Longitudinal Studies of Plasmodium falciparum Malaria in Pregnant Women Living in a Rural Cameroonian Village with High Perennial Transmission

A prospective longitudinal study of Plasmodium falciparum in pregnant women was conducted in the rural village of Ngali II where malaria is hyperendemic and individuals receive similar to 0 7 infectious mosquito bites/person/day throughout the year Pregnant women (N = 60, 19 primigravidae 41 multigravidae) were enrolled early in pregnancy (median 14 wk) and were followed monthly, with 38 women followed through term (5 7 +/- 1 1 prenatal visits and delivery) The total number of times primigravidae were slide-positive during pregnancy was higher than multigravidae (3 3 +/- 1 1 versus 1 3 +/- 1 3 times, P < 0001), but no difference in the number of polymerase chain reaction-positive cases (4 6 +/- 1 7 and 3 4 +/- 1 7 times, P = 0 106) or total genotypes they harbored (8 9 +/- 3 2 and 7 0 +/- 2 9) was found Only 7 9% women developed symptomatic infections All primigravidae and 38% multigravidae were placental malaria positive at delivery (P = 0 009) Genotyping showed that 77% of placental parasites were acquired >= 30 wks in pregnancy These results help identify the extent of malaria-associated changes women experience during pregnancy