title: Characterization of asymptomatic Plasmodium falciparum infection and its risk factors in pregnant women from the Republic of Congo.
abstract: Malaria in pregnancy remains a serious public health problem in the Republic of Congo despite the implementation of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) in 2006. The aim of this cross-sectional study was to characterize Plasmodium falciparum infections and determine possible risk factors in pregnant Congolese women attending an antenatal clinic in a periurban area of southern Brazzaville. This study was conducted from March 2012 to December 2013 in a site where several years ago, high malaria resistance to SP was reported. Pregnant women were enrolled during antenatal visits and the number of received IPTp-SP doses was recorded as well as individual sociodemographic data. Peripheral blood was collected and P. falciparum infection was checked by microscopy and by PCR targeting P. falciparum merozoite surface protein gene (msp2). Haemoglobin concentration was measured and P. falciparum positive samples were typed for msp2 allelic diversity. A total of 363 pregnant women were recruited. The prevalence of asymptomatic P. falciparum infection was 7% and 19% by microscopy and by PCR, respectively. More than one half (51.5%) of the pregnant women were anaemic. Multivariate analysis indicated that P. falciparum infection was associated with anaemia. It was also observed that women who have received IPTp-SP have significantly lower prevalence of infection. The administration of IPTp-SP did not influence the multiplicity of infection (MOI). This first study investigating asymptomatic malaria infection on pregnant women of the Republic of Congo shows that P. falciparum infections were clearly associated with maternal anaemia, and use of IPTp-SP reduced the risk of carrying asymptomatic infections.
authors.affiliation: Fondation Congolaise pour la Recherche Médicale, Brazzaville, The Republic of Congo; Faculty of Sciences and Techniques, University Marien Ngouabi, Brazzaville, The Republic of Congo; Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany. Electronic address: francine.ntoumi@uni-tuebingen.de.
authors.forename: Ntoumi
authors.initials: N
authors.lastname: Francine
authors.affiliation: Fondation Congolaise pour la Recherche Médicale, Brazzaville, The Republic of Congo.
authors.forename: Bakoua
authors.initials: B
authors.lastname: Damien
authors.affiliation: Fondation Congolaise pour la Recherche Médicale, Brazzaville, The Republic of Congo.
authors.forename: Fesser
authors.initials: F
authors.lastname: Anna
authors.affiliation: Fondation Congolaise pour la Recherche Médicale, Brazzaville, The Republic of Congo.
authors.forename: Kombo
authors.initials: K
authors.lastname: Michael
authors.affiliation: Fondation Congolaise pour la Recherche Médicale, Brazzaville, The Republic of Congo.
authors.forename: Vouvoungui J
authors.initials: VJ
authors.lastname: Christevy
authors.affiliation: Fondation Congolaise pour la Recherche Médicale, Brazzaville, The Republic of Congo; Faculty of Sciences and Techniques, University Marien Ngouabi, Brazzaville, The Republic of Congo.
authors.forename: Koukouikila-Koussounda
authors.initials: KK
authors.lastname: Felix
mesh_terms: D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use*; D058345:Asymptomatic Infections / Q000453:epidemiology; D002648:Child; D003223:Congo / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000453:epidemiology; D010963:Plasmodium falciparum / Q000187:drug effects*; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000188:drug therapy* / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D013413:Sulfadoxine / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000962:Antimalarials; D013413:Sulfadoxine
keywords: Congo Brazzaville; Multiplicity of infection; Plasmodium falciparum; Pregnant women