Epidemiology: Malaria in Pregnancy

In endemic regions, the risk of malaria is increased three- to five-fold during pregnancy. Consequences of malaria in pregnancy comprise maternal anaemia, low birth weight and preterm delivery and, thus, a high perinatal and infant mortality.


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Epidemiology

A major reason for the increased vulnerability of pregnant women lies in the selection of P. falciparum strains which - by virtue of expression of specific ligands – adhere to placental, intervillous surfaces. This also affects diagnosis and genotyping of the parasite. Studies on malaria in pregnancy have repeatedly been conducted at the Presbyterian Mission Hospital in Agogo, Ghana, since 1998. These examination aim at understanding the clinico-epidemiological and pathophysilogical pecularities of malaria in pregnancy and build the base for subsequent interventional approaches. In addition, existing preventive measures are examined regarding their effectiveness.

Project Details

Principal Investigator:
Prof. Dr. med. Frank P. Mockenhaupt

Co-workers:
Antje Tomschegg
Bärbel Jakob
Ina Danquah
Susanne Röwer

Co-operations:
Dr. Christa von Oertzen, Dr. Christiane von Gaertner, Presbyterian Mission Hospital, Agogo, Ghana
Dr. George Bedu-Addo, School of Medical Scienes, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Dr. Teunis Eggelte, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, Amsterdam, Holland
Prof. E. Kohne, Universitätskinderklinik Ulm
Prof. Ralf R. Schumann, Institut für Mikrobiologie und Hygiene, Charité, Berlin

Doctoral students:
Claudia Kantelberg
Filiz Karakya
Iris Hannibal
Jantina Mandelkow
Lena Hommerich
Marieke Schaller
Niles Eckert
Renate Boyé
Ulrike Ulmen

Project duration:
1998, 2001-2002, 2006, ongoing

Project status:
Analysis

Funding:
Charité, Industry

Papers

Danquah I, Bedu-Addo G, Mockenhaupt FP. Iron deficiency and Plasmodium falciparum infection during pregnancy. J Infect Dis. 2008 Nov 15;198(10):1573-4.

Mockenhaupt FP, Bedu-Addo G, Eggelte TA, Hommerich L, Holmberg V, von Oertzen C, Bienzle U. Rapid increase in the prevalence of sulfadoxine-pyrimethamine resistance among Plasmodium falciparum isolated from pregnant women in Ghana. J Infect Dis. 2008 Nov 15;198(10):1545-9. 

Hommerich L, von Oertzen C, Bedu-Addo G, Holmberg V, Acquah PA, Eggelte TA, Bienzle U, Mockenhaupt FP. Decline of placental malaria in southern Ghana after the implementation of intermittent preventive treatment in pregnancy. Malar J. 2007 Nov 8;6:144.

Mockenhaupt FP, Bedu-Addo G, Junge C, Hommerich L, Eggelte TA, Bienzle U. Markers of sulfadoxine-pyrimethamine resistant falciparum malaria in placenta and circulation of pregnant women. Antimicrob Agents Chemother. 2007 Jan;51(1):332-4.

Mockenhaupt FP, Bedu-Addo G, von Gaertner C, Boye R, Fricke K, Hannibal I, Karakaya F, Schaller M, Ulmen U, Acquah PA, Dietz E, Eggelte TA, Bienzle U. Detection and clinical manifestation of placental malaria in southern Ghana. Malar J. 2006 Dec 13;5:119.

Mockenhaupt FP, Hamann L, von Gaertner C, Bedu-Addo G, von Kleinsorgen C, Schumann RR, Bienzle U. Common polymorphisms of toll-like receptors 4 and 9 are associated with the clinical manifestation of malaria during pregnancy. J Infect Dis. 2006 Jul 15;194(2):184-8.

Mockenhaupt FP, Mandelkow J, Till H, Ehrhardt S, Eggelte TA, Bienzle U. Reduced prevalence of Plasmodium falciparum infection and of concomitant anaemia in pregnant women with heterozygous G6PD deficiency. Trop Med Int Health. 2003 Feb;8(2):118-24.

Mockenhaupt FP, Ulmen U, von Gaertner C, Bedu-Addo G, Bienzle U. Diagnosis of placental malaria. J Clin Microbiol. 2002 Jan;40(1):306-8.

Beck S, Mockenhaupt FP, Bienzle U, Eggelte TA, Thompson WN, Stark K. Multiplicity of Plasmodium falciparum infection in pregnancy. Am J Trop Med Hyg. 2001 Nov;65(5):631-6.

Mockenhaupt FP, Eggelte TA, Bohme T, Thompson WN, Bienzle U. Plasmodium falciparum dihydrofolate reductase alleles and pyrimethamine use in pregnant Ghanaian women. Am J Trop Med Hyg. 2001 Jul;65(1):21-6.

Mockenhaupt FP, Rong B, Till H, Thompson WN, Bienzle U. Short report: increased susceptibility to Plasmodium malariae in pregnant alpha(+)-thalassemic women. Am J Trop Med Hyg. 2001 Jan-Feb;64(1-2):6-8.

Mockenhaupt FP, Rong B, Gunther M, Beck S, Till H, Kohne E, Thompson WN, Bienzle U. Anaemia in pregnant Ghanaian women: importance of malaria, iron deficiency, and haemoglobinopathies. Trans R Soc Trop Med Hyg. 2000 Sep-Oct;94(5):477-83.

Mockenhaupt FP, Rong B, Till H, Eggelte TA, Beck S, Gyasi-Sarpong C, Thompson WN, Bienzle U. Submicroscopic Plasmodium falciparum infections in pregnancy in Ghana. Trop Med Int Health. 2000 Mar;5(3):167-73.