title: Malaria in pregnant women living in areas of low transmission on the southeast Brazilian Coast: molecular diagnosis and humoural immunity profile.
abstract: Studies on autochthonous malaria in low-transmission areas in Brazil have acquired epidemiological relevance because they suggest continued transmission in what remains of the Atlantic Forest. In the southeastern portion of the state of São Paulo, outbreaks in the municipality of Juquitiba have been the focus of studies on the prevalence of Plasmodium, including asymptomatic cases. Data on the occurrence of the disease or the presence of antiplasmodial antibodies in pregnant women from this region have not previously been described. Although Plasmodium falciparum in pregnant women has been widely addressed in the literature, the interaction of Plasmodium vivax and Plasmodium malariae with this cohort has been poorly explored to date. We monitored the circulation of Plasmodium in pregnant women in health facilities located in Juquitiba using thick blood film and molecular protocols, as well as immunological assays, to evaluate humoural immune parameters. Through real-time and nested polymerase chain reaction, P. vivax and P. malariae were detected for the first time in pregnant women, with a positivity of 5.6%. Immunoassays revealed the presence of IgG antibodies: 44% for ELISA-Pv, 38.4% for SD-Bioline-Pv and 18.4% for indirect immunofluorescence assay-Pm. The high prevalence of antibodies showed significant exposure of this population to Plasmodium. In regions with similar profiles, testing for a malaria diagnosis might be indicated in prenatal care.
authors.affiliation: Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Angélica Domingues
authors.initials: AD
authors.lastname: Hristov
authors.affiliation: Laboratório de Soroepidemiologia e Imunobiologia, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Maria Carmen Arroyo
authors.initials: MC
authors.lastname: Sanchez
authors.affiliation: Prefeitura Municipal de Juquitiba, SP, Brasil.
authors.forename: José Jarbas Bittencourt
authors.initials: JJ
authors.lastname: Ferreira
authors.affiliation: Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Giselle Fernandes Maciel de Castro
authors.initials: GF
authors.lastname: Lima
authors.affiliation: Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Juliana
authors.initials: J
authors.lastname: Inoue
authors.affiliation: Núcleo de Estudos em Malária, Superintendência de Controle de Endemias, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Maria de Jesus
authors.initials: Mde J
authors.lastname: Costa-Nascimento
authors.affiliation: Laboratório de Soroepidemiologia e Imunobiologia, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Arianni Rondelli
authors.initials: AR
authors.lastname: Sanchez
authors.affiliation: Laboratório de Soroepidemiologia e Imunobiologia, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Eduardo Milton
authors.initials: EM
authors.lastname: Ramos-Sanchez
authors.affiliation: Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Silvia Maria
authors.initials: SM
authors.lastname: Di Santi
mesh_terms: D000293:Adolescent; D000328:Adult; D000913:Antibodies, Protozoan / Q000302:isolation & purification*; D058345:Asymptomatic Infections; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D056724:Immunity, Humoral / Q000276:immunology*; D016778:Malaria, Falciparum / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D016780:Malaria, Vivax / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D010965:Plasmodium malariae / Q000276:immunology; D010966:Plasmodium vivax / Q000276:immunology; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan