P. falciparum contamination rates in pregnant ladies going to their most memorable antenatal consideration visit can be utilized to gauge the weight of jungle fever in kids living locally, as per a review driven by the Barcelona Organization of Wellbeing (ISGlobal) and the Middle for Wellbeing Exploration in Manhica (CISM). Pregnant women are the best population to monitor changes in infection prevalence and adjust control measures, according to the Nature Communications study.
In order to adjust interventions aimed at controlling or eliminating malaria, it is essential to closely monitor trends in a community or region, such as whether they are increasing or decreasing. However, it is not ideal to rely on clinical cases that arrive at health centers because many patients do not seek treatment or are asymptomatic. Cross-sectional studies, on the other hand, which collect data from a large number of people simultaneously, are costly and can only be conducted every two to three years.
Alfredo Mayor, a researcher at ISGlobal and CISM, believes that pregnant women who go to antenatal care visits are the best people to keep an eye on how often malaria and other infectious diseases are present. According to Mayor, 79% of pregnant women in sub-Saharan Africa attend at least one antenatal care visit. This is a good representation of the population as a whole. What’s more, antenatal visits enjoy the benefit of catching asymptomatic contamination since they are free of whether the individual feels unwell.”
“In sub-Saharan Africa, 79% of pregnant women attend at least one antenatal care visit, which is a good representation of the total population. In addition, antenatal visits have the advantage of capturing asymptomatic infections because they are independent of whether the person feels unwell.”
Alfredo Mayor, researcher at ISGlobal and CISM,
In this review, the city hall leader and his group estimated jungle fever predominance in 6,471 pregnant ladies going to antenatal consideration visits in three areas of southern Mozambique with various degrees of transmission (Manhiça, Magude, and Ilha Josina) and contrasted it with the commonness assessed from clinical cases or from cross-sectional examinations in kids in similar regions and throughout a similar time span (2016–2019).
Good temporal and spatial correlation The analysis demonstrates that, particularly when the parasite is detected by molecular tests (PCR), infection rates in children from cross-sectional studies closely mirror those in pregnant women. With quick demonstrative tests, the connection holds in low-transmission regions (Manhiça or Magude); however, it is lost in high-transmission regions (Ilha Josina) when multigravid ladies (who have had more than one pregnancy) are incorporated. The prevalence of multigravid women was lower than that of community children.
Arnau Pujol, who co-authored the study with Gloria Matambisso, explains, “This is because the immunity they acquired during previous pregnancies allows them to maintain low parasite densities and evade detection by rapid tests, which are less sensitive than PCR.”
Infection rates in pregnant women followed the same pattern as those in clinical cases, but with a delay of two to three months, as shown by the results. However, there was a lag of approximately three months between the declining infection rates in pregnant women and those in clinical cases. Regardless of whether the woman was primigravida, multigravida, or HIV-positive, this correlation was found in all three locations.
At long last, 60% of the disease areas of interest related to the clinical cases were likewise found in the pregnant ladies because of a product that recognizes cases that are geologically close.
“Our review shows that evaluating for P. falciparum at the primary antenatal consideration visit can be utilized to assess illness trouble in youngsters,” says Matambisso. However, the authors caution against using more sensitive tests or excluding multigravid women in high-transmission areas without taking into account the three-month delay compared to clinical cases.
More information: Arnau Pujol et al, Detecting temporal and spatial malaria patterns from first antenatal care visits, Nature Communications (2023). DOI: 10.1038/s41467-023-39662-4
