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Clinical Outcomes of Submicroscopic Infections and Correlates of Protection of VAR2CSA Antibodies in a Longitudinal Study of Pregnant Women in Colombia.
Gavina, Kenneth; Gnidehou, Sedami; Arango, Eliana; Hamel-Martineau, Chloe; Mitran, Catherine; Agudelo, Olga; Lopez, Carolina; Karidio, Aisha; Banman, Shanna; Carmona-Fonseca, Jaime; Salanti, Ali; Tuikue Ndam, Nicaise; Hawkes, Michael; Maestre, Amanda; Yanow, Stephanie K.
Afiliação
  • Gavina K; Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada.
  • Gnidehou S; Department of Biology, Campus Saint-Jean, University of Alberta, Edmonton, Alberta, Canada.
  • Arango E; Grupo Salud y Comunidad, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
  • Hamel-Martineau C; Department of Biology, Campus Saint-Jean, University of Alberta, Edmonton, Alberta, Canada.
  • Mitran C; School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
  • Agudelo O; Grupo Salud y Comunidad, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
  • Lopez C; Grupo Salud y Comunidad, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
  • Karidio A; Department of Biology, Campus Saint-Jean, University of Alberta, Edmonton, Alberta, Canada.
  • Banman S; School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
  • Carmona-Fonseca J; Grupo Salud y Comunidad, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
  • Salanti A; Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
  • Tuikue Ndam N; University of Ghana, Accra, Ghana.
  • Hawkes M; Department of Pediatrics, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada.
  • Maestre A; Grupo Salud y Comunidad, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
  • Yanow SK; Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada yanow@ualberta.ca.
Infect Immun ; 86(4)2018 04.
Article em En | MEDLINE | ID: mdl-29378797
Malaria in pregnancy can cause serious adverse outcomes for the mother and the fetus. However, little is known about the effects of submicroscopic infections (SMIs) in pregnancy, particularly in areas where Plasmodium falciparum and Plasmodium vivax cocirculate. A cohort of 187 pregnant women living in Puerto Libertador in northwest Colombia was followed longitudinally from recruitment to delivery. Malaria was diagnosed by microscopy, reverse transcription-quantitative PCR (RT-qPCR), and placental histopathology. Gestational age, hemoglobin concentration, VAR2CSA-specific IgG levels, and adhesion-blocking antibodies were measured during pregnancy. Statistical analyses were performed to evaluate the impact of SMIs on birth weight and other delivery outcomes. Twenty-five percent of women (45/180) were positive for SMIs during pregnancy. Forty-seven percent of infections (21/45) were caused by P. falciparum, 33% were caused by P. vivax, and 20% were caused by mixed Plasmodium spp. Mixed infections of P. falciparum and P. vivax were associated with lower gestational age at delivery (P = 0.0033), while other outcomes were normal. Over 60% of women had antibodies to VAR2CSA, and there was no difference in antibody levels between those with and without SMIs. The anti-adhesion function of these antibodies was associated with protection from SMI-related anemia at delivery (P = 0.0086). SMIs occur frequently during pregnancy, and while mixed infections of both P. falciparum and P. vivax were not associated with a decrease in birth weight, they were associated with significant risk of preterm birth. We propose that the lack of adverse delivery outcomes is due to functional VAR2CSA antibodies that can protect pregnant women from SMI-related anemia.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Observational_studies / Risk_factors_studies País/Região como assunto: America do sul / Colombia Idioma: En Revista: Infect Immun Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Canadá País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Observational_studies / Risk_factors_studies País/Região como assunto: America do sul / Colombia Idioma: En Revista: Infect Immun Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Canadá País de publicação: Estados Unidos