Malaria and pregnancy in Cameroonian women. Effect of pregnancy on Plasmodium falciparum parasitemia and the response to chloroquine.
The interaction between malaria and pregnancy was investigated in an epidemiologic study conducted in Mfou, a rural community in Cameroon. The study consisted of both cross-sectional and longitudinal analyses involving 225 pregnant women and 75 nonpregnant controls. Information was obtained by a standardized questionnaire to determine the pattern of antimalarial drug use. The parasitologic response to chloroquine was also determined. A dosage of chloroquine base (25 mg/kg of body weight) was given to women over a 3-day period, followed by 5 mg/kg doses administered weekly for 4 weeks. The results showed that Plasmodium falciparum infections occurred more frequently in pregnant (45%) than in nonpregnant (31%) women in terms of parasite rates (p = 0.03) and density (p less than 0.003), especially in primigravidae as compared with multigravidae matched for parity and age. Levels of parasitemia were also higher in the second trimester than in the first trimester of pregnancy (p less than 0.01). Failure to clear parasitemia after a chloroquine regimen was more frequent in pregnant than in nonpregnant women (p less than 0.01), particularly in primigravidae. Higher parasitemia and a lower parasitologic response to chloroquine in pregnant women, especially in primigravidae, suggest a relatively low level of clinical immunity and emphasize the need to target this group of women for malaria control strategies.
Mvondo
J L
JL
Institute of Medical Research and Study of Medicinal Plants, Yaoundé, Cameroon.
James
M A
MA
Campbell
C C
CC
D002163:Cameroon / Q000453:epidemiology; D002738:Chloroquine / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D016778:Malaria, Falciparum / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population; D011795:Surveys and Questionnaires
D002738:Chloroquine