Antibody to P. falciparum in pregnancy varies with intermittent preventive treatment regime and bed net use
Elizabeth H Aitken, Bernard Mbewe, Mari Luntamo, Teija Kulmala, James G Beeson, Per Ashorn, Stephen J Rogerson, Elizabeth H Aitken, Bernard Mbewe, Mari Luntamo, Teija Kulmala, James G Beeson, Per Ashorn, Stephen J Rogerson
Abstract
Background: Antibodies towards placental-binding P. falciparum are thought to protect against pregnancy malaria; however, environmental factors may affect antibody development.
Methods and findings: Using plasma from pregnant Malawian women, we measured IgG against placental-binding P. falciparum parasites by flow cytometry, and related results to intermittent preventive treatment (IPTp) regime, and bed net use. Bed net use was associated with decreased antibody levels at mid-pregnancy but not at 1 month post partum (1 mpp). At 1 mpp a more intensive IPTp regime was associated with decreased antibody levels in primigravidae, but not multigravidae.
Conclusions/significance: Results suggest bed nets and IPTp regime influence acquisition of pregnancy-specific P. falciparum immunity.
Conflict of interest statement
Competing Interests: The authors have declared that no competing interests exist.
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References
- Rogerson SJ, Hviid L, Duffy PE, Leke R, Taylor DW. Malaria in pregnancy: pathogenesis and immunity. Lancet. 2007;7:105–117.
- Serra-Casas E, Menendez C, Bardaji A, Quintó L, Dobaño C, et al. The effect of intermittent preventive treatment during pregnancy on malarial antibodies depends on HIV status and is not associated with poor delivery outcomes. J Infect Dis. 2010;201:123–31.
- Staalsoe T, Shulman CE, Dorman EK, Kawuondo K, Marsh K, et al. Intermittent preventive sulfadoxine-pyrimethamine treatment of primigravidae reduces levels of plasma immunoglobulin G, which protects against pregnancy-associated Plasmodium falciparum malaria. Infect Immun. 2004;72:5027–5030.
- Feng G, Simpson JA, Chaluluka E, Molyneux ME, Rogerson SJ. Decreasing burden of malaria in pregnancy in Malawian women and its relationship to use of intermittent preventive therapy or bed nets. PLoS One. 2010;5(8):e12012.
- Aitken EH, Mbewe B, Luntamo M, Maleta K, Kulmala T, et al. Antibodies to chondroitin sulfate A-binding infected erythrocytes: dynamics and protection during pregnancy in women receiving intermittent preventive treatment. J Infect Dis. 2010;201:1316–25.
- Luntamo M, Kulmala T, Mbewe B, Cheung YB, Maleta K, et al. Effect of repeated treatment of pregnant women with sulfadoxine-pyrimethamine and azithromycin on preterm delivery in Malawi: A randomized controlled trial. Am J Trop Med Hyg. 2010;83:1212–20.
- van Eijk AM, Ayisi JG, ter Kuile FO, Otieno JA, Misore AO, et al. Effectiveness of intermittent preventive treatment with sulphadoxine-pyrimethamine for control of malaria in pregnancy in western Kenya: a hospital-based study. Trop Med Int Health. 2004;9:351–60.
- Enosse S, Magnussen P, Abacassamo F, Gómez-Olivé X, Rønn AM, et al. Rapid increase of Plasmodium falciparum dhfr/dhps resistant haplotypes, after the adoption of sulphadoxine-pyrimethamine as first line treatment in 2002, in southern Mozambique. Malar J. 2008;7:115.
- Nkhoma S, Molyneux M, Ward S. Molecular surveillance for drug-resistant Plasmodiumfalciparum malaria in Malawi. Acta Trop. 2007;102:138–42.
- WHO. A strategic framework for malaria prevention and control during pregnancy in the African region. Brazzaville: World Health Organization Regional Office for Africa; 2004.
- Rantala AM, Taylor SM, Trottman PA, Luntamo M, Mbewe B, et al. Comparison of real-time PCR and microscopy for malaria parasite detection in Malawian pregnant women. Malar J. 2010;9:269.
- Greenwood AM, Menendez C, Alonso PL, Jaffar S, Langerock P, et al. Can malaria chemoprophylaxis be restricted to first pregnancies? Trans R Soc Trop Med Hyg. 1994;88:681–2.
Source: PubMed