Overview of Epidemiology of Malaria Associated with Pregnancy in Northwestern Colombia, 1985-2020

  • Jaime Carmona-Fonseca Professor, School of Medicine, University of Antioquia. Coordinator “Grupo Salud y Comunidad-César Uribe Piedrahita”, Universidad de Antioquia. Medellín, Colombia.
  • Jaiberth Antonio Cardona-Arias Professor, School of Microbiology, Universidad de Antioquia. Medellín, Colombia.
Keywords: Malaria, Plasmodium, Pregnancy, Placenta, Neonate, Epidemiology, Colombia

Abstract

Background: Knowledge about malaria associated with pregnancy (MAP) is scarce in Latin America and Colombia.

Methodology: This paper presents an overview of studies captained in Pubmed, Lilacs, GoogleScholar and thesis repositories from six Colombian universities and bibliographic references of manuscripts.

Results: The following topics have been described: study sites, infectious agents, genetic variation of Plasmodium in MAP, vector resistance to insecticides, incubation period, natural susceptibility and resistance to infection, immunity in MAP, frequency, coexistence of gestational (GM) and placental (PM) malaria, associated factors, efficacy of antimalarial treatment, material living conditions in MAP. The MAP has a high prevalence, with a high frequency of submicroscopic infections. There are cases of MAP due to P. falciparum, P. vivax, or both. Monotherapy with chloroquine or amodiaquine for MAP for P. vivax has efficacy greater than 95% and artemether-lumefantrine or artesunate-mefloquine 100% for P. falciparum. There are high rates of anemia in pregnancies (30-70%). In “The Region,” there is no problem of resistance of vectors to insecticides. MAP occurs in poor territories, with interaction of food insecurity, chronic malnutrition, dissatisfaction of basic needs, intestinal parasites, violence and abuse of human rights.

Conclusions: MAP study is just beginning in Colombia; there are no programmes that effectively operate to detect and solve this problem; Government agencies, international health organizations, and private companies should finance the multidisciplinary and comprehensive research (natural and social) of the MAP, in order to know its main characteristics throughout the country and use that knowledge as a basis to seek solutions.

How to cite this article:
Carmona-Fonseca J, Cardona-Arias JA. Overview of Epidemiology of Malaria Associated with Pregnancy in Northwestern Colombia, 1985-2020. J Commun Dis. 2021;53(4):140-147.

DOI: https://doi.org/10.24321/0019.5138.202184

References

Bergström S, Fernandes A, Schwalbach J, Perez O, Miyar R. Materno-fetal transmission of pregnancy malaria: an immunoparasitological study on 202 parturients in Maputo. Gynecol Obstet Inves. 1993;35:103-7. [PubMed] [Google Scholar]

Williams J, Njie F, Cairns M, Bojang K, Coulibaly SO, Kayentao K. Non-falciparum malaria infections in pregnant women in West Africa. Malar J. 2016 Jan;15:53. [PubMed] [Google Scholar]

Barber BE, Bird E, Wilkes CS, William T, Grigg MJ, Paramaswaran U, Menon J, Jelip J, Yeo TW, Anstey NM. Plasmodium knowlesi malaria during pregnancy. J Infect Dis. 2015 Apr;211:1104-10. [PubMed] [Google Scholar]

Ta TH, Hisam S, Lanza M, Jiram AI, Ismail N, Rubio JM. First case of a naturally acquired human infection with Plasmodium cynomolgi. Malar J. 2014 Feb;13:68. [PubMed] [Google Scholar]

Rogerson SJ, Meghna D, Mayor A, Sicuri E, Taylor SM, van Eijk AM. Burden, pathology, and costs of malaria in pregnancy: new developments for an old problema. Lancet Infect Dis. 2018 Apr;18:e107-e18. [PubMed] [Google Scholar]

Bauserman M, Conroy A, North K, Patterson J, Bose C, Meshnick S. An overview of malaria in pregnancy. Semin Perinatol. 2019 Aug;43:282-290. [PubMed] [Google Scholar]

Restrepo-Posada DC, Carmona-Fonseca J, Cardona-Arias JA. Systematic review of microeconomic análisis of pregnancy-associated malaria. Heliyon. 2020 Jul;6:e04558. [PubMed] [Google Scholar]

Restrepo-Posada DC, Carmona-Fonseca J, Cardona-Arias JA. Cost-effectiveness of rapid diagnostic tests, compared to microscopic tests, for the diagnosis and treatment of gestational malaria in Colombia from an institutional perspective. Malar J. 2020 Nov;19:400. [PubMed] [Google Scholar]

Arismendi Solano MJ. Magnitud de la malaria gestacional en el Urabá Antioqueño, período 2000-2006. Medellín: Universidad de Antioquia;. 2008. 119 p. Spanish. [Google Scholar]

Carmona-Fonseca J, Maestre A. Prevention of Plasmodium vivax malaria recurrence: efficacy of the standard total dose of primaquine administered over 3 days. Acta Trop. 2009 Nov;112:188-92. [PubMed] [Google Scholar]

Bardají A, Martínez-Espinosa FE, Arévalo-Herrera M, Padilla N, Kochar S, Ome-Kaius M, Bôtto-Menezes C, Castellanos ME, Kochar DK, Kochar SK, Betuela I, Mueller I, Rogerson S, Chitnis C, Hans D, Menegon M, Severini C, Del Portillo H, Dobaño C, Mayor A, Ordi J, Piqueras M, Sanz S, Wahlgren M, Slutsker L, Desai M, Menéndez C; PregVax Study Group. Burden and impact of Plasmodium vivax in pregnancy: A multi-centre prospective observational study. PLOS Negl Trop Dis. 2017 Jun;11(6):e0005606. [PubMed] [Google Scholar]

Carmona-Fonseca J. La Región “Urabá Antioqueño-Cuencas altas de los ríos Sinú y San Jorge-Bajo Cauca Antioqueño”: “guarida” del paludismo colombiano. Rev Universidad Industrial de Santander. Salud. 2017;49:577-89. Spanish. [Google Scholar]

Carmona-Fonseca J. The epidemiology of malaria in Colombia: a heretical view. Medicina Soc. 2020;13:1-14. [Google Scholar]

Carmona-Fonseca J, Arias MM, Correa A, Lemos M. Malaria gestacional y condiciones de vida. Medicina Social. 2011;6:97-107. Spanish. [Google Scholar]

Carrasquilla-García YE. Coinfección Plasmodium-Geohelmintos en gestantes: epidemiología, desenlaces materno-neonatales, histopatología placentaria; Colombia, 2017-2019. Medellín: Universidad de Antioquia; 2021. 130 p. Spanish.

Ortega-Montes JE, Valencia-Jiménez NN, Restrepo-Valencia M. La economía política de la pobreza y la desigualdad social: el caso de Montería. Cuaderno de Vivienda y Urbanismo (Universidad Javeriana, Colombia). 2008;1:96-123. Spanish. [Google Scholar]

Correa A, Guzmán V, Carmona-Fonseca J, Blair S, Morales D. Alimentación y malaria: una aproximación biosocial. Invest Educ Enferm. 2002;20:30-47. Spanish. [Google Scholar]

Robinson JA. La miseria en Colombia. Revista Desarrollo y Sociedad Primer semestre. 2016;76:9-90. Spanish. [Google Scholar]

Arango EM. Características genéticas de Plasmodium vivax y Plasmodium falciparum presentes en casos de malaria gestacional y placentaria de Urabá-Altos Sinú y San Jorge-Bajo Cauca, 2005-2011. Medellín: Universidad de Antioquia; 2013. 170 p. Spanish. [Google Scholar]

Instituto Nacional de Salud de Colombia. Informe de vigilancia entomológica de malaria Colombia. Bogotá: Instituto Nacional de Salud. 2018; p. 14. Spanish.

Orjuela LI, Morales JA, Ahumada ML, Ríos JF, González JJ, Yañez J, Rosales A, Cabarcas D, Venegas J, Yasnot M, Quiñones M. Insecticide resistance and its intensity in populations of malaria vectors in Colombia. Biomed Res Int. 2018 Aug:9163543. [PubMed] [Google Scholar]

Agudelo O, Arango E, Maestre A, Jaime Carmona-Fonseca J. Prevalence of gestational, placental and congenital malaria in north-west Colombia. Malar J. 2013 Sep;12:341. [PubMed] [Google Scholar]

Agudelo O, Aristizabal B, Yanow S.K, Arango E, Carmona-Fonseca J, Maestre A. Submicroscopic infection of placenta by Plasmodium produces Th1/Th2 cytokine imbalance, inflammation and hypoxia in women from north-west Colombia. Malar J. 2014 Mar;13:122. [PubMed] [Google Scholar]

Agudelo-García OM, Arango-Flórez EM, Carmona-Fonseca J. Submicroscopic and asymptomatic congenital infection by Plasmodium vivax or P. falciparum in Colombia: 37 cases with placental histopathology and cytokine profile in maternal and placental blood. J Trop Med. 2017:3680758. [PubMed] [Google Scholar]

Álvarez-Larrotta C, Agudelo OM, Duque Y, Gavina K, Yanow SK, Maestre A, Carmona-Fonseca J, Arango E. Submicroscopic Plasmodium infection during pregnancy is associated with reduced antibody levels to tetanus toxoid. Clin Exp Immunol. 2019 Jan;195:96-108. [PubMed] [Google Scholar]

Arango E, Maestre A, Carmona-Fonseca J. Effect of submicroscopic or polyclonal Plasmodium falciparum infection on mother and gestation product: systematic review. Rev Bras Epidemiol. 2010 Sep;13:373-86. [PubMed] [Google Scholar]

Arango EM, Samuel R, Agudelo OM, Carmona-Fonseca J, Maestre A, Yanow SK. Genotype comparison of Plasmodium vivax and Plasmodium falciparum clones from pregnant and non-pregnant populations in North-west Colombia. Malar J. 2012 Nov;11:392. [PubMed] [Google Scholar]

Arango EM, Samuel R, Agudelo OM, Carmona-Fonseca J, Maestre A, Yanow SK. Molecular detection of malaria at delivery reveals a high frequency of submicroscopic infections and associated placental damage in pregnant women from Northwest Colombia. Am J Trop Med Hyg. 2013 Jul;89:178-83. [PubMed] [Google Scholar]

Campos IM. Evaluación de la capacidad diagnóstica de la reacción en cadena de la polimerasa (PCR), la microscopía y la histopatología para la detección de la infección por Plasmodium spp en placenta, sangre periférica materna y sangre del cordón umbilical; Urabá, 2005-2007. Medellín: Universidad de Antioquia. 2009. 180 p. Spanish.

Camargo-Ayala PA, Cubides JR, Niño CH, Camargo M, Rodríguez-Celis CA, Quiñones T, Sánchez-Suárez L, Patarroyo ME, Patarroyo MA. High Plasmodium malariae prevalence in an endemic area of the Colombian Amazon region. PLoS One. 2016 Jul;11:e0159968. [PubMed] [Google Scholar]

Vergara J, Hurtado S, Alvarez VH, Arévalo M, Herrera S. Caracterización de la transmisión de Plasmodium malariae en cuatro regiones colombianas endémicas de malaria. Biomedica. 2001;21:53-61. Spanish. [Google Scholar]

Cox-Singh J. Zoonotic malaria: Plasmodium knowlesi, an emerging pathogen. Curr Opin Infect Dis. 2012 Oct;25:530-6. [PubMed] [Google Scholar]

Millar SB, Cox-Singh J. Human infections with Plasmodium knowlesi-zoonotic malaria. Clin Microbiol Infect. 2015 Jul;21:640-8. [PubMed] [Google Scholar]

Duque-Isaza YY. Malaria gestacional vivax: genotipos plasmodiales y perfil inmunológico en primoinfección y recurrencia; Colombia, 2018-2019. Medellín: Universidad de Antioquia; 2020. 165 p. Spanish.

Rajwani J, Klinger CM, Arango E, Arroyo MI, Sabbagh A, Maestre A, Dacks JB, Gnidehou S, Yanow SK. Genetic analysis of ID1-DBL2X predicts its validity as a vaccine candidate in Colombia and supports at least two independently introduced Plasmodium falciparum populations in the region. Infect Genet Evol. 2017 Nov;55:175-85. [PubMed] [Google Scholar]

Dobaño C, Bardají A, Arévalo-Herrera M, Martínez-Espinosa FE, Bôtto-Menezes C, Padilla N, Menegon M, Kochar S, Kochar SK, Unger H, Ome-Kaius M, Rosanas-Urgell A, Malheiros A, Castellanos ME, Hans D, Desai M, Casellas A, Chitnis CE, Severini C, Mueller I, Rogerson S, Menéndez C, Requena P. Cytokine signatures of Plasmodium vivax infection during pregnancy and delivery outcomes. PLoS Negl Trop Dis. 2020 May;14:e0008155. [PubMed] [Google Scholar]

Gnidehou S, Doritchamou J, Arango EM, Cabrera A, Arroyo MI, Kain KC, Ndam NT, Maestre A, Yanow SK. Functional antibodies against VAR2CSA in nonpregnant populations from Colombia exposed to Plasmodium falciparum and Plasmodium vivax. Infect Immun. 2014 Jun;82:2565-73. [PubMed] [Google Scholar]

Lopez-Perez M, Larsen MD, Bayarri-Olmos R, Ampomah P, Stevenson L, Arévalo-Herrera M. IgG responses to the Plasmodium falciparum antigen VAR2CSA in Colombia are restricted to pregnancy and are not induced by exposure to Plasmodium vivax. Infect Immun. 2018 Jul;86:e00136-18. [PubMed] [Google Scholar]

Gnidehou S, Mitran CJ, Arango E, Banman S, Mena A, Medawar E, Lima BAS, Doritchamou J, Rajwani J, Jin A, Gavina K, Ntumngia F, Duffy P, Narum D, Ndam NT, Nielsen MA, Salanti A, Kano FS, Carvalho LH, Adams JH, Maestre A, Good MF, Yanow SK. Cross-species immune recognition between Plasmodium vivax Duffy binding protein antibodies and the Plasmodium falciparum surface antigen VAR2CSA. J Infect Dis. 2019 Jan;219:110-20. [PubMed] [Google Scholar]

Gnidehou S, Yanow SK. VAR2CSA antibodies in non-pregnant populations. Trends Parasitol. 2021 Jan;37(1):65-76. [PubMed] [Google Scholar]

Mitran CJ, Mena A, Gnidehou S, Banman S, Arango E, Lima BAS, Lugo H, Ganesan A, Salanti A, Mbonye A, Ntumngia F, Barakat K, Adams J, Kano F, Carvalho L, Maestre A, Good M, Yanow. Antibodies to cryptic epitopes in distant homologues underpin a mechanism of heterologous immunity between Plasmodium vivax PvDBP and Plasmodium falciparum VAR2CSA. mBio. 2019 Oct;10:e02343-19. [PubMed] [Google Scholar]

Fowkes FJ, McGready R, Cross NJ, Hommel M, Simpson JA, Elliott SR, Richards JS, Lackovic K, Viladpai-Nguen J, Narum D, Tsuboi T, Anders RF, Nosten F, Beeson JG. New insights into acquisition, boosting, and longevity of immunity to malaria in pregnant women. J Infect Dis. 2012 Nov;206:1612-21. [PubMed] [Google Scholar]

Ayadi I, Balam S, Audran R, Bikorimana JP, Nebie I, Diakité M, Felger I, Tanner M, Spertini F, Corradin G, Arevalo M, Herrera S, Agnolon V. P. falciparum and P. vivax orthologous coiled-coil candidates for a potential cross-protective vaccine. Front Immunol. 2020 Oct;11:574330. [PubMed] [Google Scholar]

Gonzalez L, Vega J, Ramirez JL, Bedoya G, Carmona-Fonseca J, Maestre A. Relationship between Duffy blood groups genotypes and malaria infection in different ethnic groups of Choco- Colombia. Colombia Médica. 2012 Sep;43:189-95. [PubMed] [Google Scholar]

Marchesini PCJ. Reducing the burden of malaria in pregnancy. Geneva: World Health Organization; 2004. 2 p.

Rijken MJ, McGready R, Boel ME, Rogerson S, Nosten F. Malaria in pregnancy in the Asia-Pacific region. Lancet Infect Dis. 2012 Jan;12:75-88. [PubMed] [Google Scholar]

Carmona-Fonseca J, Arango EM. Asymptomatic plasmodial infection in pregnant women: a global scenario. J Vector Borne Dis. 2017 Jul-Sep;54:201-6. [PubMed] [Google Scholar]

Carmona-Fonseca J, Maestre A. Incidencia de las malarias gestacional, congénita y placentaria en Urabá (antioquia, colombia), 2005-2007. Revista Colombiana de Obstetricia y Ginecología. 2009;60:19-33. Spanish.

Maestre A, Carmona-Fonseca J. Immune responses during gestational malaria: a review of the current knowledge and future trend of research. J Infect Dev Ctries. 2014 Apr;8:391-402. [PubMed] [Google Scholar]

Castro-Cavadía C, Carmona-Fonseca J. Assessment of the efficacy and safety of chloroquine monotherapy for the treatment of acute uncomplicated gestational malaria caused by P. vivax, Córdoba, Colombia, 2015-2017. Rev Colomb Obstet Ginecol. 2020 Mar;71:21-33. [PubMed] [Google Scholar]

Carmona-Fonseca J, Agudelo-García OM, Arango-Flórez E. Eficacia terapéutica y eventos adversos de tratamientos para malaria vivax y malaria falciparum en gestantes en las regiones de Urabá y Alto San Jorge, Colombia, 2008-2011. Rev Colomb Obstet Ginecol. 2013;64:27-37. Spanish. [Google Scholar]

Arroyo Arroyo MI. Eficacia de varios esquemas de dosificación de primaquina contra la gametocitemia de Plasmodium falciparum. Medellín: Universidad de Antioquia; 2015. 120 p. Spanish.

Published
2021-12-31