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Imbert P, Nizard J, Werkoff G, Kendjo E, Ficko C, Thellier M. Pregnancy outcomes in women with imported malaria in mainland France: A retrospective study from 2004 to 2014. Travel Med Infect Dis 2024; 60:102727. [PMID: 38768905 DOI: 10.1016/j.tmaid.2024.102727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 05/07/2024] [Accepted: 05/14/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVES There is little data on pregnant women with imported malaria in high-income countries, especially regarding offspring outcomes. We wanted to determine pregnancy outcomes of imported malaria in pregnant women in mainland France. PATIENTS AND METHODS We conducted a retrospective, descriptive study of outcomes in pregnant women hospitalized with malaria from 2004 to 2014 in two regions of mainland France. An adverse outcome was defined as a miscarriage, stillbirth, preterm birth (<35 weeks of gestation), low birth weight (LBW) defined as less than 2500 g, or congenital malaria. RESULTS Of 60 pregnancies, 5 were excluded because of elective abortions; 55 were investigated, of which 11 were primigravidae and 44 multigravidae. Pregnancies were singleton (n = 51) or twin (n = 4). Mean age was 30.4 years (range:19-45 y). Among the 55 cases, 9 ended in a miscarriage (8 singletons and 1 twin pregnancy) and 1 had a stillbirth at 21 weeks of gestation, all immediately after the malarial episode. 45 gave birth (29 vaginal deliveries and 16 caesarean sections) to 48 (42 singletons and 6 twins) newborns. Amongst these, 30 were healthy full-term newborns, 10 had LBW, and 8 were preterm. Overall, 26 of 55 (47.3%) pregnancies, and 29 of 59 (49.2%) offsprings had adverse outcomes. Compared to singleton pregnancies, twin pregnancies were associated with adverse outcomes (p = 0.0438). CONCLUSIONS Imported malaria has a severe impact on pregnancy outcomes. Prevention and management of imported malaria in pregnancy should be optimized.
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Affiliation(s)
- P Imbert
- Service des maladies infectieuses et tropicales, Hôpital d'instruction des armées Bégin, 69 Avenue de Paris, 94160, Saint-Mandé, France
| | - J Nizard
- Service de gynécologie obstétrique, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, 47 Boulevard de L'Hôpital, 75013, Paris, France
| | - G Werkoff
- Service de gynécologie, Hôpital d'instruction des armées Bégin, 69 Avenue de Paris, 94160, Saint-Mandé, France
| | - E Kendjo
- Service de parasitologie-mycologie, Centre National de Référence du paludisme, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, 47 Boulevard de L'Hôpital, 75013, Paris, France
| | - C Ficko
- Service des maladies infectieuses et tropicales, Hôpital d'instruction des armées Bégin, 69 Avenue de Paris, 94160, Saint-Mandé, France
| | - M Thellier
- Service de parasitologie-mycologie, Centre National de Référence du paludisme, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, 47 Boulevard de L'Hôpital, 75013, Paris, France; UMRS 1136, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Sorbonne Université, 27 Rue Chaligny, 75571, Paris 12, France; UPMC, Faculté de médecine, Sorbonne Université, Université Pierre-et-Marie-Curie, 91 Boulevard de l'Hôpital, 75013, Paris, France
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Rodriguez-Morales AJ, Bolívar-Mejía A, Alarcón-Olave C, Calvo-Betancourt LS. Plasmodium vivax Malaria in Latin America. NEGLECTED TROPICAL DISEASES 2015. [DOI: 10.1007/978-3-7091-1422-3_5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Rai P, Majumdar K, Sharma S, Chauhan R, Chandra J. Congenital malaria in a neonate: case report with a comprehensive review on differential diagnosis, treatment and prevention in Indian perspective. J Parasit Dis 2013; 39:345-8. [PMID: 26064034 DOI: 10.1007/s12639-013-0342-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 06/24/2013] [Indexed: 11/26/2022] Open
Abstract
Although malaria in pregnancy, lactation and congenital malaria can be a disease burden in the endemic zones of Africa and Indian sub-continent, it is still epidemiologically less investigated in India. As it may lead to considerable maternal and perinatal morbidity and mortality, awareness and timely intervention is necessary for desirable outcome and prevention of the condition. Very few reports of congenital malaria are available in the literature from an endemic country like India. Herein we describe a case of congenital malaria from north India in a 21-day neonate. Clinical presentation of this condition in the neonate may offer a considerable diagnostic challenge, and differentiation from vector borne malaria in infants may be important from the management point of view. Hence a review of the differential diagnosis, management and prevention of congenital malaria has been attempted in the Indian perspective.
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Affiliation(s)
- Preeti Rai
- Department of Pathology, Lady Hardinge Medical College, New Delhi, India
| | - Kaushik Majumdar
- Department of Pathology, Lady Hardinge Medical College, New Delhi, India
| | - Sunita Sharma
- Department of Pathology, Lady Hardinge Medical College, New Delhi, India
| | - Richa Chauhan
- Department of Pathology, Lady Hardinge Medical College, New Delhi, India
| | - Jagdish Chandra
- Department of Paediatrics, Lady Hardinge Medical College, New Delhi, India
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Rodriguez-Morales AJ, Herrera-Martínez AD, Herrera-Martínez Y. Imported cases of malaria admitted to a hospital in Western Venezuela, 1998–2009. Travel Med Infect Dis 2010; 8:269-71. [DOI: 10.1016/j.tmaid.2010.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Revised: 07/06/2010] [Accepted: 07/07/2010] [Indexed: 11/28/2022]
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Rodriguez-Morales AJ, Ferrer MV, Barrera MA, Pacheco M, Daza V, Franco-Paredes C. Imported cases of malaria admitted to two hospitals of Margarita Island, Venezuela, 1998-2005. Travel Med Infect Dis 2008; 7:44-8. [PMID: 19174301 DOI: 10.1016/j.tmaid.2008.09.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2008] [Revised: 09/13/2008] [Accepted: 09/22/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Imported cases of malaria constitute an important public health problem in many countries, even in those with autochthonous cases, where disease could be acquired in these areas and then seen in non-endemic regions. Non-immune populations are susceptible to complications due to malaria infection, particularly in malaria caused by Plasmodium falciparum. However, Plasmodium vivax the predominant Plasmodium spp. in Venezuela can also lead to severe malaria. METHODS We reviewed retrospectively cases of malaria to identify the clinical features of those imported cases diagnosed at two institutions in Margarita Island (a non-endemic area), Venezuela, in an 8-year period. We conducted a retrospective observational study to identify the clinical and epidemiological features among hospitalized patients at Hospital Central and Hospital Agustin Hernández with malaria acquired at malaria-endemic locations. RESULTS We identified eighteen imported cases of malaria confirmed by thin and thick peripheral blood smears at these two institutions over an 8-year period. The mean age of diagnosis was 27 years. P. vivax was responsible for the majority of cases. All patients presented with fever, 89% with malaise, 78% with chills, and 67% with myalgia, among others symptoms. Mean haemoglobin levels on admission were 8.1g/dL (100% <12g/dL); platelets: 79,283cells/mm(3) (89% had platelets below 150,000); and a mean total leukocyte count: 3.4x10(3)cells/mm(3) (78% had leukopenia). Thirty nine percent of patients required blood transfusions. Two fatalities were identified (CFR=11%), one associated to severe malaria due to P. falciparum and the other due to a complicated case of P. vivax malaria. DISCUSSION Imported cases of malaria due to P. vivax and P. falciparum in the studied population are associated with significant hematological complications. These findings illustrate the importance of educating non-immune populations about the malaria risk and prevention strategies; and from a pubic health perspective, the need to develop further malaria prevention strategies at a national level.
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Rifakis PM, Hernandez O, Fernández CT, Rodriguez-Morales AJ, Von A, Franco-Paredes C. Atypical Plasmodium vivax malaria in a traveler: bilateral hydronephrosis, severe thrombocytopenia, and hypotension. J Travel Med 2008; 15:119-21. [PMID: 18346245 DOI: 10.1111/j.1708-8305.2007.00178.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We report a case of Plasmodium vivax infection manifested as severe thrombocytopenia, bilateral hydronephrosis, and hypotension in a returning traveler from a malaria-endemic area in Venezuela. While most of the efforts to prevent malaria in travelers focus on the life-threatening consequences of Plasmodium falciparum malaria, nonimmune travelers who encounter infection with P vivax may also develop serious complications. This case highlights the importance of preventing malaria cases among nonimmune or semi-immune individuals traveling to P vivax-endemic areas.
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Affiliation(s)
- Pedro M Rifakis
- Internal Medicine, Hosipital de Emergencia Pérez de León, Caracas, Venezuela
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