Highly effective therapy for maternal malaria associated with a lower risk of vertical transmission.

Poespoprodjo, JR; Fobia, W; Kenangalem, E; Hasanuddin, A; Sugiarto, P; Tjitra, E; Anstey, N; Price, R

Journal article

Highly effective therapy for maternal malaria associated with a lower risk of vertical transmission.

Abstract:: BACKGROUND: The epidemiology of congenital malaria was investigated in a hospital-based malaria surveillance study in Papua, Indonesia. METHODS: From April 2005 to January 2010, 4878 delivering women and their newborns underwent prospective clinical review and malaria screening by peripheral blood microscopy. FINDINGS: Congenital malaria occurred in 8 per 1000 (38/4884) live births, with Plasmodium falciparum accounting for 76.3% (29) and P. vivax for 15.8% (6) of infections. Maternal malaria at delivery (adjusted odds ratio [AOR], 9.5; 95% confidence interval [CI], 4.2-21.5; P < .001), age ≤ 16 years (AOR, 4; 95% CI, 1.4-12.1; P = .011), and prior malaria during pregnancy (AOR, 2.2; 95% CI, 1.1-4.4, P = .022) were independent risk factors for vertical transmission. Of 29 mothers and neonates with contemporaneous peripheral parasitemia, 17% (5) had discordant parasite species, suggesting possible antenatal malaria transmission. Newborns with malaria were at significantly greater risk of low birth weight (AOR, 2.8; 95% CI, 1.2-6.6; P = .002). Following introduction of dihydroartemisinin-piperaquine for uncomplicated malaria in the second and third trimesters of pregnancy, congenital malaria incidence fell from 3.2% to 0.2% (odds ratio, 0.07; 95% CI, .03-.15; P < .001). CONCLUSIONS: Congenital malaria is an important cause of neonatal morbidity in this region co-endemic for P. falciparum and P. vivax malaria. The introduction of artemisinin-combination therapy was associated with a significant risk reduction in the vertical transmission of malaria.

Publication status:: Published

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APA Style

Poespoprodjo, J. R., Fobia, W., Kenangalem, E., Hasanuddin, A., Sugiarto, P., Tjitra, E., Anstey, N., & Price, R. (2011). Highly effective therapy for maternal malaria associated with a lower risk of vertical transmission. Journal of Infectious Diseases, 204(10), 1613–1619.

MLA Style

Poespoprodjo, J. R., et al. “Highly Effective Therapy for Maternal Malaria Associated with a Lower Risk of Vertical Transmission.” Journal of Infectious Diseases, vol. 204, no. 10, 2011, pp. 1613–19.

Chicago Style

Poespoprodjo, JR, W Fobia, E Kenangalem, A Hasanuddin, P Sugiarto, E Tjitra, N Anstey, and R Price. 2011. “Highly Effective Therapy for Maternal Malaria Associated with a Lower Risk of Vertical Transmission.” Journal of Infectious Diseases 204 (10): 1613–19.
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