Epidemiology, Malaria and Pregnancy

McGregor, Ian A.

doi:10.4269/ajtmh.1984.33.517

Cited by 458Malaria Research and ControlHistory of Medicine and Tropical HealthMosquito-borne diseases and control

Epidemiology, Malaria and Pregnancy

McGregor, Ian A.·1984·The American Journal of Tropical Medicine and Hygiene

DOI 10.4269/ajtmh.1984.33.517

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Abstract

It is a great honor for me to be invited to give this Soper Lecture. I met Fred Soper only once—at the 6th International Congresses of Tropical Medicine and Malaria at Lisbon in 1958. I had, of course, known of him for a number of years beforehand, and had read with the greatest interest his account of how Anopheles gambiae was halted in its invasion of Brazil and finally expelled from an area of some 18,000 square miles. In his lifetime, Soper was associated with many significant achievements in diverse fields of public health, but to me as a malariologist none compares with his eradication of Anopheles gambiae from Brazil. More than 40 years later, this episode still stands as one of the most significant victories that man has scored over malaria and epitomizes Soper's administrative genius and technological competence.

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In areas of stable malaria transmission, primigravidae are at highest risk of P. falciparum pregnancy malaria and women develop resistance over 1-2 pregnancies that controls infection and prevents severe sequelae.
“In areas of stable malaria transmission, primigravidae are at highest risk of P. falciparum pregnancy malaria and women develop resistance over 1–2 pregnancies that controls infection and prevents severe sequelae [6, 7].”
From Antibody levels to recombinant VAR2CSA domains vary with Plasmodium falciparum parasitaemia, gestational age, and gravidity, but do not predict pregnancy outcomes (2018) · cites this paper as [6]
Susceptibility to malaria diminishes with successive pregnancies, and this pattern is most prominent in high transmission areas where primigravidae are more susceptible to P. falciparum infection and disease than multigravidae.
“Susceptibility diminishes with successive pregnancies, and this pattern is most prominent in high transmission areas where primigravidae are significantly more susceptible to Plasmodium falciparum infection and disease than multigravidae [3,4].”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [3]
In malaria endemic areas, pregnant women are more susceptible to malaria infection than their nonpregnant counterparts.
“In malaria endemic areas, pregnant women are more susceptible to malaria infection than their nonpregnant counterparts[3,4].”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [3]

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Background
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van den Broek, N. R. (1998) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1998.tb10120.x · Cited by 95 · see citing works
THE IMPORTANCE OF THE PERIOD OF MALARIAL INFECTION DURING PREGNANCY ON BIRTH WEIGHT IN TROPICAL AFRICA
Cottrell, G., Mary, J., Barro, D., & Cot, M. (2007) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.2007.76.849 · Cited by 93 · see citing works
“which usually affects 10%–15% of births in malaria-endemic areas.(3,4) The mean decrease in birth weight related to placental infection ranges from 55 g to 348 g (all parities).”
Background
Anaemia in pregnant Ghanaian women: importance of malaria, iron deficiency, and haemoglobinopathies
Mockenhaupt, F. P., Rong, B., Günther, M., Beck, S., Till, H., KOHNE, E., Thompson, W. N. A., & Bienzle, U. (2000) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1016/s0035-9203(00)90057-9 · Cited by 93 · see citing works
Malaria and anaemia in pregnant women in urban Zanzibar, Tanzania
Matteelli, A., Donato, F., Shein, A., Muchi, J. A., Leopardi, O., Astori, L., & Carosi, G. (1994) · Annals of Tropical Medicine and Parasitology · doi:10.1080/00034983.1994.11812894 · Cited by 91 · see citing works
Impact of placental Plasmodium falciparum malaria on pregnancy and perinatal outcome in sub-Saharan Africa: I: introduction to placental malaria.
Uneke, C. J. (2007) · PubMed Central · Cited by 92 · see citing works
Distinct Th1- and Th2-Type Prenatal Cytokine Responses toPlasmodium falciparumErythrocyte Invasion Ligands
Malhotra, I. J., Mungai, P., Muchiri, E. M., Ouma, J. H., Sharma, S., Kazura, J. W., & King, C. L. (2005) · Infection and Immunity · doi:10.1128/iai.73.6.3462-3470.2005 · Cited by 89 · see citing works
“(41), we assessed the relationship between parity and CBL cytokine responses.”
Background
Prevalence and risk factors for Plasmodium falciparum malaria in pregnant women of eastern Sudan
Adam, I., Khamis, A. H., & Elbashir, M. I. (2005) · Malaria Journal · doi:10.1186/1475-2875-4-18 · Cited by 89 · see citing works
“Dafallah SE, EL-Agib FH, Bushra GO: Maternal mortality in a teaching hospital in Sudan.”
BackgroundInfluential
Malaria chemoprophylaxis, birth weight and child survival
Greenwood, A. M., ARMSTRONG, J. R. M., Byass, P., Snow, R. W., & Greenwood, B. M. (1992) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1016/0035-9203(92)90078-q · Cited by 88 · see citing works
Malaria in the Pregnant Woman
Duffy, P. E., & Fried, M. (2005) · Springer eBooks · doi:10.1007/3-540-29088-5_7 · Cited by 86 · see citing works
Plasmodiumin the placenta: parasites, parity, protection, prevention and possibly preeclampsia
Duffy, P. E. (2007) · Parasitology · doi:10.1017/s0031182007000170 · Cited by 84 · see citing works
“To explain parity-related resistance, MacGregor speculated that local uteroplacental immune responses were required for protection, and that these might develop over successive pregnancies (McGregor, 1984).”
Background
Azithromycin-chloroquine and the intermittent preventive treatment of malaria in pregnancy
Chico, R. M., Pittrof, R., Greenwood, B. M., & Chandramohan, D. (2008) · Malaria Journal · doi:10.1186/1475-2875-7-255 · Cited by 83 · see citing works
“LBW is a strong predictor of infant mortality in sub-Saharan Africa; death within the first year of life is three-times higher for LBW newborns compared to neonates of normal birth-weight [7].”
BackgroundInfluential
The role of chemokines in severe malaria: more than meets the eye
Ioannidis, L. J., Nie, C. Q., & Hansen, D. S. (2013) · Parasitology · doi:10.1017/s0031182013001984 · Cited by 84 · see citing works
“…serious complication has been found to be associated with adverse pregnancy outcomes including premature labour, intrauterine growth retardation and low birth weight delivery, and is responsible for more than 75000 infant deaths each year (McGregor, 1984; Steketee et al. 2001; Desai et al. 2007).”
Background
Cytoadherence of Plasmodium falciparum to intercellular adhesion molecule 1 and chondroitin-4-sulfate expressed by the syncytiotrophoblast in the human placenta
Maubert, B., Guilbert, L. J., & Deloron, P. (1997) · Infection and Immunity · doi:10.1128/iai.65.4.1251-1257.1997 · Cited by 84 · see citing works
“Three observations suggest that IRBCs are sequestered in the intravillous spaces of the placenta: at delivery IRBCs are more frequently found in the placenta than in the peripheral blood (25); parasite densities are often much higher in the placenta than in the peripheral blood (4, 16); and lastly, most of the P.”
Background
Determinants of Anemia among Pregnant Women in Mali
Ayoya, M. A., Spiekermann‐Brouwer, G. M., Traoré, A. K., Stoltzfus, R. J., & Garza, C. (2006) · Food and Nutrition Bulletin · doi:10.1177/156482650602700101 · Cited by 83 · see citing works
A community randomized controlled trial of insecticide‐treated bednets for the prevention of malaria and anaemia among primigravid women on the Kenyan coast
Shulman, Shulman, Dorman, Dorman, Talisuna, Lowe, Lowe, Nevill, Nevill, Snow, et al. (1998) · Tropical Medicine & International Health · doi:10.1046/j.1365-3156.1998.00214.x · Cited by 83 · see citing works
“It has long been recognized that malaria parasitaemia is more prevalent, with higher parasite burdens, in pregnant women than in nonpregnant women (McGregor 1984; Brabin 1983) and that the increase in prevalence and density of parasitaemia is greatest in primigravidae and decreases as gravidity…”
Background
Weather and Infant Mortality in Africa
Kudamatsu, M., Persson, T., & Strömberg, D. (2012) · Cited by 103 · see citing works
Malaria-related maternal mortality in urban Mozambique
Granja, A. C. L., Machungo, F., Gomes, A., Bergström, S., & Brabin, B. J. (1998) · Annals of Tropical Medicine and Parasitology · doi:10.1080/00034983.1998.11813288 · Cited by 82 · see citing works
Diagnosing malaria in pregnancy: An update
Fried, M., Muehlenbachs, A., & Duffy, P. E. (2012) · Expert Review of Anti-infective Therapy · doi:10.1586/eri.12.98 · Cited by 80 · see citing works
Mefloquine antimalarial prophylaxis in pregnancy: dose finding and pharmacokinetic study.
Nosten, F. H., Karbwang, J., White, N. J., Honeymoon, Bangchang, K. N., BUNNAG, D., & Harinasuta, T. (1990) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.1990.tb03746.x · Cited by 79 · see citing works
The placenta and malaria
Matteelli, A., Caligaris, S., Castelli, F., & Carosi, G. (1997) · Annals of Tropical Medicine and Parasitology · doi:10.1080/00034989760563 · Cited by 87 · see citing works
Prevention of anaemia in pregnancy using insecticide-treated bednets and sulfadoxine-pyrimethamine in a highly malarious area of Kenya: a randomized controlled trial
Njagi, J. K., Magnussen, P., Estambale, B., Ouma, J., & Mugo, B. (2003) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1016/s0035-9203(03)90141-6 · Cited by 78 · see citing works
The role ofPlasmodium falciparumvariant surface antigens in protective immunity and vaccine development
Hviid, L. (2010) · Human Vaccines · doi:10.4161/hv.6.1.9602 · Cited by 75 · see citing works
“falciparum malaria than their non-pregnant peers, this susceptibility is highly parity-dependent (decreases with increasing parity).(12) The finding that levels of VSA PAM /VAR2CSA-specific antibodies are also highly dependent on parity (increase with increasing parity) suggest that the two phenomena are related.”
Background
Performance of rapid diagnostic test, blood-film microscopy and PCR for the diagnosis of malaria infection among febrile children from Korogwe District, Tanzania
Mahende, C., Ngasala, B., Lusingu, J., Yong, T., Lushino, P., Lemnge, M., Mmbando, B. P., & Premji, Z. (2016) · Malaria Journal · doi:10.1186/s12936-016-1450-z · Cited by 75 · see citing works
“Infants appear to be relatively protected from malaria (and other infections) for the first 6 months of life, mainly due to acquiring maternal antibodies and the presence of foetal haemoglobin [22–24].”
Background
Real-Time Quantitative PCR for Determining the Burden ofPlasmodium falciparumParasites during Pregnancy and Infancy
Malhotra, I. J., Dent, A. E., Mungai, P., Muchiri, E. M., & King, C. L. (2005) · Journal of Clinical Microbiology · doi:10.1128/jcm.43.8.3630-3635.2005 · Cited by 74 · see citing works
“falciparum parasites, develop episodes of symptomatic malaria, and have involvement of the placenta than are multiparous women based on BS analysis (3, 16, 21).”
Background
Malaria in pregnancy in rural Mozambique: the role of parity, submicroscopic and multiple Plasmodium falciparum infections
Saute, F., Menendez, C., Mayor, A., Aponte, J., Gomez‐Olive, X., Dgedge, M., & Alonso, P. (2002) · Tropical Medicine & International Health · doi:10.1046/j.1365-3156.2002.00831.x · Cited by 74 · see citing works
“As previously reported (McGregor 1984; Diagne et al. 2000), malaria parasitaemia was more frequent during the second trimester, suggesting that this is the time of maximum risk for malaria infection during gestation.”
Background
The Status of Malaria among Pregnant Women: A Study in Lagos, Nigeria
Okwa, O. (2003) · African Journal of Reproductive Health · doi:10.2307/3583292 · Cited by 74 · see citing works
The effect of timing and frequency of Plasmodium falciparum infection during pregnancy on the risk of low birth weight and maternal anemia
Kalilani, L., Mofolo, I., Chaponda, M., Rogerson, S. J., & Meshnick, S. R. (2010) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1016/j.trstmh.2010.01.013 · Cited by 74 · see citing works
“In high transmission areas, women of reproductive age have acquired partial immunity to malaria [4].”
Background
Neonatal Infections: A Global Perspective
Stoll, B. J. (2006) · Elsevier eBooks · doi:10.1016/b0-72-160537-0/50004-9 · Cited by 73 · see citing works
MALARIA-ASSOCIATED CYTOKINE CHANGES IN THE PLACENTA OF WOMEN WITH PRE-TERM DELIVERIES IN YAOUNDE, CAMEROON
SUGUITAN, A. L., CADIGAN, T. J., NGUYEN, T. A., ZHOU, A., LEKE, R. J. I., METENOU, S., THUITA, L., MEGNEKOU, R., FOGAKO, J., LEKE, R. G. F., et al. (2003) · The American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.2003.69.574 · Cited by 72 · see citing works
“Their malariometric profile, however, is similar to that reported for pregnant women in other African countries.(1,2) The influence of other diseases on the results is difficult to assess, including infection with human immunodeficiency virus, which infects an estimated 4.”
Result
Influence of placental malaria infection on foetal outcome in the Gambia: twenty years after Ian Mcgregor.
Okoko, B. J., Ota, M. O. C., Yamuah, L. K., Idiong, D., Mkpanam, S. N., Avieka, A., BANYA, W. A. S., & Osinusi, K. (2002) · PubMed · Cited by 72 · see citing works
Micronutrient malnutrition and the pathogenesis of malarial anemia
Nussenblatt, V. R., & Semba, R. D. (2002) · Acta Tropica · doi:10.1016/s0001-706x(02)00049-9 · Cited by 72 · see citing works
Relationships between maternal malaria and malarial immune responses in mothers and neonates
Rasheed, F. N., Bulmer, J. N., de Francisco, A., Jawla, M., Jakobsen, P., Jepson, A., & Greenwood, B. M. (1995) · Parasite Immunology · doi:10.1111/j.1365-3024.1995.tb00960.x · Cited by 72 · see citing works
“In hyperendemic areas, malarial parasites often concentrate in the intervillous spaces of placentas (McGregor 1984).”
BackgroundInfluential
Congenital Malaria in the United States: Report of a Case and Review
Hulbert, T. V. (1992) · Clinical Infectious Diseases · doi:10.1093/clinids/14.4.922 · Cited by 72 · see citing works
“Infants of mothers who have had malaria in the past are probably less severely affected because maternal IgG transfer; however, they are not completely protected [27, 29, 32].”
BackgroundInfluential
Human immunodeficiency virus seropositivity and malaria as risk factors for third-trimester anemia in asymptomatic pregnant women in western Kenya.
van Eijk, A. M., Ayisi, J., ter Kuile, F. O., Misore, A. O., Otieno, J. A., KOLCZAK, M. S., Kager, P. A., Steketee, R. W., & Nahlen, B. L. (2001) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.2001.65.623 · Cited by 71 · see citing works

Morphological Identification of Malaria Vectors within Anopheles Species in Parts of Kano State, Nigeria
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Sibling species of the major malaria vector Anopheles gambiae display divergent preferences for aquatic breeding sites in southern Nigeria
Ebhodaghe, F. I., Sanchez-Vargas, I., Isaac, C., Foy, B. D., & Hemming-Schroeder, E. (2024) · Malaria Journal · doi:10.1186/s12936-024-04871-9 · Cited by 15 · see citing works
Comparative Experimental Infection of Anopheles moucheti and Anopheles gambiae with Plasmodium falciparum.
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Molecular identification and wing variations among malaria vectors in Akure North Local Government Area, Nigeria
Akeju, A. V., Olusi, T. A., & Simon-Oke, I. A. (2022) · Scientific Reports · doi:10.1038/s41598-022-11917-y · Cited by 11 · see citing works

Authors: McGregor, I. A.
Corresponding author: McGregor, Ian A.
Venue: The American Journal of Tropical Medicine and Hygiene
Publisher: American Society of Tropical Medicine and Hygiene
Published: 1984-07
Volume: 33
Issue: 4
Pages: 517-525
ISSN: 0002-9637 (ISSN-L)
DOI: 10.4269/ajtmh.1984.33.517
OpenAlex: W74585451
Cited by: 452
References: 0
Citations by year: 2024: 7 · 2023: 4 · 2022: 1 · 2021: 8 · 2020: 5 · 2019: 5 · 2018: 8 · 2017: 9 · 2016: 7 · 2015: 10 · 2014: 11 · 2013: 14 · 2012: 14
FWCI: 2.44
Type: journal article
Language: en
Open access: closed
Locations: American Journal of Tropical Medicine and Hygiene (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
Social Sciences › Arts and Humanities › History › History of Medicine and Tropical Health
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mosquito-borne diseases and control
Keywords: malaria in pregnancy, malaria epidemiology, mosquito control
MeSH terms: Adolescent, Adult, Africa, Birth Weight, Disease Susceptibility, Female, Fetal Blood, Fetal Death, Hemoglobins, Humans, Immunity, Active, Immunity, Maternally-Acquired, Immunoglobulins, Infant, Newborn, Malaria, Male, Maternal-Fetal Exchange, Middle Aged, Parity, Placenta Diseases, Plasmodium, Pregnancy, Pregnancy Complications, Infectious, Seasons, Uterus

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Epidemiology, Malaria and Pregnancy

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