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Addressing Knowledge Gaps: Plasmodium Vivax Infection in Pregnancy

This post is part of a blog series on Malaria in Pregnancy. To view the entire series, click here.

A couple of months ago, I had the chance to meet again with the members of the Plasmodium Vivax Infection in Pregnancy (PregVax) Consortium in Dehli, India– a country that contributes to nearly 80% of the malaria cases in Southeast Asia. P.vivax is the most common of human malaria species and causes up to 80 million cases annually with the majority occurring in Asia and the Western Pacific, Central and South America and the Middle East.

The PregVax Consortium started back in 2008 to address the knowledge gaps in P. vivax infection in pregnancy. Approximately 25 million pregnant women exposed yearly to malaria live in areas where P. vivax is endemic. While the effects of P. falciparum malaria in pregnancy have been well characterised and are responsible for considerable maternal and infant morbidity and mortality, surprisingly little is known about the impact of P. vivax infection during gestation.

The PregVax project is a cohort observational study of pregnant women from five P. vivax endemic countries (Brazil, Colombia, Guatemala, India and Papua New Guinea) that represent most of the world’s P. vivax infections. It aims to describe the epidemiological and clinical features of P.vivax malaria in pregnancy. Compiling this information in a methodologically standardized way is essential to describe the impact of P. vivax malaria in pregnancy. In addition, the project has been working to determine whether there are pregnancy specific P. vivax immune responses and characterize genotypically and phenotypically the parasites of the placenta. In an unprecedented effort, almost 10,000 pregnant women have been enrolled at the different project sites during their routine antenatal care visits and followed-up at the health facility until delivery or end of pregnancy.

More accurate data of vivax malaria during gestation are essential to improve its clinical management and to guide control policies. Furthermore, elucidating the mechanisms involved in the pathology of P. vivax in pregnancy will help to develop specific control tools such as more effective drugs and vaccines.

Although P. falciparum is the most deadly species and the subject of most malaria-related research and literature, more attention should be given to P. vivax. Furthermore, understanding the mechanism involved in P. vivax malaria may also help to elucidate important gaps in the knowledge of P. facilparum infection in pregnancy.

Coordinating the PregVax project  is challenging because of the ambitious objectives and the large cohort size. In fact, this is the first study of this kind in this area. As we are reaching the final stages of the PregVax project, I would like to take this opportunity to thank the European Commission whose research program, 7th Framework Program, made Malaria in Pregnancy one of its priorities and our consortium partners together with our collaborators from Centers for Disease Control and Prevention and the University of Melbourne. I left Dehli with the sense that we are making progress as we gain insight on critical aspects of this issue. Results will soon be shared with the scientific community.

P. vivax was usually considered to be the benign malaria. However, its infection often leads to severe disease–and quality of life and productivity are negatively affected. Absenteeism from work and school and the anaemia that this disease leads to hampers the development of endemic areas. The economic impact of P. vivax malaria mandates that more resources be allocated specifically to research on this parasite.

I think I can speak for everyone at the PregVax Consortium when I say that we look forward to assisting in any way that we can to achieve this vision.

Prof. Clara Menéndez leads the Maternal, Child and Reproductive Health Initiative at the Barcelona Institute for Global Health and is the PregVax Consortium Co-ordinator.

Categories: Contributor Posts Malaria in Pregnancy Series Maternal Health

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