unguja, Zanzibar.
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Figure 1: Placental specimens collected by month in Pemba and Unguja, Zanzibar.

Mentions: In total, 1,411 pregnant women were enrolled at the time of delivery. Data and specimens from 74 enrollees were not analyzed because of mislabeling, duplicate IDs, missing client cards, or loss. After exclusion of these 74 women, our analysis included 1,339 women from Pemba (N = 694) and Unguja (N = 645). The average age of enrolled women was 27 years (range = 15–48 years), and 433 (32%) women were primigravidae (Table 1). The proportion of primigravidae varied by facility (from 14% of the enrolled women at Mwembeladu to 42% of the enrolled women at Mnazi Mmoja). The enrollees included both singleton (N = 1,326) and twin (N = 13) pregnancies. Birth outcomes experienced by these women included 1,308 (97%) live births, 22 (2%) stillbirths, and 73 (5%) LBW deliveries (Table 1). The majority of enrolments (67%) occurred in the first 4 months of the study (Figure 1), likely because of SP stockouts preceding and during this period. Overall, 6% of all deliveries at the six facilities were enrolled (ranging from 4% to 15%). Although only 23% of all deliveries at Zanzibar health facilities occurred on Pemba in 2011, deliveries from Pemba comprised 52% of the total enrolment in this study.


Placental malaria is rare among Zanzibari pregnant women who did not receive intermittent preventive treatment in pregnancy.

Plotkin M, Said K, Msellem MI, Chase RP, Hendler N, Khamis AR, Roman E, Kitojo C, Schwartz AC, Gutman J, McElroy PD - Am. J. Trop. Med. Hyg. (2014)

Placental specimens collected by month in Pemba and Unguja, Zanzibar.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4125264&req=5

Figure 1: Placental specimens collected by month in Pemba and Unguja, Zanzibar.
Mentions: In total, 1,411 pregnant women were enrolled at the time of delivery. Data and specimens from 74 enrollees were not analyzed because of mislabeling, duplicate IDs, missing client cards, or loss. After exclusion of these 74 women, our analysis included 1,339 women from Pemba (N = 694) and Unguja (N = 645). The average age of enrolled women was 27 years (range = 15–48 years), and 433 (32%) women were primigravidae (Table 1). The proportion of primigravidae varied by facility (from 14% of the enrolled women at Mwembeladu to 42% of the enrolled women at Mnazi Mmoja). The enrollees included both singleton (N = 1,326) and twin (N = 13) pregnancies. Birth outcomes experienced by these women included 1,308 (97%) live births, 22 (2%) stillbirths, and 73 (5%) LBW deliveries (Table 1). The majority of enrolments (67%) occurred in the first 4 months of the study (Figure 1), likely because of SP stockouts preceding and during this period. Overall, 6% of all deliveries at the six facilities were enrolled (ranging from 4% to 15%). Although only 23% of all deliveries at Zanzibar health facilities occurred on Pemba in 2011, deliveries from Pemba comprised 52% of the total enrolment in this study.

Bottom Line: Dried placental blood spot specimens were analyzed by polymerase chain reaction (PCR); 9 of 1,349 specimens (0.7%; precision estimate = 0.2-1.1%) were PCR-positive for Plasmodium falciparum.Placental infection was detected on both Pemba (N = 3) and Unguja (N = 6).It may be reasonable for the Ministry of Health to consider discontinuing IPTp, intensifying surveillance efforts, and promoting insecticide-treated nets and effective case management of malaria in pregnancy.

View Article: PubMed Central - PubMed

Affiliation: Jhpiego Tanzania, Dar es Salaam, Tanzania; Zanzibar Malaria Elimination Programme Zanzibar Ministry of Health, Tanzania; Jhpiego Baltimore, Baltimore, Maryland; Department of International Health, John Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Medicine, University of California, San Francisco, California; US President's Malaria Initiative and Centers for Disease Control and Prevention Tanzania, Dar es Salaam, Tanzania; Centers for Disease Control and Prevention, Atlanta, Georgia Marya.Plotkin@jhpiego.org.

Show MeSH
Related in: MedlinePlus