title: Non-falciparum malaria infections in pregnant women in West Africa.
abstract: BACKGROUND
  Non-Plasmodium falciparum malaria infections are found in many parts of sub-Saharan Africa but little is known about their importance in pregnancy.
  
  
  METHODS
  Blood samples were collected at first antenatal clinic attendance from 2526 women enrolled in a trial of intermittent screening and treatment of malaria in pregnancy (ISTp) versus intermittent preventive treatment (IPTp) conducted in Burkina Faso, The Gambia, Ghana and Mali. DNA was extracted from blood spots and tested for P. falciparum, Plasmodium vivax, Plasmodium malariae and Plasmodium ovale using a nested PCR test. Risk factors for a non-falciparum malaria infection were investigated and the influence of these infections on the outcome of pregnancy was determined.
  
  
  RESULTS
  P. falciparum infection was detected frequently (overall prevalence by PCR: 38.8 %, [95 % CI 37.0, 40.8]), with a prevalence ranging from 10.8 % in The Gambia to 56.1 % in Ghana. Non-falciparum malaria infections were found only rarely (overall prevalence 1.39 % [95 % CI 1.00, 1.92]), ranging from 0.17 % in the Gambia to 3.81 % in Mali. Ten non-falciparum mono-infections and 25 mixed falciparum and non-falciparum infections were found. P. malariae was the most frequent non-falciparum infection identified; P. vivax was detected only in Mali. Only four of the non-falciparum mono-infections were detected by microscopy or rapid diagnostic test. Recruitment during the late rainy season and low socio-economic status were associated with an increased risk of non-falciparum malaria as well as falciparum malaria. The outcome of pregnancy did not differ between women with a non-falciparum malaria infection and those who were not infected with malaria at first ANC attendance.
  
  
  CONCLUSIONS
  Non-falciparum infections were infrequent in the populations studied, rarely detected when present as a mono-infection and unlikely to have had an important impact on the outcome of pregnancy in the communities studied due to the small number of women infected with non-falciparum parasites.
authors.affiliation: Navrongo Health Research Centre, Navrongo, Ghana. john.williams@navrongo-hrc.org.
authors.forename: John
authors.initials: J
authors.lastname: Williams
authors.affiliation: Medical Research Council Unit, Fajara, Gambia. fnjie@mrc.gm.
authors.forename: Fanta
authors.initials: F
authors.lastname: Njie
authors.affiliation: London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK. Matthew.Cairns@lshtm.ac.uk.
authors.forename: Matthew
authors.initials: M
authors.lastname: Cairns
authors.affiliation: Medical Research Council Unit, Fajara, Gambia. kbojang@mrc.gm.
authors.forename: Kalifa
authors.initials: K
authors.lastname: Bojang
authors.affiliation: Faculty of Health Sciences, University of Ouagadougou, Ouagadougou, Burkina Faso. sheickoumar2@yahoo.fr.
authors.forename: Sheick Oumar
authors.initials: SO
authors.lastname: Coulibaly
authors.affiliation: Malaria Research and Training Centre, Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques and Technologies, Bamako, Mali. kayentao@icermali.org.
authors.forename: Kassoum
authors.initials: K
authors.lastname: Kayentao
authors.affiliation: London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK. iabubakar@mrc.gm.
authors.forename: Ismaela
authors.initials: I
authors.lastname: Abubakar
authors.affiliation: Medical Research Council Unit, Fajara, Gambia. francisakor@gmail.com.
authors.forename: Francis
authors.initials: F
authors.lastname: Akor
authors.affiliation: Medical Research Council Unit, Fajara, Gambia. k2mohd@gmail.com.
authors.forename: Khalifa
authors.initials: K
authors.lastname: Mohammed
authors.affiliation: Faculty of Health Sciences, University of Ouagadougou, Ouagadougou, Burkina Faso. batrichcard@yahoo.fr.
authors.forename: Richard
authors.initials: R
authors.lastname: Bationo
authors.affiliation: Faculty of Health Sciences, University of Ouagadougou, Ouagadougou, Burkina Faso. edgardabira@yahoo.fr.
authors.forename: Edgar
authors.initials: E
authors.lastname: Dabira
authors.affiliation: Faculty of Health Sciences, University of Ouagadougou, Ouagadougou, Burkina Faso. alamissas@yahoo.fr.
authors.forename: Alamissa
authors.initials: A
authors.lastname: Soulama
authors.affiliation: Malaria Research and Training Centre, Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques and Technologies, Bamako, Mali. mdjimde@icermali.org.
authors.forename: Moussa
authors.initials: M
authors.lastname: Djimdé
authors.affiliation: Malaria Research and Training Centre, Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques and Technologies, Bamako, Mali. etienne@icermali.org.
authors.forename: Etienne
authors.initials: E
authors.lastname: Guirou
authors.affiliation: Navrongo Health Research Centre, Navrongo, Ghana. Timothy.Awine@navrongo-hrc.org.
authors.forename: Timothy
authors.initials: T
authors.lastname: Awine
authors.affiliation: Navrongo Health Research Centre, Navrongo, Ghana. microquaye@hotmail.com.
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Quaye
authors.affiliation: JSGlobal, Barcelona Centre for International Health Research (CRESIB), Department of Pathology, Hospital Clinic-Universitat de Barcelona, Barcelona, Spain. jordi@clinic.ub.es.
authors.forename: Jaume
authors.initials: J
authors.lastname: Ordi
authors.affiliation: Malaria Research and Training Centre, Faculty of Medicine and Odonto-Stomatology, University of Sciences, Techniques and Technologies, Bamako, Mali. okd@icermali.org.
authors.forename: Ogobara
authors.initials: O
authors.lastname: Doumbo
authors.affiliation: Navrongo Health Research Centre, Navrongo, Ghana. abraham.hodgson@ghsmail.org.
authors.forename: Abraham
authors.initials: A
authors.lastname: Hodgson
authors.affiliation: Navrongo Health Research Centre, Navrongo, Ghana. aroduro@yahoo.com.
authors.forename: Abraham
authors.initials: A
authors.lastname: Oduro
authors.affiliation: Institute of International Health, Immunology and Microbiology, Centre for Medical Parasitology and Institute of Veterinary Disease Biology, University of Copenhagen, Copenhagen, Denmark. pma@life.ku.dk.
authors.forename: Pascal
authors.initials: P
authors.lastname: Magnussen
authors.affiliation: Liverpool School of Tropical Medicine, Liverpool, UK. terkuile@liverpool.ac.uk.
authors.forename: Feiko O
authors.initials: FO
authors.lastname: Ter Kuile
authors.affiliation: London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK. arouna@arouna.org.
authors.forename: Arouna
authors.initials: A
authors.lastname: Woukeu
authors.affiliation: London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK. Paul.Milligan@lshtm.ac.uk.
authors.forename: Paul
authors.initials: P
authors.lastname: Milligan
authors.affiliation: School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. ktagbor@yahoo.com.
authors.forename: Harry
authors.initials: H
authors.lastname: Tagbor
authors.affiliation: London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK. Brian.Greenwood@lshtm.ac.uk.
authors.forename: Brian
authors.initials: B
authors.lastname: Greenwood
authors.affiliation: London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK. daniel.chandramohan@lshtm.ac.uk.
authors.forename: Daniel
authors.initials: D
authors.lastname: Chandramohan
mesh_terms: D000328:Adult; D000354:Africa, Western / Q000453:epidemiology; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D008288:Malaria / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000453:epidemiology*; D016780:Malaria, Vivax / Q000453:epidemiology*; D011247:Pregnancy; D055815:Young Adult
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