gms | German Medical Science

10th Malaria Meeting

Working party Malaria / Section Antiparasitic Chemotherapy of the Paul-Ehrlich-Society (PEG e.V.) in cooperation with the German Society for Tropical Medicine and International Health (DTG e.V.) and the German Society for Parasitology (DGP e.V.)

09.11. - 10.11.2012, Marburg an der Lahn

Genetic epidemiology of Malagasy Plasmodium falciparum in pregnant women in two different transmission strata

Meeting Abstract

  • O. Maiga-Ascofare - Bernhard Nocht Institute for Tropical Medicine Hamburg, Germany
  • M. Girmann - Bernhard Nocht Institute for Tropical Medicine Hamburg, Germany
  • N. G. Schwarz - Bernhard Nocht Institute for Tropical Medicine Hamburg, Germany
  • N. Randriamampionona - Université d'Antananarivo, Madagascar
  • R. Rakotozandrindrainy - Université d'Antananarivo, Madagascar
  • J. May - Bernhard Nocht Institute for Tropical Medicine Hamburg, Germany

10th Malaria Meeting. Marburg, 09.-10.11.2012. Düsseldorf: German Medical Science GMS Publishing House; 2013. Doc12mal07

doi: 10.3205/12mal07, urn:nbn:de:0183-12mal072

Published: January 8, 2013

© 2013 Maiga-Ascofare et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Malaria epidemiology in Madagascar is classified into four different strata, ranging from unstable seasonal transmission to hyperendemic perennial transmission areas. Most malaria studies in Madagascar are focused on children. However because of the low transmission in some areas with correspondingly low challenge of the immune system, adults and specifically pregnant women are also at risk.

The objective of our study was to gain information on the genetic epidemiology of malaria infections in pregnant women in order to provide information for malaria control and elimination programs in Madagascar.

We collected 1,244 blood samples from healthy pregnant women from April to July 2010 at six locations in two of the four different malaria epidemiology strata: three sites in the equatorial east coast area with perennial transmission of malaria (Mananjary, Manakara and Ifanadiana) and the three others, in the highland with an unstable seasonal transmission of malaria (Tsiroanomandy, Moramanga and Ambositra). Species of Plasmodium were detected using a Real-Time PCR. In P. falciparum positive samples (n=233), the prevalence of common antimalarial drug resistance markers as pfcrt K76T, pfmdr1 N86Y, pfdhfr (at codons N51I, C59R, S108N, and I164L) and pfdhps (at codons A437G and K540E) was determined by PCR-RFLP. Finally, the multiplicity of infection was evaluated by genotyping 6 different neutral microsatellites (TA60, TA81, TA87, ARAII, Polyalpha, PfPK2).

As expected, the prevalence of P. falciparum infections was higher in the coast areas (0.10 to 0.26) than in the highlands (0.08 to 0.14). Eleven samples were infected by non-falciparum species: 9 samples with P. malariae (8/9 in the coast), one with P. ovale in the coast and one with P. vivax in the highlands. We are currently analysing the data from the drug resistance markers and microsatellites genotyping. We will discuss the prevalence of the drug resistance markers regarding the policy of antimalarial drug use established in Madagascar; the multiplicity of infection and the structure of Malagasy P. falciparum populations among the 6 different locations of the study.

Our findings will enhance the comprehension of malaria genetic epidemiology in two different transmission strata in Madagascar with a fine description of P. falciparum infections among a neglected population at risk.