A malaria study in Brazilian pregnant women by researchers at the University of Sao Paulo (USP) found that Lancet Regional Health – Americas According to the researchers, this study is the first to provide insight into endemic malaria during pregnancy in terms of spatial and temporal trends.
The survey results are malaria In the northern regions of Brazil, especially in the Amazon, pregnancies during pregnancy remain a major public health problem, with cases falling by half during the period analyzed (2004–18). The researchers attribute this decline to the expansion of health service networks providing diagnosis and treatment, and the inclusion of artemisinin in treatment regimens from 2006.
They also believe that local governments in the region should be given autonomy and national public action to fight malaria should be decentralized by allowing local government medical teams to change with each election. , we believe that this decline could have been even greater.
“Although several studies have been published on malaria during pregnancy in Brazil, none present a comprehensive survey of the disease, and most were conducted in specific locations or regions. to epidemiologically characterize the disease,” Claudio Romero Farias Marinho, the last author of the article, told Agência FAPESP. Head of the Institute of Immunoparasitology.
high risk group
Pregnant woman is one of them high risk group As for malaria, says Marinho. The disease is caused by protozoa of the genus Plasmodium, which are transmitted by Anopheles mosquitoes. Pregnant women infected with malaria are at risk of severe anemia, premature birth, miscarriage and stillbirth. The fetus may have microcephaly or intrauterine growth restriction and developmental delay after birth.
“Studies show that malaria affects development and brain function, causing cognitive and neurological deficits that can lead to cerebral palsy and epilepsy. respiratory problems It makes them more susceptible to infections during childhood and increases their risk of developing chronic conditions such as diabetes and high blood pressure in adulthood,” Marinho said.
These are the reasons why a study conducted by Ph.D. Jamille Dombrowski focused on malaria during pregnancy. Candidate for ICB-USP with a scholarship from FAPESP to work with researchers from the School of Public Health (FSP-USP).The group analyzed 61,833 data pregnant woman Malaria mined from the Ministry of Health’s Epidemiological Surveillance System (SIVEP-Malaria) for 15 years from 2004 to 2018.
The results show that the municipalities of Acre, Amazonas, Rondonia and Para, all states of the northern region of Brazil, have high incidence of malaria during pregnancy. Young women were most at risk, especially those between the ages of 15 and 24. This is because the percentage of primiparous women (having their first pregnancy) is the highest for this age group. Specific immunity to placental malaria forms is acquired after several pregnancies and is therefore low in primiparous women.
“It’s important to note that northern primiparous women are very young and have less exposure to parasites.
The study also found evidence that treatment regimens in these patients may be incorrect given the high rates of primaquine reported. This drug is contraindicated during pregnancy because it can cross the placenta, destroy red blood vessels in the fetus, impair oxygen transport, and cause miscarriage.
Findings by Marinho and his group will help the Ministry of Health formulate. public policy To control malaria and provide better care for sick pregnant women. It will be possible to identify areas in need of more surveillance or additional interventions, including specific strategies to protect pregnant women and their babies from the devastating consequences of malaria.
Investigators who have created a full epidemiological picture are now focused on early diagnosis of a complication known as placental malaria, characterized by the accumulation of Plasmodium-infected red blood cells in the placenta and fetal membranes. This can only be detected after the baby is born, so no intervention or treatment is possible.
Dombrowski is working on a new project to identify biomarkers that can be measured quickly and affordably, allowing the analysis to be introduced into the antenatal routine.
For more information:
Jamille Gregório Dombrowski et al. Mapping and characterizing areas of high malaria during pregnancy in Brazil: a spatio-temporal analysis. The Lancet Regional Health—Americas (2022). DOI: 10.1016/j.lana.2022.100285
Quote: A map of researchers investigating the incidence of malaria during pregnancy in Brazil on August 16, 2022 from https://medicalxpress.com/news/2022-08-incidence-malaria-pregnancy-brazil.html to 2022 Retrieved on August 16th
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