Description

In the study of Muehlenbachs et al on chronic placental malaria they identified reasons why a woman could experience multiple malarial episodes during a pregnancy. Women living along the Thai-Burma border reported up to 11 episodes during the 10 months of gestation. The authors are from the University of Washington in Seattle, National Institute of Allergy and Infectious Diseases, Shoklo Malaria Research Institute, Mahidol Oxford University Tropical Medicine Research Program, Natational Insittue of Medical Research in Tanzania and Churchill Hospital (Oxford).


 

Reasons for multiple episodes of malaria during a short time period:

(1) poor host immunity to malaria (as is seen in visitors from nonmalarious regions)

(2) immunodeficiency

(3) multiple species of Plasmodia in the region

(4) re-exposure with reinfection to the same species

(5) failure to treat adequately

(6) drug resistance

(7) failure to take prophylaxis

(8) failure to use environmental protection

(9) recrudescence

 

Issues to untangle:

(1) number of episodes following a single exposure

(2) number of episodes due to reinfection by the same species

(3) number of episodes due to infection by different species

 

A woman with multiple episodes of malaria is at increased risk for placental malaria, which can lead to growth retardation, miscarriage and other problems during the gestation.

 


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