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Detection and clinical manifestation of placental malaria in the Ashantiregion of Ghana.

Abstract

Kate Gyimah

Malaria is a life-threatening disease caused by a protozoan parasite called Plasmodium, which lives part of its lifein humans and part in Anopheles mosquitoes. The disease is endemic in tropical and subtropical regions, includingAfrica, Asia, Latin America, the Middle East and some parts of Europe.Malaria in pregnancy considered to be one of the major public health issues in sub-Saharan Africa. Pregnant women are of a specific risk group for Plasmodium falciparum infection, malaria and related health issues. This increased risk is partially due to physiological changes of immunity. Moreover, in pregnancy and by virtue of specific expression variants of the P. falciparum Erythrocyte Membrane Protein-1, parasite strains adhere to the syncytiotrophoblast, that is the surface lining the placental intervillous space. The research was conducted in the Dichemso district in the Ashanti region of Ghana. Dichemsois district of about 25000 inhabitants. Subsistence farming and trade are the main sources of income in the district. In the year 2000, P. falciparum among women attending antenatal care at Church of God Hospital was detected in 41% and 59% by microscopy and PCR assays of peripheral blood samples, respectively. From January 2019 to January 2020, women attending Church of God hospital for delivery were asked to participate in the present study and recruited after informed written consent was obtained. All women were clinically examined, sociodemographic data were documented, and venous peripheral blood collected into EDTA. Fever was defined as an axillary temperature >37.4°C. Following expulsion and after a small incision had been made into the maternal surface of the placenta, blood from the intervillous space was collected with a syringe containing EDTA. P. falciparum was screened for in both placental and peripheral blood samples by microscopy, HRP2 test, and PCR: malaria parasites were counted microscopically on Giemsa-stained thick blood films per 500 white blood cells for peripheral samples and per 100 high-power fields for placental samples in which the presence of leukocyte-associated haemozoin was also recorded.