Vivax malaria in pregnancy and lactation: a long way to health equity
Abstract Background The Sustainable Development Goals (SDG) call for increased gender equity and reduction in malaria-related mortality and morbidity. Plasmodium vivax infections in pregnancy are associated with maternal anaemia and increased adverse perinatal outcomes. Providing radical cure for wo...
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ftdoajarticles:oai:doaj.org/article:dc06c68a995046329dc5ff6fd2318a0e 2023-05-15T15:09:24+02:00 Vivax malaria in pregnancy and lactation: a long way to health equity Tobias Brummaier Mary Ellen Gilder Gornpan Gornsawun Cindy S. Chu Germana Bancone Mupawjay Pimanpanarak Kesinee Chotivanich François Nosten Rose McGready 2020-01-01T00:00:00Z https://doi.org/10.1186/s12936-020-3123-1 https://doaj.org/article/dc06c68a995046329dc5ff6fd2318a0e EN eng BMC https://doi.org/10.1186/s12936-020-3123-1 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-020-3123-1 1475-2875 https://doaj.org/article/dc06c68a995046329dc5ff6fd2318a0e Malaria Journal, Vol 19, Iss 1, Pp 1-7 (2020) Plasmodium vivax Equity Primaquine Radical cure G6PD deficiency Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2020 ftdoajarticles https://doi.org/10.1186/s12936-020-3123-1 2022-12-31T06:55:40Z Abstract Background The Sustainable Development Goals (SDG) call for increased gender equity and reduction in malaria-related mortality and morbidity. Plasmodium vivax infections in pregnancy are associated with maternal anaemia and increased adverse perinatal outcomes. Providing radical cure for women with 8-aminoquinolines (e.g., primaquine) is hindered by gender-specific complexities. Case presentation A symptomatic episode of vivax malaria at 18 weeks of gestation in a primigravid woman was associated with maternal anaemia, a recurrent asymptomatic P. vivax episode, severe intra-uterine growth restriction with no other identifiable cause and induction to reduce the risk of stillbirth. At 5 months postpartum a qualitative glucose-6-phosphate dehydrogenase (G6PD) point-of-care test was normal and radical cure with primaquine was prescribed to the mother. A 33% fractional decrease in haematocrit on day 7 of primaquine led to further testing which showed intermediate phenotypic G6PD activity; the G6PD genotype could not be identified. Her infant daughter was well throughout maternal treatment and found to be heterozygous for Mahidol variant. Conclusion Adverse effects of vivax malaria in pregnancy, ineligibility of radical cure for pregnant and postpartum women, and difficulties in diagnosing intermediate levels of G6PD activity multiplied morbidity in this woman. Steps towards meeting the SDG include prevention of malaria in pregnancy, reducing unnecessary exclusion of women from radical cure, and accessible quantitative G6PD screening in P. vivax-endemic settings. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 19 1 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
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Plasmodium vivax Equity Primaquine Radical cure G6PD deficiency Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Plasmodium vivax Equity Primaquine Radical cure G6PD deficiency Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Tobias Brummaier Mary Ellen Gilder Gornpan Gornsawun Cindy S. Chu Germana Bancone Mupawjay Pimanpanarak Kesinee Chotivanich François Nosten Rose McGready Vivax malaria in pregnancy and lactation: a long way to health equity |
topic_facet |
Plasmodium vivax Equity Primaquine Radical cure G6PD deficiency Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background The Sustainable Development Goals (SDG) call for increased gender equity and reduction in malaria-related mortality and morbidity. Plasmodium vivax infections in pregnancy are associated with maternal anaemia and increased adverse perinatal outcomes. Providing radical cure for women with 8-aminoquinolines (e.g., primaquine) is hindered by gender-specific complexities. Case presentation A symptomatic episode of vivax malaria at 18 weeks of gestation in a primigravid woman was associated with maternal anaemia, a recurrent asymptomatic P. vivax episode, severe intra-uterine growth restriction with no other identifiable cause and induction to reduce the risk of stillbirth. At 5 months postpartum a qualitative glucose-6-phosphate dehydrogenase (G6PD) point-of-care test was normal and radical cure with primaquine was prescribed to the mother. A 33% fractional decrease in haematocrit on day 7 of primaquine led to further testing which showed intermediate phenotypic G6PD activity; the G6PD genotype could not be identified. Her infant daughter was well throughout maternal treatment and found to be heterozygous for Mahidol variant. Conclusion Adverse effects of vivax malaria in pregnancy, ineligibility of radical cure for pregnant and postpartum women, and difficulties in diagnosing intermediate levels of G6PD activity multiplied morbidity in this woman. Steps towards meeting the SDG include prevention of malaria in pregnancy, reducing unnecessary exclusion of women from radical cure, and accessible quantitative G6PD screening in P. vivax-endemic settings. |
format |
Article in Journal/Newspaper |
author |
Tobias Brummaier Mary Ellen Gilder Gornpan Gornsawun Cindy S. Chu Germana Bancone Mupawjay Pimanpanarak Kesinee Chotivanich François Nosten Rose McGready |
author_facet |
Tobias Brummaier Mary Ellen Gilder Gornpan Gornsawun Cindy S. Chu Germana Bancone Mupawjay Pimanpanarak Kesinee Chotivanich François Nosten Rose McGready |
author_sort |
Tobias Brummaier |
title |
Vivax malaria in pregnancy and lactation: a long way to health equity |
title_short |
Vivax malaria in pregnancy and lactation: a long way to health equity |
title_full |
Vivax malaria in pregnancy and lactation: a long way to health equity |
title_fullStr |
Vivax malaria in pregnancy and lactation: a long way to health equity |
title_full_unstemmed |
Vivax malaria in pregnancy and lactation: a long way to health equity |
title_sort |
vivax malaria in pregnancy and lactation: a long way to health equity |
publisher |
BMC |
publishDate |
2020 |
url |
https://doi.org/10.1186/s12936-020-3123-1 https://doaj.org/article/dc06c68a995046329dc5ff6fd2318a0e |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 19, Iss 1, Pp 1-7 (2020) |
op_relation |
https://doi.org/10.1186/s12936-020-3123-1 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-020-3123-1 1475-2875 https://doaj.org/article/dc06c68a995046329dc5ff6fd2318a0e |
op_doi |
https://doi.org/10.1186/s12936-020-3123-1 |
container_title |
Malaria Journal |
container_volume |
19 |
container_issue |
1 |
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1766340611231711232 |