Biology Reference
In-Depth Information
et al., 2012a
), approximately 70% of that observed following maternal fal-
ciparum malaria (median 150-192 g) (
Poespoprodjo et al., 2008
;
Rijken
et al., 2012a
). A single episode of
P. vivax
infection in the first trimes-
ter increases risk of miscarriage to 2.7-fold and fourfold with asymp-
tomatic and symptomatic malaria, respectively, a rate similar to that with
P. falciparum
(
McGready et al., 2012a
). Other consequences of maternal
vivax malaria (
Nosten et al., 1999
;
Poespoprodjo et al., 2008
;
Rijken et al.,
2012a
;
Rodriguez-Morales et al., 2006
;
McGready et al., 2012a
;
Singh
et al., 1999
), including maternal anaemia and low birth weight, contribute
to greater infant mortality (
Luxemburger et al., 2001
).
Plasmodium vivax
in pregnancy is thus responsible for substantial indirect mortality in the
first year of life.
8.3.3. Congenital malaria
Plasmodium vivax
can cause congenital malaria (
Poespoprodjo et al., 2011
;
Valecha et al., 2007
;
Del Punta et al., 2010
;
McGready et al., 2004
;
Liu
et al., 2012
;
Vottier et al., 2008
), through transplacental infection
in utero
or during delivery (
Rijken et al., 2012a
;
Poespoprodjo et al., 2011
). A
Papuan study found that
P. vivax
congenital infection (alone or mixed)
occurred in 1.6 per 1000 live births (
Poespoprodjo et al., 2011
). In Papua,
congenital malaria was independently associated with low birth weight
and was mostly asymptomatic at birth (
Poespoprodjo et al., 2011
). Similar
to congenital falciparum malaria (
Poespoprodjo et al., 2010
), congeni-
tal vivax malaria can cause severe illness mimicking neonatal sepsis (
Del
Punta et al., 2010
).
9. SEVERE AND FATAL DISEASE RESULTING FROM
TREATMENT WITH PRIMAQUINE
Morbidity and mortality secondary to adverse effects of primaquine
are likely to be underestimated in populations with unmonitored use of pri-
maquine and high prevalence of G6PD deficiency (see
Baird and Surjadjaja,
2010
and Chapter 4). Primaquine-induced haemolysis in patients with
G6PD deficiency can cause life-threatening AKI and severe anaemia. In
Manaus, G6PD-associated AKI and severe haemolytic anaemia accounted
for two (8%) of the 24 cases of vivax malaria requiring intensive care admis-
sion (
Lanca et al., 2012
). Furthermore, of the 17 deaths in the Manaus
autopsy series, two (12%) resulted from AKI and severe anaemia due to
G6PD-related primaquine-induced haemolysis (
Lacerda et al., 2012
).
