The Placenta and Plasmodium Infections: a Case Study from Blue Nile State, Sudan
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THE PLACENTA, TROPICAL DISEASES, AND PREGNANCIES (D SCHWARTZ, SECTION EDITOR)
The Placenta and Plasmodium Infections: a Case Study from Blue Nile State, Sudan Samia A. Omer 1
&
Suad M. Sulaiman 2
Accepted: 24 September 2020 # Springer Nature Switzerland AG 2020, corrected publication October/2020
Abstract Purpose of Review Sequestration of Plasmodium-infected cells in the placenta causes significant adverse effects on mothers and their fetuses. With progress in understanding placental malaria and associated adverse consequences, this review addresses the situation in an area with high prevalence, in Blue Nile State, Sudan, where protective interventions are not adequately provided. Recent Findings Several studies have confirmed that malaria infection during pregnancy with parasites in the placenta, even at sub-patent level detected by molecular techniques, can result in maternal morbidity, fetal growth restriction, and reduced birth weight. Thus, malaria protection measures and antenatal care are vital for pregnant women in endemic areas. Summary Falciparum and vivax-infected erythrocytes are able to sequester in the placenta and not easily detected in peripheral blood during antenatal period. Recently, several biological biomarkers associated with malaria infection during pregnancy were detected. Such biomarkers could be used as indicators for identifying women at risk of placental infection complications, particularly when pre-eclampsia may occur. Keywords Plasmodium infections . Placenta . Biomarkers . Blue Nile State, Sudan
Introduction Malaria remains a major health problem in endemic areas among children and pregnant women. Between 2015 and 2017, the global number of malaria cases increased from 211 million to 219 million and is related to an increase in deaths [1]. It has been estimated that 200,000 infants and 10,000 maternal deaths occur per year in Africa caused by malaria-related morbidity [2]. Pregnant women are more susceptible to Plasmodium infections than the general population with 2- to 3-fold increased risk of malaria infection [1, 3, 4], due to hormonal alterations [5], pregnancy-related immune suppression, and cell sequestration in the placenta [6, 7]. In This article is part of the Topical Collection on The Placenta, Tropical Diseases, and Pregnancies * Samia A. Omer [email protected] 1
Department of Immunology and Biotechnology, Tropical Medicine Research Institute, National Centre for Research, Khartoum, Sudan
2
Sudan Medical Heritage Foundation, Khartoum, Sudan
addition, there is increased attractiveness of pregnant women to mosquitoes due to increased abdomen temperature [8, 9]. Among the five known Plasmodium species that infect humans, only Plasmodium falciparum (P. falciparum) and Plasmodium vivax (P. vivax) have been linked with pregnancy-associated malaria (PAM) resulting in placental malaria (PM) with pronounced maternal and fetal health consequences. PM increases the risk of maternal anemia, pregnancy loss, and low birth weight (LBW) (defined as birth weight < 2500 g)
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