Publications

" Our main objective is to develop and maintain over time a good expertise and infrastructure ensuring high quality training and clinical research."
Prof Halidou TINTO, PharmD, Msc, PhD Head of the CRUN

2024
Journal Articles
	Myriam El Gaaloul, Andre Marie Tchouatieu, Kassoum Kayentao, Brice Campo, Benedicte Buffet, Hanu Ramachandruni, Jean Louis Ndiaye, Timothy N. C. Wells, Celine Audibert, Jane Achan, Cristina Donini, Hellen C. Barsosio, Halidou Tinto Chemoprevention of malaria with long-acting oral and injectable drugs: an updated target product profile Journal Article In: Malaria journal, vol. 23, iss. 1, pp. 315, 2024, ISSN: 1475-2875. Abstract \| BibTeX \| Tags: Administration, Andre Marie Tchouatieu, Antimalarials* / administration & dosage, Antimalarials* / therapeutic use, Chemoprevention* / methods, doi:10.1186/s12936-024-05128-1, Female, Halidou Tinto, Humans, Injections, Malaria* / prevention & control, MEDLINE, Myriam El Gaaloul, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Oral, PMC11490162, pmid:39425110, Pregnancy, PubMed Abstract, Review \| Links: Close Close @article{nokey, title = {Chemoprevention of malaria with long-acting oral and injectable drugs: an updated target product profile}, author = {Myriam El Gaaloul and Andre Marie Tchouatieu and Kassoum Kayentao and Brice Campo and Benedicte Buffet and Hanu Ramachandruni and Jean Louis Ndiaye and Timothy N. C. Wells and Celine Audibert and Jane Achan and Cristina Donini and Hellen C. Barsosio and Halidou Tinto}, url = {https://pubmed.ncbi.nlm.nih.gov/39425110/}, doi = {10.1186/S12936-024-05128-1}, issn = {1475-2875}, year = {2024}, date = {2024-01-01}, journal = {Malaria journal}, volume = {23}, issue = {1}, pages = {315}, publisher = {Malar J}, abstract = {\<p\>Malaria is preventable, but the burden of disease remains high with over 249 million cases and 608,000 deaths reported in 2022. Historically, the most important protective interventions have been vector control and chemopreventive medicines with over 50 million children receiving seasonal malaria chemoprevention in the year 2023. Two vaccines are approved and starting to be deployed, bringing additional protection for children up to 36 months. However, the impact of these currently available tools is somewhat limited on various fronts. Vaccines exhibit partial efficacy, are relatively costly, and not accessible in all settings. The challenges encountered with chemoprevention are barriers to acceptability and feasibility, including frequency of dosing, and the lack of options in the first trimester of pregnancy and for women living with HIV. Also, the emergence of resistance against chemopreventive medicines is concerning. To address these limitations, a target product profile (TPP) is proposed as a road map to guide innovation and to boost the quest for novel chemopreventive alternatives. This TPP describes the ideal product attributes, while acknowledging potential trade-offs that may be needed. Critically, it considers the target populations most at risk; primarily infants, children, and pregnant women. Malaria control and elimination requires appropriate chemoprevention, not only in areas of high endemicity and transmission, but also in lower transmission areas where immunity is declining, as well as for travellers from areas where malaria has been eliminated. New medicines should show acceptable safety and tolerability, with high and long protective efficacy. Formulations and costs need to support operational adherence, access, and effectiveness. Next generation long-acting oral and injectable drugs are likely to constitute the backbone of malaria prevention. Therefore, the perspectives of front-line experts in malaria prevention, researchers, and those involved in drug development are captured in the TPP. This inclusive approach aims at concentrating efforts and aligning responses across the community to develop new and transformative medicines.\</p\>}, keywords = {Administration, Andre Marie Tchouatieu, Antimalarials* / administration \& dosage, Antimalarials* / therapeutic use, Chemoprevention* / methods, doi:10.1186/s12936-024-05128-1, Female, Halidou Tinto, Humans, Injections, Malaria* / prevention \& control, MEDLINE, Myriam El Gaaloul, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Oral, PMC11490162, pmid:39425110, Pregnancy, PubMed Abstract, Review}, pubstate = {published}, tppubtype = {article} } Close <p>Malaria is preventable, but the burden of disease remains high with over 249 million cases and 608,000 deaths reported in 2022. Historically, the most important protective interventions have been vector control and chemopreventive medicines with over 50 million children receiving seasonal malaria chemoprevention in the year 2023. Two vaccines are approved and starting to be deployed, bringing additional protection for children up to 36 months. However, the impact of these currently available tools is somewhat limited on various fronts. Vaccines exhibit partial efficacy, are relatively costly, and not accessible in all settings. The challenges encountered with chemoprevention are barriers to acceptability and feasibility, including frequency of dosing, and the lack of options in the first trimester of pregnancy and for women living with HIV. Also, the emergence of resistance against chemopreventive medicines is concerning. To address these limitations, a target product profile (TPP) is proposed as a road map to guide innovation and to boost the quest for novel chemopreventive alternatives. This TPP describes the ideal product attributes, while acknowledging potential trade-offs that may be needed. Critically, it considers the target populations most at risk; primarily infants, children, and pregnant women. Malaria control and elimination requires appropriate chemoprevention, not only in areas of high endemicity and transmission, but also in lower transmission areas where immunity is declining, as well as for travellers from areas where malaria has been eliminated. New medicines should show acceptable safety and tolerability, with high and long protective efficacy. Formulations and costs need to support operational adherence, access, and effectiveness. Next generation long-acting oral and injectable drugs are likely to constitute the backbone of malaria prevention. Therefore, the perspectives of front-line experts in malaria prevention, researchers, and those involved in drug development are captured in the TPP. This inclusive approach aims at concentrating efforts and aligning responses across the community to develop new and transformative medicines.</p> Close
	Irene Molina–de Fuente, Marc Christian Tahita, Kabore Bérenger, Thuy Huong Ta Tang, Luz García, Vicenta González, Agustín Benito, Judith M. Hübschen, Halidou Tinto, Pedro Berzosa Malaria diagnosis challenges and pfhrp2 and pfhrp3 gene deletions using pregnant women as sentinel population in Nanoro region, Burkina Faso Journal Article In: Pathogens and global health, vol. 118, iss. 6, 2024, ISSN: 2047-7732. Abstract \| BibTeX \| Tags: Adolescent, Adult, Antigens, Burkina Faso / epidemiology, Diagnostic Tests, doi:10.1080/20477724.2024.2388489, Falciparum* / diagnosis, Falciparum* / epidemiology, Falciparum* / parasitology, Female, Gene Deletion, Humans, Irene Molina-de la Fuente, Malaria, Marc Christian Tahita, MEDLINE, Microscopy, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Parasitic / diagnosis, Parasitic / epidemiology, Pedro Berzosa, Plasmodium falciparum / genetics, Plasmodium falciparum* / isolation & purification, PMC11441055, pmid:39140699, Pregnancy, Pregnancy Complications, Protozoan Proteins* / genetics, Protozoan* / genetics, PubMed Abstract, Research Support, Routine* / methods, Sensitivity and Specificity, Young Adult \| Links: Close Close @article{nokey, title = {Malaria diagnosis challenges and pfhrp2 and pfhrp3 gene deletions using pregnant women as sentinel population in Nanoro region, Burkina Faso}, author = {Irene Molina\textendashde Fuente and Marc Christian Tahita and Kabore B\'{e}renger and Thuy Huong Ta Tang and Luz Garc\'{i}a and Vicenta Gonz\'{a}lez and Agust\'{i}n Benito and Judith M. H\"{u}bschen and Halidou Tinto and Pedro Berzosa}, url = {https://pubmed.ncbi.nlm.nih.gov/39140699/}, doi = {10.1080/20477724.2024.2388489}, issn = {2047-7732}, year = {2024}, date = {2024-01-01}, journal = {Pathogens and global health}, volume = {118}, issue = {6}, publisher = {Pathog Glob Health}, abstract = {Malaria in pregnancy causes adverse consequences and prompt and accurate diagnosis is essential for case management. In malaria endemic countries, diagnosis is mainly based on rapid diagnostic tests (RDT) and microscopy. However, increasing reports of false negatives caused by low parasitemia and pfhrp2/3 deletions raise concerns about HRP2-based RDT usefulness. This study aimed to assess RDT and microscopy performance and to describe pfhrp2/3 deletions in a cohort of 418 pregnant women in Burkina Faso. Malaria was diagnosed using RDT and microscopy and blood samples were collected during antenatal care visits. Diagnostic results were compared to PCR as gold standard. Pfhrp2 and pfhrp3 deletions were characterized for patients with confirmed P. falciparum infection. RDT had better sensitivity (76%) but lower specificity (83%) than microscopy (sensitivity = 57%; specificity = 98%). Low parasitemia (\<150 parasites/µL), especially in multigravidae, was the principal factor causing false negatives by both methods. Moreover, pfhrp2 deletion frequency among overall false negatives by RDT was 21.43%. Higher frequency of deletions was found among all samples, independently of RDT result, for example around 2% of samples had double deletions meaning that the majority of deletions had no effect on RDT testing. Finally, it was found higher pfhrp2 deletion in women with lower uterine height during the first trimester. Wider and National surveillance study of deletions is recommended among pregnant women and in Burkina Faso.}, keywords = {Adolescent, Adult, Antigens, Burkina Faso / epidemiology, Diagnostic Tests, doi:10.1080/20477724.2024.2388489, Falciparum / diagnosis, Falciparum* / epidemiology, Falciparum* / parasitology, Female, Gene Deletion, Humans, Irene Molina-de la Fuente, Malaria, Marc Christian Tahita, MEDLINE, Microscopy, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Parasitic / diagnosis, Parasitic / epidemiology, Pedro Berzosa, Plasmodium falciparum / genetics, Plasmodium falciparum* / isolation \& purification, PMC11441055, pmid:39140699, Pregnancy, Pregnancy Complications, Protozoan Proteins* / genetics, Protozoan* / genetics, PubMed Abstract, Research Support, Routine* / methods, Sensitivity and Specificity*, Young Adult}, pubstate = {published}, tppubtype = {article} } Close Malaria in pregnancy causes adverse consequences and prompt and accurate diagnosis is essential for case management. In malaria endemic countries, diagnosis is mainly based on rapid diagnostic tests (RDT) and microscopy. However, increasing reports of false negatives caused by low parasitemia and pfhrp2/3 deletions raise concerns about HRP2-based RDT usefulness. This study aimed to assess RDT and microscopy performance and to describe pfhrp2/3 deletions in a cohort of 418 pregnant women in Burkina Faso. Malaria was diagnosed using RDT and microscopy and blood samples were collected during antenatal care visits. Diagnostic results were compared to PCR as gold standard. Pfhrp2 and pfhrp3 deletions were characterized for patients with confirmed P. falciparum infection. RDT had better sensitivity (76%) but lower specificity (83%) than microscopy (sensitivity = 57%; specificity = 98%). Low parasitemia (<150 parasites/µL), especially in multigravidae, was the principal factor causing false negatives by both methods. Moreover, pfhrp2 deletion frequency among overall false negatives by RDT was 21.43%. Higher frequency of deletions was found among all samples, independently of RDT result, for example around 2% of samples had double deletions meaning that the majority of deletions had no effect on RDT testing. Finally, it was found higher pfhrp2 deletion in women with lower uterine height during the first trimester. Wider and National surveillance study of deletions is recommended among pregnant women and in Burkina Faso. Close
	Ulugbek Khudayberdievich Mirzaev, Serge Ouoba, Ko Ko, Zayar Phyo, Chanroth Chhoung, Akuffo Golda Ataa, Aya Sugiyama, Tomoyuki Akita, Junko Tanaka Systematic review and meta-analysis of hepatitis E seroprevalence in Southeast Asia: a comprehensive assessment of epidemiological patterns Journal Article In: BMC infectious diseases, vol. 24, iss. 1, 2024, ISSN: 1471-2334. Abstract \| BibTeX \| Tags: Asia, doi:10.1186/s12879-024-09349-2, Female, Hepatitis Antibodies* / blood, Hepatitis E virus* / immunology, Hepatitis E* / blood, Hepatitis E* / epidemiology, Humans, Immunoglobulin G* / blood, Immunoglobulin M* / blood, Junko Tanaka, Male, MEDLINE, Meta-Analysis, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11127338, pmid:38789918, Pregnancy, Prevalence, PubMed Abstract, Risk Factors, Serge Ouoba, Seroepidemiologic Studies, Southeastern / epidemiology, Systematic review, Ulugbek Khudayberdievich Mirzaev \| Links: Close Close @article{Mirzaev2024, title = {Systematic review and meta-analysis of hepatitis E seroprevalence in Southeast Asia: a comprehensive assessment of epidemiological patterns}, author = {Ulugbek Khudayberdievich Mirzaev and Serge Ouoba and Ko Ko and Zayar Phyo and Chanroth Chhoung and Akuffo Golda Ataa and Aya Sugiyama and Tomoyuki Akita and Junko Tanaka}, url = {https://pubmed.ncbi.nlm.nih.gov/38789918/}, doi = {10.1186/S12879-024-09349-2}, issn = {1471-2334}, year = {2024}, date = {2024-01-01}, journal = {BMC infectious diseases}, volume = {24}, issue = {1}, publisher = {BMC Infect Dis}, abstract = {The burden of hepatitis E in Southeast Asia is substantial, influenced by its distinct socio-economic and environmental factors, as well as variations in healthcare systems. The aim of this study was to assess the pooled seroprevalence of hepatitis E across countries within the Southeast Asian region by the UN division. The study analyzed 66 papers across PubMed, Web of Science, and Scopus databases, encompassing data from of 44,850 individuals focusing on anti-HEV seroprevalence. The investigation spanned nine countries, excluding Brunei and East Timor due to lack of data. The pooled prevalence of anti-HEV IgG was determined to be 21.03%, with the highest prevalence observed in Myanmar (33.46%) and the lowest in Malaysia (5.93%). IgM prevalence was highest in Indonesia (12.43%) and lowest in Malaysia (0.91%). The study stratified populations into high-risk (farm workers, chronic patients) and low-risk groups (general population, blood donors, pregnant women, hospital patients). It revealed a higher IgG\textemdash28.9%, IgM\textemdash4.42% prevalence in the former group, while the latter group exhibited figures of 17.86% and 3.15%, respectively, indicating occupational and health-related vulnerabilities to HEV. A temporal analysis (1987\textendash2023), indicated an upward trend in both IgG and IgM prevalence, suggesting an escalating HEV burden. These findings contribute to a better understanding of HEV seroprevalence in Southeast Asia, shedding light on important public health implications and suggesting directions for further research and intervention strategies. Key points Research Question Investigate the seroprevalence of hepatitis E virus (HEV) in Southeast Asian countries focusing on different patterns, timelines, and population cohorts. Findings Sporadic Transmission of IgG and IgM Prevalence: • Pooled anti-HEV IgG prevalence: 21.03% • Pooled anti-HEV IgM prevalence: 3.49% Seroprevalence among specific groups: High-risk group (farm workers and chronic patients): • anti-HEV IgG: 28.9% • anti-HEV IgM: 4.42% Low-risk group (general population, blood donors, pregnant women, hospital patients): • anti-HEV IgG: 17.86% • anti-HEV IgM: 3.15% Temporal Seroprevalence of HEV: Anti-HEV IgG prevalence increased over decades (1987\textendash1999; 2000\textendash2010; 2011\textendash2023): 12.47%, 18.43%, 29.17% as an anti-HEV IgM prevalence: 1.92%, 2.44%, 5.27% Importance Provides a comprehensive overview of HEV seroprevalence in Southeast Asia. Highlights variation in seroprevalence among different population groups. Reveals increasing trend in HEV seroprevalence over the years. Distinguishes between sporadic and epidemic cases for a better understanding of transmission dynamics.}, keywords = {Asia, doi:10.1186/s12879-024-09349-2, Female, Hepatitis Antibodies* / blood, Hepatitis E virus* / immunology, Hepatitis E* / blood, Hepatitis E* / epidemiology, Humans, Immunoglobulin G* / blood, Immunoglobulin M* / blood, Junko Tanaka, Male, MEDLINE, Meta-Analysis, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11127338, pmid:38789918, Pregnancy, Prevalence, PubMed Abstract, Risk Factors, Serge Ouoba, Seroepidemiologic Studies, Southeastern / epidemiology, Systematic review, Ulugbek Khudayberdievich Mirzaev}, pubstate = {published}, tppubtype = {article} } Close The burden of hepatitis E in Southeast Asia is substantial, influenced by its distinct socio-economic and environmental factors, as well as variations in healthcare systems. The aim of this study was to assess the pooled seroprevalence of hepatitis E across countries within the Southeast Asian region by the UN division. The study analyzed 66 papers across PubMed, Web of Science, and Scopus databases, encompassing data from of 44,850 individuals focusing on anti-HEV seroprevalence. The investigation spanned nine countries, excluding Brunei and East Timor due to lack of data. The pooled prevalence of anti-HEV IgG was determined to be 21.03%, with the highest prevalence observed in Myanmar (33.46%) and the lowest in Malaysia (5.93%). IgM prevalence was highest in Indonesia (12.43%) and lowest in Malaysia (0.91%). The study stratified populations into high-risk (farm workers, chronic patients) and low-risk groups (general population, blood donors, pregnant women, hospital patients). It revealed a higher IgG—28.9%, IgM—4.42% prevalence in the former group, while the latter group exhibited figures of 17.86% and 3.15%, respectively, indicating occupational and health-related vulnerabilities to HEV. A temporal analysis (1987–2023), indicated an upward trend in both IgG and IgM prevalence, suggesting an escalating HEV burden. These findings contribute to a better understanding of HEV seroprevalence in Southeast Asia, shedding light on important public health implications and suggesting directions for further research and intervention strategies. Key points Research Question Investigate the seroprevalence of hepatitis E virus (HEV) in Southeast Asian countries focusing on different patterns, timelines, and population cohorts. Findings Sporadic Transmission of IgG and IgM Prevalence: • Pooled anti-HEV IgG prevalence: 21.03% • Pooled anti-HEV IgM prevalence: 3.49% Seroprevalence among specific groups: High-risk group (farm workers and chronic patients): • anti-HEV IgG: 28.9% • anti-HEV IgM: 4.42% Low-risk group (general population, blood donors, pregnant women, hospital patients): • anti-HEV IgG: 17.86% • anti-HEV IgM: 3.15% Temporal Seroprevalence of HEV: Anti-HEV IgG prevalence increased over decades (1987–1999; 2000–2010; 2011–2023): 12.47%, 18.43%, 29.17% as an anti-HEV IgM prevalence: 1.92%, 2.44%, 5.27% Importance Provides a comprehensive overview of HEV seroprevalence in Southeast Asia. Highlights variation in seroprevalence among different population groups. Reveals increasing trend in HEV seroprevalence over the years. Distinguishes between sporadic and epidemic cases for a better understanding of transmission dynamics. Close
	Kadiatou Koita, Joel D. Bognini, Efundem Agboraw, Mahamadou Dembélé, Seydou Yabré, Biébo Bihoun, Oumou Coulibaly, Hamidou Niangaly, Jean Batiste N’Takpé, Maia Lesosky, Dario Scaramuzzi, Eve Worrall, Jenny Hill, Valérie Briand, Halidou Tinto, Kassoum Kayentao Increasing the uptake of Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) through seasonal malaria chemoprevention channel delivery: protocol of a multicenter cluster randomized implementation trial in Mali and Burkina Faso Journal Article In: BMC public health, vol. 24, iss. 1, 2024, ISSN: 1471-2458. Abstract \| BibTeX \| Tags: Antimalarials* / therapeutic use, Burkina Faso, Chemoprevention, Child, Clinical Trial Protocol, doi:10.1186/s12889-023-17529-z, Drug Combinations, Female, Humans, Joel D Bognini, Kadiatou Koita, Kassoum Kayentao, Malaria* / drug therapy, Malaria* / prevention & control, Mali, MEDLINE, Multicenter Studies as Topic, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Parasitic* / prevention & control, PMC10763117, pmid:38166711, Pregnancy, Pregnancy Complications, Preschool, PubMed Abstract, Pyrimethamine / therapeutic use, Randomized Controlled Trials as Topic, Research Support, Seasons, Sulfadoxine / therapeutic use \| Links: Close Close @article{Koita2024, title = {Increasing the uptake of Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) through seasonal malaria chemoprevention channel delivery: protocol of a multicenter cluster randomized implementation trial in Mali and Burkina Faso}, author = {Kadiatou Koita and Joel D. Bognini and Efundem Agboraw and Mahamadou Demb\'{e}l\'{e} and Seydou Yabr\'{e} and Bi\'{e}bo Bihoun and Oumou Coulibaly and Hamidou Niangaly and Jean Batiste N’Takp\'{e} and Maia Lesosky and Dario Scaramuzzi and Eve Worrall and Jenny Hill and Val\'{e}rie Briand and Halidou Tinto and Kassoum Kayentao}, url = {https://pubmed.ncbi.nlm.nih.gov/38166711/}, doi = {10.1186/S12889-023-17529-Z}, issn = {1471-2458}, year = {2024}, date = {2024-01-01}, journal = {BMC public health}, volume = {24}, issue = {1}, publisher = {BMC Public Health}, abstract = {Background: The uptake of Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) remains unacceptably low, with more than two-thirds of pregnant women in sub-Saharan Africa still not accessing the three or more doses recommended by the World Health Organisation (WHO). In contrast, the coverage of Seasonal Malaria Chemoprevention (SMC), a more recent strategy recommended by the WHO for malaria prevention in children under five years living in Sahelian countries with seasonal transmission, including Mali and Burkina-Faso, is high (up to 90%). We hypothesized that IPTp-SP delivery to pregnant women through SMC alongside antenatal care (ANC) will increase IPTp-SP coverage, boost ANC attendance, and increase public health impact. This protocol describes the approach to assess acceptability, feasibility, effectiveness, and cost-effectiveness of the integrated strategy. Methods and analysis: This is a multicentre, cluster-randomized, implementation trial of IPTp-SP delivery through ANC + SMC vs ANC alone in 40 health facilities and their catchment populations (20 clusters per arm). The intervention will consist of monthly administration of IPTp-SP through four monthly rounds of SMC during the malaria transmission season (July to October), for two consecutive years. Effectiveness of the strategy to increase coverage of three or more doses of IPTp-SP (IPTp3 +) will be assessed using household surveys and ANC exit interviews. Statistical analysis of IPT3 + and four or more ANC uptake will use a generalized linear mixed model. Feasibility and acceptability will be assessed through in-depth interviews and focus group discussions with health workers, pregnant women, and women with a child \< 12 months. Discussion: This multicentre cluster randomized implementation trial powered to detect a 45% and 22% increase in IPTp-SP3 + uptake in Mali and Burkina-Faso, respectively, will generate evidence on the feasibility, acceptability, effectiveness, and cost-effectiveness of IPTp-SP delivered through the ANC + SMC channel. The intervention is designed to facilitate scalability and translation into policy by leveraging existing resources, while strengthening local capacities in research, health, and community institutions. Findings will inform the local national malaria control policies. Trial registration: Retrospectively registered on August 11th, 2022; registration # PACTR202208844472053. Protocol v4.0 dated September 04, 2023. Trail sponsor: University of Sciences Techniques and Technologies of Bamako (USTTB), Mali.}, keywords = {Antimalarials* / therapeutic use, Burkina Faso, Chemoprevention, Child, Clinical Trial Protocol, doi:10.1186/s12889-023-17529-z, Drug Combinations, Female, Humans, Joel D Bognini, Kadiatou Koita, Kassoum Kayentao, Malaria* / drug therapy, Malaria* / prevention \& control, Mali, MEDLINE, Multicenter Studies as Topic, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Parasitic* / prevention \& control, PMC10763117, pmid:38166711, Pregnancy, Pregnancy Complications, Preschool, PubMed Abstract, Pyrimethamine / therapeutic use, Randomized Controlled Trials as Topic, Research Support, Seasons, Sulfadoxine / therapeutic use}, pubstate = {published}, tppubtype = {article} } Close Background: The uptake of Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) remains unacceptably low, with more than two-thirds of pregnant women in sub-Saharan Africa still not accessing the three or more doses recommended by the World Health Organisation (WHO). In contrast, the coverage of Seasonal Malaria Chemoprevention (SMC), a more recent strategy recommended by the WHO for malaria prevention in children under five years living in Sahelian countries with seasonal transmission, including Mali and Burkina-Faso, is high (up to 90%). We hypothesized that IPTp-SP delivery to pregnant women through SMC alongside antenatal care (ANC) will increase IPTp-SP coverage, boost ANC attendance, and increase public health impact. This protocol describes the approach to assess acceptability, feasibility, effectiveness, and cost-effectiveness of the integrated strategy. Methods and analysis: This is a multicentre, cluster-randomized, implementation trial of IPTp-SP delivery through ANC + SMC vs ANC alone in 40 health facilities and their catchment populations (20 clusters per arm). The intervention will consist of monthly administration of IPTp-SP through four monthly rounds of SMC during the malaria transmission season (July to October), for two consecutive years. Effectiveness of the strategy to increase coverage of three or more doses of IPTp-SP (IPTp3 +) will be assessed using household surveys and ANC exit interviews. Statistical analysis of IPT3 + and four or more ANC uptake will use a generalized linear mixed model. Feasibility and acceptability will be assessed through in-depth interviews and focus group discussions with health workers, pregnant women, and women with a child < 12 months. Discussion: This multicentre cluster randomized implementation trial powered to detect a 45% and 22% increase in IPTp-SP3 + uptake in Mali and Burkina-Faso, respectively, will generate evidence on the feasibility, acceptability, effectiveness, and cost-effectiveness of IPTp-SP delivered through the ANC + SMC channel. The intervention is designed to facilitate scalability and translation into policy by leveraging existing resources, while strengthening local capacities in research, health, and community institutions. Findings will inform the local national malaria control policies. Trial registration: Retrospectively registered on August 11th, 2022; registration # PACTR202208844472053. Protocol v4.0 dated September 04, 2023. Trail sponsor: University of Sciences Techniques and Technologies of Bamako (USTTB), Mali. Close
2023
Journal Articles
	Japhet Kabalu Tshiongo, Flory Luzolo, Melissa Kabena, Lise Kuseke, Moussa Djimde, Patrick Mitashi, Crispin Lumbala, Kassoum Kayentao, Sandra Menting, Petra F. Mens, Henk D. F. H. Schallig, Pascal Lutumba, Halidou Tinto, Hypolite Muhindo Mavoko, Vivi Maketa Performance of ultra-sensitive malaria rapid diagnostic test to detect Plasmodium falciparum infection in pregnant women in Kinshasa, the Democratic Republic of the Congo Journal Article In: Malaria journal, vol. 22, iss. 1, 2023, ISSN: 1475-2875. Abstract \| BibTeX \| Tags: Antigens, Democratic Republic of the Congo, Diagnostic Tests, doi:10.1186/s12936-023-04749-2, Falciparum* / epidemiology, Female, Flory Luzolo, Humans, Japhet Kabalu Tshiongo, Malaria, Malaria, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Plasmodium falciparum, PMC10594769, pmid:37872634, Pregnancy, Pregnant Women, Protozoan, PubMed Abstract, Rapid diagnostic tests, Routine / methods, Sensitivity and Specificity, Vivi Maketa \| Links: Close Close @article{nokey, title = {Performance of ultra-sensitive malaria rapid diagnostic test to detect Plasmodium falciparum infection in pregnant women in Kinshasa, the Democratic Republic of the Congo}, author = {Japhet Kabalu Tshiongo and Flory Luzolo and Melissa Kabena and Lise Kuseke and Moussa Djimde and Patrick Mitashi and Crispin Lumbala and Kassoum Kayentao and Sandra Menting and Petra F. Mens and Henk D. F. H. Schallig and Pascal Lutumba and Halidou Tinto and Hypolite Muhindo Mavoko and Vivi Maketa}, url = {https://pubmed.ncbi.nlm.nih.gov/37872634/}, doi = {10.1186/S12936-023-04749-2}, issn = {1475-2875}, year = {2023}, date = {2023-01-01}, journal = {Malaria journal}, volume = {22}, issue = {1}, publisher = {Malar J}, abstract = {Background: Low peripheral parasitaemia caused by sequestration of Plasmodium falciparum in the placenta hampers the diagnosis of malaria in pregnant women, leading to microscopy or conventional rapid diagnostic tests (RDTs) false-negative results. Although mainly asymptomatic, maternal malaria remains harmful to pregnant women and their offspring in endemic settings and must be adequately diagnosed. Ultra-sensitive RDTs (uRDTs) are thought to be more sensitive than RDTs, and their diagnostic performance was assessed in the current study in pregnant women living in Kinshasa, a stable malaria transmission area in the Democratic Republic of the Congo. Methods: To assess and compare the diagnostic performances of both RDTs and uRDTs, 497 peripheral blood samples were tested using microscopy and quantitative polymerase chain reaction (qPCR) as the index and the reference tests, respectively. The agreement between the different diagnostic tests assessed was estimated by Cohen's Kappa test. Results: The median parasite density by qPCR was 292 p/μL of blood [IQR (49.7\textendash1137)]. Using qPCR as the reference diagnostic test, the sensitivities of microscopy, RDT and uRDT were respectively [55.7% (95% CI 47.6\textendash63.6)], [81.7% (95%CI 74.7\textendash87.3)] and [88% (95% CI 81.9\textendash92.6)]. The specificities of the tests were calculated at 98.5% (95% CI 96.6\textendash99.5), 95.2% (95% CI 92.5\textendash97.2) and 94.4% (95% CI 91.4\textendash96.6) for microscopy, RDT and uRDT, respectively. The agreement between qPCR and uRDT was almost perfect (Kappa = 0.82). For parasite density (qPCR) below 100 p/µL, the sensitivity of RDT was 62% (95% CI 47.1\textendash75.3) compared to 68% (95% CI 53.3\textendash80.4) for uRDT. Between 100 and 200 p/µL, the sensitivity of RDT was higher, but still lower compared to uRDT: 89.4% (95% CI 66.8\textendash98.7) for RDT versus 100% (95% CI 82.3\textendash100) for uRDT. In both cases, microscopy was lower, with 20% (95% CI 10\textendash33.7) and 47.3% (95% CI 24.4\textendash71.1) respectively. Conclusions: uRDT has the potential to improve malaria management in pregnant women as it has been found to be slightly more sensitive than RDT in the detection of malaria in pregnant women but the difference was not significant. Microscopy has a more limited value for the diagnosis of malaria during the pregnancy, because of its lower sensitivity.}, keywords = {Antigens, Democratic Republic of the Congo, Diagnostic Tests, doi:10.1186/s12936-023-04749-2, Falciparum / epidemiology, Female, Flory Luzolo, Humans, Japhet Kabalu Tshiongo, Malaria, Malaria*, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Plasmodium falciparum, PMC10594769, pmid:37872634, Pregnancy, Pregnant Women, Protozoan, PubMed Abstract, Rapid diagnostic tests, Routine / methods, Sensitivity and Specificity, Vivi Maketa}, pubstate = {published}, tppubtype = {article} } Close Background: Low peripheral parasitaemia caused by sequestration of Plasmodium falciparum in the placenta hampers the diagnosis of malaria in pregnant women, leading to microscopy or conventional rapid diagnostic tests (RDTs) false-negative results. Although mainly asymptomatic, maternal malaria remains harmful to pregnant women and their offspring in endemic settings and must be adequately diagnosed. Ultra-sensitive RDTs (uRDTs) are thought to be more sensitive than RDTs, and their diagnostic performance was assessed in the current study in pregnant women living in Kinshasa, a stable malaria transmission area in the Democratic Republic of the Congo. Methods: To assess and compare the diagnostic performances of both RDTs and uRDTs, 497 peripheral blood samples were tested using microscopy and quantitative polymerase chain reaction (qPCR) as the index and the reference tests, respectively. The agreement between the different diagnostic tests assessed was estimated by Cohen's Kappa test. Results: The median parasite density by qPCR was 292 p/μL of blood [IQR (49.7–1137)]. Using qPCR as the reference diagnostic test, the sensitivities of microscopy, RDT and uRDT were respectively [55.7% (95% CI 47.6–63.6)], [81.7% (95%CI 74.7–87.3)] and [88% (95% CI 81.9–92.6)]. The specificities of the tests were calculated at 98.5% (95% CI 96.6–99.5), 95.2% (95% CI 92.5–97.2) and 94.4% (95% CI 91.4–96.6) for microscopy, RDT and uRDT, respectively. The agreement between qPCR and uRDT was almost perfect (Kappa = 0.82). For parasite density (qPCR) below 100 p/µL, the sensitivity of RDT was 62% (95% CI 47.1–75.3) compared to 68% (95% CI 53.3–80.4) for uRDT. Between 100 and 200 p/µL, the sensitivity of RDT was higher, but still lower compared to uRDT: 89.4% (95% CI 66.8–98.7) for RDT versus 100% (95% CI 82.3–100) for uRDT. In both cases, microscopy was lower, with 20% (95% CI 10–33.7) and 47.3% (95% CI 24.4–71.1) respectively. Conclusions: uRDT has the potential to improve malaria management in pregnant women as it has been found to be slightly more sensitive than RDT in the detection of malaria in pregnant women but the difference was not significant. Microscopy has a more limited value for the diagnosis of malaria during the pregnancy, because of its lower sensitivity. Close
	Hamtandi Magloire Natama, Gemma Moncunill, Marta Vidal, Toussaint Rouamba, Ruth Aguilar, Rebeca Santano, Eduard Rovira-Vallbona, Alfons Jiménez, M. Athanase Somé, Hermann Sorgho, Innocent Valéa, Maminata Coulibaly-Traoré, Ross L. Coppel, David Cavanagh, Chetan E. Chitnis, James G. Beeson, Evelina Angov, Sheetij Dutta, Benoit Gamain, Luis Izquierdo, Petra F. Mens, Henk D. F. H. Schallig, Halidou Tinto, Anna Rosanas-Urgell, Carlota Dobaño Associations between prenatal malaria exposure, maternal antibodies at birth, and malaria susceptibility during the first year of life in Burkina Faso Journal Article In: Infection and immunity, vol. 91, iss. 10, pp. 290, 2023, ISSN: 1098-5522. Abstract \| BibTeX \| Tags: Antibodies, Antigens, Burkina Faso / epidemiology, Carlota Dobaño, Child, Cohort Studies, doi:10.1128/iai.00268-23, Falciparum, Female, Gemma Moncunill, Hamtandi Magloire Natama, Humans, Immunoglobulin G, Infant, Malaria, Malaria / epidemiology, Maternal Exposure, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, Newborn, NIH, NLM, placenta, Plasmodium falciparum, PMC10580994, pmid:37754682, Pregnancy, Preschool, Protozoan, PubMed Abstract \| Links: Close Close @article{Natama2023, title = {Associations between prenatal malaria exposure, maternal antibodies at birth, and malaria susceptibility during the first year of life in Burkina Faso}, author = {Hamtandi Magloire Natama and Gemma Moncunill and Marta Vidal and Toussaint Rouamba and Ruth Aguilar and Rebeca Santano and Eduard Rovira-Vallbona and Alfons Jim\'{e}nez and M. Athanase Som\'{e} and Hermann Sorgho and Innocent Val\'{e}a and Maminata Coulibaly-Traor\'{e} and Ross L. Coppel and David Cavanagh and Chetan E. Chitnis and James G. Beeson and Evelina Angov and Sheetij Dutta and Benoit Gamain and Luis Izquierdo and Petra F. Mens and Henk D. F. H. Schallig and Halidou Tinto and Anna Rosanas-Urgell and Carlota Doba\~{n}o}, url = {https://pubmed.ncbi.nlm.nih.gov/37754682/}, doi = {10.1128/IAI.00268-23}, issn = {1098-5522}, year = {2023}, date = {2023-01-01}, journal = {Infection and immunity}, volume = {91}, issue = {10}, pages = {290}, publisher = {Infect Immun}, abstract = {In this study, we investigated how different categories of prenatal malaria exposure (PME) influence levels of maternal antibodies in cord blood samples and the subsequent risk of malaria in early childhood in a birth cohort study (N = 661) nested within the COSMIC clinical trial (NCT01941264) in Burkina Faso. Plasmodium falciparum infections during pregnancy and infants’ clinical malaria episodes detected during the first year of life were recorded. The levels of maternal IgG and IgG1-4 to 15 P. falciparum antigens were measured in cord blood by quantitative suspension array technology. Results showed a significant variation in the magnitude of maternal antibody levels in cord blood, depending on the PME category, with past placental malaria (PM) more frequently associated with significant increases of IgG and/or subclass levels across three groups of antigens defined as pre-erythrocytic, erythrocytic, and markers of PM, as compared to those from the cord of non-exposed control infants. High levels of antibodies to certain erythrocytic antigens (i.e., IgG to EBA140 and EBA175, IgG1 to EBA175 and MSP142, and IgG3 to EBA140 and MSP5) were independent predictors of protection from clinical malaria during the first year of life. By contrast, high levels of IgG, IgG1, and IgG2 to the VAR2CSA DBL1-2 and IgG4 to DBL3-4 were significantly associated with an increased risk of clinical malaria. These findings indicate that PME categories have different effects on the levels of maternal-derived antibodies to malaria antigens in children at birth, and this might drive heterogeneity to clinical malaria susceptibility in early childhood.}, keywords = {Antibodies, Antigens, Burkina Faso / epidemiology, Carlota Doba\~{n}o, Child, Cohort Studies, doi:10.1128/iai.00268-23, Falciparum, Female, Gemma Moncunill, Hamtandi Magloire Natama, Humans, Immunoglobulin G, Infant, Malaria, Malaria / epidemiology, Maternal Exposure, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, Newborn, NIH, NLM, placenta, Plasmodium falciparum, PMC10580994, pmid:37754682, Pregnancy, Preschool, Protozoan, PubMed Abstract}, pubstate = {published}, tppubtype = {article} } Close In this study, we investigated how different categories of prenatal malaria exposure (PME) influence levels of maternal antibodies in cord blood samples and the subsequent risk of malaria in early childhood in a birth cohort study (N = 661) nested within the COSMIC clinical trial (NCT01941264) in Burkina Faso. Plasmodium falciparum infections during pregnancy and infants’ clinical malaria episodes detected during the first year of life were recorded. The levels of maternal IgG and IgG1-4 to 15 P. falciparum antigens were measured in cord blood by quantitative suspension array technology. Results showed a significant variation in the magnitude of maternal antibody levels in cord blood, depending on the PME category, with past placental malaria (PM) more frequently associated with significant increases of IgG and/or subclass levels across three groups of antigens defined as pre-erythrocytic, erythrocytic, and markers of PM, as compared to those from the cord of non-exposed control infants. High levels of antibodies to certain erythrocytic antigens (i.e., IgG to EBA140 and EBA175, IgG1 to EBA175 and MSP142, and IgG3 to EBA140 and MSP5) were independent predictors of protection from clinical malaria during the first year of life. By contrast, high levels of IgG, IgG1, and IgG2 to the VAR2CSA DBL1-2 and IgG4 to DBL3-4 were significantly associated with an increased risk of clinical malaria. These findings indicate that PME categories have different effects on the levels of maternal-derived antibodies to malaria antigens in children at birth, and this might drive heterogeneity to clinical malaria susceptibility in early childhood. Close
	Moussa Djimde, Japhet Kabalu Tshiongo, Hypolite Mavoko Muhindo, Halidou Tinto, Esperanca Sevene, Maminata Traore, Anifa Vala, Salesio MacUacua, Berenger Kabore, Edgard Diniba Dabira, Annette Erhart, Hamadoun Diakite, Mohamed Keita, Mireia Piqueras, Raquel González, Clara Menendez, Thomas P. C. Dorlo, Issaka Sagara, Petra Mens, Henk Schallig, Umberto D'Alessandro, Kassoum Kayentao Efficacy and safety of pyronaridine-artesunate (PYRAMAX) for the treatment of P. falciparum uncomplicated malaria in African pregnant women (PYRAPREG): study protocol for a phase 3, non-inferiority, randomised open-label clinical trial Journal Article In: BMJ open, vol. 13, iss. 10, 2023, ISSN: 2044-6055. Abstract \| BibTeX \| Tags: Antimalarials* / adverse effects, Artemether, Artemether / therapeutic use, Artemisinins* / adverse effects, Clinical Trial Protocol, Clinical Trials, doi:10.1136/bmjopen-2022-065295, Drug Combinations, Falciparum* / drug therapy, Female, Humans, Infant, Japhet Kabalu Tshiongo, Kassoum Kayentao, Lumefantrine Drug Combination / therapeutic use, Malaria, Malaria* / drug therapy, MEDLINE, Moussa Djimde, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Phase III as Topic, PMC10565244, pmid:37813539, Pregnancy, Pregnant Women, PubMed Abstract, Randomized Controlled Trials as Topic, Research Support, Sub-Saharan African People, Treatment Outcome \| Links: Close Close @article{Djimde2023, title = {Efficacy and safety of pyronaridine-artesunate (PYRAMAX) for the treatment of P. falciparum uncomplicated malaria in African pregnant women (PYRAPREG): study protocol for a phase 3, non-inferiority, randomised open-label clinical trial}, author = {Moussa Djimde and Japhet Kabalu Tshiongo and Hypolite Mavoko Muhindo and Halidou Tinto and Esperanca Sevene and Maminata Traore and Anifa Vala and Salesio MacUacua and Berenger Kabore and Edgard Diniba Dabira and Annette Erhart and Hamadoun Diakite and Mohamed Keita and Mireia Piqueras and Raquel Gonz\'{a}lez and Clara Menendez and Thomas P. C. Dorlo and Issaka Sagara and Petra Mens and Henk Schallig and Umberto D'Alessandro and Kassoum Kayentao}, url = {https://pubmed.ncbi.nlm.nih.gov/37813539/}, doi = {10.1136/BMJOPEN-2022-065295}, issn = {2044-6055}, year = {2023}, date = {2023-01-01}, journal = {BMJ open}, volume = {13}, issue = {10}, publisher = {BMJ Open}, abstract = {Introduction Malaria infection during pregnancy increases the risk of low birth weight and infant mortality and should be prevented and treated. Artemisinin-based combination treatments are generally well tolerated, safe and effective; the most used being artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP). Pyronaridine-artesunate (PA) is a new artemisinin-based combination. The main objective of this study is to determine the efficacy and safety of PA versus AL or DP when administered to pregnant women with confirmed Plasmodium falciparum infection in the second or third trimester. The primary hypothesis is the pairwise non-inferiority of PA as compared with either AL or DP. Methods and analysis A phase 3, non-inferiority, randomised, open-label clinical trial to determine the safety and efficacy of AL, DP and PA in pregnant women with malaria in five sub-Saharan, malaria-endemic countries (Burkina Faso, Democratic Republic of the Congo, Mali, Mozambique and the Gambia). A total of 1875 pregnant women will be randomised to one of the treatment arms. Women will be actively monitored until Day 63 post-treatment, at delivery and 4-6 weeks after delivery, and infants' health will be checked on their first birthday. The primary endpoint is the PCR-adjusted rate of adequate clinical and parasitological response at Day 42 in the per-protocol population. Ethics and dissemination This protocol has been approved by the Ethics Committee for Health Research in Burkina Faso, the National Health Ethics Committee in the Democratic Republic of Congo, the Ethics Committee of the Faculty of Medicine and Odontostomatology/Faculty of Pharmacy in Mali, the Gambia Government/MRCG Joint Ethics Committee and the National Bioethics Committee for Health in Mozambique. Written informed consent will be obtained from each individual prior to her participation in the study. The results will be published in peer-reviewed open access journals and presented at (inter)national conferences and meetings. Trial registration number PACTR202011812241529.}, keywords = {Antimalarials* / adverse effects, Artemether, Artemether / therapeutic use, Artemisinins* / adverse effects, Clinical Trial Protocol, Clinical Trials, doi:10.1136/bmjopen-2022-065295, Drug Combinations, Falciparum* / drug therapy, Female, Humans, Infant, Japhet Kabalu Tshiongo, Kassoum Kayentao, Lumefantrine Drug Combination / therapeutic use, Malaria, Malaria* / drug therapy, MEDLINE, Moussa Djimde, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Phase III as Topic, PMC10565244, pmid:37813539, Pregnancy, Pregnant Women, PubMed Abstract, Randomized Controlled Trials as Topic, Research Support, Sub-Saharan African People, Treatment Outcome}, pubstate = {published}, tppubtype = {article} } Close Introduction Malaria infection during pregnancy increases the risk of low birth weight and infant mortality and should be prevented and treated. Artemisinin-based combination treatments are generally well tolerated, safe and effective; the most used being artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP). Pyronaridine-artesunate (PA) is a new artemisinin-based combination. The main objective of this study is to determine the efficacy and safety of PA versus AL or DP when administered to pregnant women with confirmed Plasmodium falciparum infection in the second or third trimester. The primary hypothesis is the pairwise non-inferiority of PA as compared with either AL or DP. Methods and analysis A phase 3, non-inferiority, randomised, open-label clinical trial to determine the safety and efficacy of AL, DP and PA in pregnant women with malaria in five sub-Saharan, malaria-endemic countries (Burkina Faso, Democratic Republic of the Congo, Mali, Mozambique and the Gambia). A total of 1875 pregnant women will be randomised to one of the treatment arms. Women will be actively monitored until Day 63 post-treatment, at delivery and 4-6 weeks after delivery, and infants' health will be checked on their first birthday. The primary endpoint is the PCR-adjusted rate of adequate clinical and parasitological response at Day 42 in the per-protocol population. Ethics and dissemination This protocol has been approved by the Ethics Committee for Health Research in Burkina Faso, the National Health Ethics Committee in the Democratic Republic of Congo, the Ethics Committee of the Faculty of Medicine and Odontostomatology/Faculty of Pharmacy in Mali, the Gambia Government/MRCG Joint Ethics Committee and the National Bioethics Committee for Health in Mozambique. Written informed consent will be obtained from each individual prior to her participation in the study. The results will be published in peer-reviewed open access journals and presented at (inter)national conferences and meetings. Trial registration number PACTR202011812241529. Close
	Anna Maria Eijk, Kasia Stepniewska, Jenny Hill, Steve M. Taylor, Stephen J. Rogerson, Gilles Cottrell, R. Matthew Chico, Julie R. Gutman, Halidou Tinto, Holger W. Unger, Stephanie K. Yanow, Steven R. Meshnick, Feiko O. Kuile, Alfredo Mayor, Steve M. Taylor, Stephen J. Rogerson, R. Matthew Chico, Julie R. Gutman, Hallidou Tinto, Holger W. Unger, Stephanie K. Yanow, Manfred Accrombessi, Ayola A. Adegnika, Rukhsana Ahmed, Eliana María Arango-Flórez, Myriam Arevalo-Herrera, Emmanual Arinaitwe, Paulo Arnaldo, Per Ashorn, Ulla Ashorn, Azucena Bardaji, Inoni Betuela, Praveen K. Bharti, Francis Bohissou, Camila Bôtto-Menezes, Vera Braun, Valerie Briand, Jessica Briggs, María Eugenia Castellanos, Daniel Chandramohan, Enesia Banda Chaponda, Chetan Chitnis, Lauren M. Cohee, Michel Cot, Umberto d'Alessandro, Lise Denoeud-Ndam, Meghna Desai, Alassane Dicko, Xavier Ding, Grant Dorsey, Patrick E. Duffy, Maha A. Elbadry, Sonia M. Enosse, Yue Fan, Nadine Fievet, Michal Fried, Blaise Genton, Raquel Gonzalez, Brian Greenwood, Linda Kalilani, Johanna H. Kattenberg, Kassoum Kayentao, Carole Khairallah, Christopher L. King, Dhanpat Kumar Kochar, Swati Kochar, Felix Koukouikila-Koussounda, Sarah H. Landis, Miriam K. Laufer, Rose F. Leke, Eusebio Macete, Sonia Maculuve, Mwayiwawo Madanitsa, Almahamoudou Mahamar, Ken Maleta, Indu Malhotra, Rella Zoleko Manego, Flor Ernestina Martinez-Espinosa, Achille Massougbodji, Don Mathanga, Michela Menegon, Clara Menendez, Petra Mens, Martin Meremikwu, Frank P. Mockenhaupt, Ghyslain Mombo-Ngoma, Dominic Mosha, Ivo Mueller, Alain Nahum, Paul Natureeba, Nicaise Ndam, Francine Ntoumi, Olabisi A. Oduwole, Bernard A. Okech, Maria Ome-Kaius, Kephas Otieno, Norma Padilla, Michal Ramharter, Rosemary Rochford, Anna Rosanas-Urgell, Maria Ruperez, Katherine R. Sabourin, Sergi Sanz, Henk D. Schallig, Susana Scott, Esperanca Sevene, Carlo Severini, Harry Tagbor, Diane Wallace Taylor, Maminata Traore Coulibaly, Ana Vasquez, Annie Walker-Abbey, Blair J. Wylie, Djimon M. Zannou, Stephen R. Meshnick Prevalence of and risk factors for microscopic and submicroscopic malaria infections in pregnancy: a systematic review and meta-analysis Journal Article In: The Lancet. Global health, vol. 11, iss. 7, pp. e1061-e1074, 2023, ISSN: 2214-109X. Abstract \| BibTeX \| Tags: {Adult, Anna Maria van Eijk, Antimalarials* / therapeutic use, Author(firstnames='Achille', Author(firstnames='Alain', Author(firstnames='Alassane', Author(firstnames='Alfredo', Author(firstnames='Almahamoudou', Author(firstnames='Ana', Author(firstnames='Anna', Author(firstnames='Annie', Author(firstnames='Ayola A', Author(firstnames='Azucena', Author(firstnames='Bernard A', Author(firstnames='Blair J', Author(firstnames='Blaise', Author(firstnames='Brian', Author(firstnames='Camila', Author(firstnames='Carlo', Author(firstnames='Carole', Author(firstnames='Chetan', Author(firstnames='Christopher L', Author(firstnames='Clara', Author(firstnames='Daniel', Author(firstnames='Dhanpat Kumar', Author(firstnames='Diane Wallace', Author(firstnames='Djimon M', Author(firstnames='Dominic', Author(firstnames='Don', Author(firstnames='Eliana María', Author(firstnames='Emmanual', Author(firstnames='Enesia Banda', Author(firstnames='Esperanca', Author(firstnames='Eusebio', Author(firstnames='Feiko O', Author(firstnames='Felix', Author(firstnames='Flor Ernestina', Author(firstnames='Francine', Author(firstnames='Francis', Author(firstnames='Frank P', Author(firstnames='Ghyslain', Author(firstnames='Gilles', Author(firstnames='Grant', Author(firstnames='Hallidou', Author(firstnames='Harry', Author(firstnames='Henk D', Author(firstnames='Holger W', Author(firstnames='Indu', Author(firstnames='Inoni', Author(firstnames='Ivo', Author(firstnames='Jenny', Author(firstnames='Jessica', Author(firstnames='Johanna H', Author(firstnames='Julie R', Author(firstnames='Kasia', Author(firstnames='Kassoum', Author(firstnames='Katherine R', Author(firstnames='Ken', Author(firstnames='Kephas', Author(firstnames='Lauren M', Author(firstnames='Linda', Author(firstnames='Lise', Author(firstnames='Maha A', Author(firstnames='Maminata', Author(firstnames='Manfred', Author(firstnames='María Eugenia', Author(firstnames='Maria', Author(firstnames='Martin', Author(firstnames='Meghna', Author(firstnames='Michal', Author(firstnames='Michel', Author(firstnames='Michela', Author(firstnames='Miriam K', Author(firstnames='Mwayiwawo', Author(firstnames='Myriam', Author(firstnames='Nadine', Author(firstnames='Nicaise', Author(firstnames='Norma', Author(firstnames='Olabisi A', Author(firstnames='Patrick E', Author(firstnames='Paul', Author(firstnames='Paulo', Author(firstnames='Per', Author(firstnames='Petra', Author(firstnames='Praveen K', Author(firstnames='R Matthew', Author(firstnames='Raquel', Author(firstnames='Rella', Author(firstnames='Rose F', Author(firstnames='Rosemary', Author(firstnames='Rukhsana', Author(firstnames='Sarah H', Author(firstnames='Sergi', Author(firstnames='Sonia M', Author(firstnames='Sonia', Author(firstnames='Stephanie K', Author(firstnames='Stephen J', Author(firstnames='Stephen R', Author(firstnames='Steve M', Author(firstnames='Susana', Author(firstnames='Swati', Author(firstnames='Ulla', Author(firstnames='Umberto', Author(firstnames='Valerie', Author(firstnames='Vera', Author(firstnames='Xavier', Author(firstnames='Yue', CollabAuthor(name='Subpatent Malaria in Pregnancy Group', Falciparum* / drug therapy, Female, Humans, Kasia Stepniewska, Malaria, Malaria* / prevention & control, MEDLINE, Meta-Analysis, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, P.H.S., PMC10880462, Pregnancy, Prevalence, PubMed Abstract, Research Support, Risk Factors, Systematic review, U.S. Gov't \| Links: Close Close @article{nokey, title = {Prevalence of and risk factors for microscopic and submicroscopic malaria infections in pregnancy: a systematic review and meta-analysis}, author = {Anna Maria Eijk and Kasia Stepniewska and Jenny Hill and Steve M. Taylor and Stephen J. Rogerson and Gilles Cottrell and R. Matthew Chico and Julie R. Gutman and Halidou Tinto and Holger W. Unger and Stephanie K. Yanow and Steven R. Meshnick and Feiko O. Kuile and Alfredo Mayor and Steve M. Taylor and Stephen J. Rogerson and R. Matthew Chico and Julie R. Gutman and Hallidou Tinto and Holger W. Unger and Stephanie K. Yanow and Manfred Accrombessi and Ayola A. Adegnika and Rukhsana Ahmed and Eliana Mar\'{i}a Arango-Fl\'{o}rez and Myriam Arevalo-Herrera and Emmanual Arinaitwe and Paulo Arnaldo and Per Ashorn and Ulla Ashorn and Azucena Bardaji and Inoni Betuela and Praveen K. Bharti and Francis Bohissou and Camila B\^{o}tto-Menezes and Vera Braun and Valerie Briand and Jessica Briggs and Mar\'{i}a Eugenia Castellanos and Daniel Chandramohan and Enesia Banda Chaponda and Chetan Chitnis and Lauren M. Cohee and Michel Cot and Umberto d'Alessandro and Lise Denoeud-Ndam and Meghna Desai and Alassane Dicko and Xavier Ding and Grant Dorsey and Patrick E. Duffy and Maha A. Elbadry and Sonia M. Enosse and Yue Fan and Nadine Fievet and Michal Fried and Blaise Genton and Raquel Gonzalez and Brian Greenwood and Linda Kalilani and Johanna H. Kattenberg and Kassoum Kayentao and Carole Khairallah and Christopher L. King and Dhanpat Kumar Kochar and Swati Kochar and Felix Koukouikila-Koussounda and Sarah H. Landis and Miriam K. Laufer and Rose F. Leke and Eusebio Macete and Sonia Maculuve and Mwayiwawo Madanitsa and Almahamoudou Mahamar and Ken Maleta and Indu Malhotra and Rella Zoleko Manego and Flor Ernestina Martinez-Espinosa and Achille Massougbodji and Don Mathanga and Michela Menegon and Clara Menendez and Petra Mens and Martin Meremikwu and Frank P. Mockenhaupt and Ghyslain Mombo-Ngoma and Dominic Mosha and Ivo Mueller and Alain Nahum and Paul Natureeba and Nicaise Ndam and Francine Ntoumi and Olabisi A. Oduwole and Bernard A. Okech and Maria Ome-Kaius and Kephas Otieno and Norma Padilla and Michal Ramharter and Rosemary Rochford and Anna Rosanas-Urgell and Maria Ruperez and Katherine R. Sabourin and Sergi Sanz and Henk D. Schallig and Susana Scott and Esperanca Sevene and Carlo Severini and Harry Tagbor and Diane Wallace Taylor and Maminata Traore Coulibaly and Ana Vasquez and Annie Walker-Abbey and Blair J. Wylie and Djimon M. Zannou and Stephen R. Meshnick}, url = {https://pubmed.ncbi.nlm.nih.gov/37276878/}, doi = {10.1016/S2214-109X(23)00194-8}, issn = {2214-109X}, year = {2023}, date = {2023-01-01}, journal = {The Lancet. Global health}, volume = {11}, issue = {7}, pages = {e1061-e1074}, publisher = {Lancet Glob Health}, abstract = {Background: Malaria infections during pregnancy can cause adverse birth outcomes, yet many infections are undetected by microscopy. We aimed to describe the epidemiology of submicroscopic malaria infections in pregnant women in Asia, the Americas, and Africa using aggregated and individual participant data (IPD). Methods: For this systematic review and meta-analysis, studies (published Jan 1, 1997 to Nov 10, 2021) with information on both microscopic and submicroscopic infections during pregnancy from Asia, the Americas, or Africa, identified in the Malaria-in-Pregnancy Library, were eligible. Studies (or subgroups or study groups) that selected participants on the basis of the presence of fever or a positive blood smear were excluded to avoid selection bias. We obtained IPD (when available) and aggregated data. Estimates of malaria transmission intensity and sulfadoxine\textendashpyrimethamine resistance, matched by study location and year, were obtained using publicly available data. One-stage multivariable logit and multinomial models with random intercepts for study site were used in meta-analysis to assess prevalence of and risk factors for submicroscopic infections during pregnancy and at delivery. This study is registered with PROSPERO, number CRD42015027342. Findings: The search identified 87 eligible studies, 68 (78%) of which contributed to the analyses. Of these 68 studies, 45 (66%) studies contributed IPD (48 869 participants) and 23 (34%) studies contributed aggregated data (11 863 participants). During pregnancy, median prevalence estimates were 13·5% (range 0·0\textendash55·9, 66 substudies) for submicroscopic and 8·0% (0·0\textendash50·6, 66 substudies) for microscopic malaria. Among women with positive Plasmodium nucleic acid amplification tests (NAATs), the median proportion of submicroscopic infections was 58·7% (range 0·0\textendash100); this proportion was highest in the Americas (73·3%, 0·0\textendash100), followed by Asia (67·2%, 36·4\textendash100) and Africa (56·5%, 20·5\textendash97·7). In individual patient data analysis, compared with women with no malaria infections, those with submicroscopic infections were more likely to present with fever in Africa (adjusted odds ratio 1·32, 95% CI 1·02\textendash1·72; p=0·038) but not in other regions. Among women with NAAT-positive infections in Asia and the Americas, Plasmodium vivax infections were more likely to be submicroscopic than Plasmodium falciparum infections (3·69, 2·45\textendash5·54; p\<0·0001). Risk factors for submicroscopic infections among women with NAAT-positive infections in Africa included older age (age ≥30 years), multigravidity, and no HIV infection. Interpretation: During pregnancy, submicroscopic infections are more common than microscopic infections and are associated with fever in Africa. Malaria control in pregnancy should target both microscopic and submicroscopic infections. Funding: Bill \& Melinda Gates Foundation through the Worldwide Antimalarial Resistance Network.}, keywords = {{Adult, Anna Maria van Eijk, Antimalarials* / therapeutic use, Author(firstnames='Achille', Author(firstnames='Alain', Author(firstnames='Alassane', Author(firstnames='Alfredo', Author(firstnames='Almahamoudou', Author(firstnames='Ana', Author(firstnames='Anna', Author(firstnames='Annie', Author(firstnames='Ayola A', Author(firstnames='Azucena', Author(firstnames='Bernard A', Author(firstnames='Blair J', Author(firstnames='Blaise', Author(firstnames='Brian', Author(firstnames='Camila', Author(firstnames='Carlo', Author(firstnames='Carole', Author(firstnames='Chetan', Author(firstnames='Christopher L', Author(firstnames='Clara', Author(firstnames='Daniel', Author(firstnames='Dhanpat Kumar', Author(firstnames='Diane Wallace', Author(firstnames='Djimon M', Author(firstnames='Dominic', Author(firstnames='Don', Author(firstnames='Eliana Mar\'{i}a', Author(firstnames='Emmanual', Author(firstnames='Enesia Banda', Author(firstnames='Esperanca', Author(firstnames='Eusebio', Author(firstnames='Feiko O', Author(firstnames='Felix', Author(firstnames='Flor Ernestina', Author(firstnames='Francine', Author(firstnames='Francis', Author(firstnames='Frank P', Author(firstnames='Ghyslain', Author(firstnames='Gilles', Author(firstnames='Grant', Author(firstnames='Hallidou', Author(firstnames='Harry', Author(firstnames='Henk D', Author(firstnames='Holger W', Author(firstnames='Indu', Author(firstnames='Inoni', Author(firstnames='Ivo', Author(firstnames='Jenny', Author(firstnames='Jessica', Author(firstnames='Johanna H', Author(firstnames='Julie R', Author(firstnames='Kasia', Author(firstnames='Kassoum', Author(firstnames='Katherine R', Author(firstnames='Ken', Author(firstnames='Kephas', Author(firstnames='Lauren M', Author(firstnames='Linda', Author(firstnames='Lise', Author(firstnames='Maha A', Author(firstnames='Maminata', Author(firstnames='Manfred', Author(firstnames='Mar\'{i}a Eugenia', Author(firstnames='Maria', Author(firstnames='Martin', Author(firstnames='Meghna', Author(firstnames='Michal', Author(firstnames='Michel', Author(firstnames='Michela', Author(firstnames='Miriam K', Author(firstnames='Mwayiwawo', Author(firstnames='Myriam', Author(firstnames='Nadine', Author(firstnames='Nicaise', Author(firstnames='Norma', Author(firstnames='Olabisi A', Author(firstnames='Patrick E', Author(firstnames='Paul', Author(firstnames='Paulo', Author(firstnames='Per', Author(firstnames='Petra', Author(firstnames='Praveen K', Author(firstnames='R Matthew', Author(firstnames='Raquel', Author(firstnames='Rella', Author(firstnames='Rose F', Author(firstnames='Rosemary', Author(firstnames='Rukhsana', Author(firstnames='Sarah H', Author(firstnames='Sergi', Author(firstnames='Sonia M', Author(firstnames='Sonia', Author(firstnames='Stephanie K', Author(firstnames='Stephen J', Author(firstnames='Stephen R', Author(firstnames='Steve M', Author(firstnames='Susana', Author(firstnames='Swati', Author(firstnames='Ulla', Author(firstnames='Umberto', Author(firstnames='Valerie', Author(firstnames='Vera', Author(firstnames='Xavier', Author(firstnames='Yue', CollabAuthor(name='Subpatent Malaria in Pregnancy Group', Falciparum* / drug therapy, Female, Humans, Kasia Stepniewska, Malaria, Malaria* / prevention \& control, MEDLINE, Meta-Analysis, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, P.H.S., PMC10880462, Pregnancy, Prevalence, PubMed Abstract, Research Support, Risk Factors, Systematic review, U.S. Gov't}, pubstate = {published}, tppubtype = {article} } Close Background: Malaria infections during pregnancy can cause adverse birth outcomes, yet many infections are undetected by microscopy. We aimed to describe the epidemiology of submicroscopic malaria infections in pregnant women in Asia, the Americas, and Africa using aggregated and individual participant data (IPD). Methods: For this systematic review and meta-analysis, studies (published Jan 1, 1997 to Nov 10, 2021) with information on both microscopic and submicroscopic infections during pregnancy from Asia, the Americas, or Africa, identified in the Malaria-in-Pregnancy Library, were eligible. Studies (or subgroups or study groups) that selected participants on the basis of the presence of fever or a positive blood smear were excluded to avoid selection bias. We obtained IPD (when available) and aggregated data. Estimates of malaria transmission intensity and sulfadoxine–pyrimethamine resistance, matched by study location and year, were obtained using publicly available data. One-stage multivariable logit and multinomial models with random intercepts for study site were used in meta-analysis to assess prevalence of and risk factors for submicroscopic infections during pregnancy and at delivery. This study is registered with PROSPERO, number CRD42015027342. Findings: The search identified 87 eligible studies, 68 (78%) of which contributed to the analyses. Of these 68 studies, 45 (66%) studies contributed IPD (48 869 participants) and 23 (34%) studies contributed aggregated data (11 863 participants). During pregnancy, median prevalence estimates were 13·5% (range 0·0–55·9, 66 substudies) for submicroscopic and 8·0% (0·0–50·6, 66 substudies) for microscopic malaria. Among women with positive Plasmodium nucleic acid amplification tests (NAATs), the median proportion of submicroscopic infections was 58·7% (range 0·0–100); this proportion was highest in the Americas (73·3%, 0·0–100), followed by Asia (67·2%, 36·4–100) and Africa (56·5%, 20·5–97·7). In individual patient data analysis, compared with women with no malaria infections, those with submicroscopic infections were more likely to present with fever in Africa (adjusted odds ratio 1·32, 95% CI 1·02–1·72; p=0·038) but not in other regions. Among women with NAAT-positive infections in Asia and the Americas, Plasmodium vivax infections were more likely to be submicroscopic than Plasmodium falciparum infections (3·69, 2·45–5·54; p<0·0001). Risk factors for submicroscopic infections among women with NAAT-positive infections in Africa included older age (age ≥30 years), multigravidity, and no HIV infection. Interpretation: During pregnancy, submicroscopic infections are more common than microscopic infections and are associated with fever in Africa. Malaria control in pregnancy should target both microscopic and submicroscopic infections. Funding: Bill & Melinda Gates Foundation through the Worldwide Antimalarial Resistance Network. Close
	Holger W. Unger, Anastasia Jessica Hadiprodjo, Julie R. Gutman, Valerie Briand, Nadine Fievet, Innocent Valea, Halidou Tinto, Umberto D’Alessandro, Sarah H. Landis, Feiko Ter Kuile, Peter Ouma, Martina Oneko, Victor Mwapasa, Laurence Slutsker, Dianne J. Terlouw, Simon Kariuki, John Ayisi, Bernard Nahlen, Meghna Desai, Mwayi Madanitsa, Linda Kalilani-Phiri, Per Ashorn, Kenneth Maleta, Antoinette Tshefu-Kitoto, Ivo Mueller, Danielle Stanisic, Jordan Cates, Anna Maria Van Eijk, Maria Ome-Kaius, Elizabeth H. Aitken, Stephen J. Rogerson Fetal sex and risk of pregnancy-associated malaria in Plasmodium falciparum-endemic regions: a meta-analysis Journal Article In: Scientific reports, vol. 13, iss. 1, 2023, ISSN: 2045-2322. Abstract \| BibTeX \| Tags: Anastasia Jessica Hadiprodjo, doi:10.1038/s41598-023-37431-3, Extramural, Falciparum* / complications, Falciparum* / epidemiology, Female, Holger W Unger, Humans, Infant, Low Birth Weight, Malaria, Malaria* / complications, Malaria* / epidemiology, MEDLINE, Meta-Analysis, N.I.H., National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, Newborn, NIH, NLM, Non-U.S. Gov't, placenta, Plasmodium falciparum, PMC10293221, pmid:37365258, Pregnancy, PubMed Abstract, Research Support, Stephen J Rogerson, Stillbirth \| Links: Close Close @article{Unger2023, title = {Fetal sex and risk of pregnancy-associated malaria in Plasmodium falciparum-endemic regions: a meta-analysis}, author = {Holger W. Unger and Anastasia Jessica Hadiprodjo and Julie R. Gutman and Valerie Briand and Nadine Fievet and Innocent Valea and Halidou Tinto and Umberto D’Alessandro and Sarah H. Landis and Feiko Ter Kuile and Peter Ouma and Martina Oneko and Victor Mwapasa and Laurence Slutsker and Dianne J. Terlouw and Simon Kariuki and John Ayisi and Bernard Nahlen and Meghna Desai and Mwayi Madanitsa and Linda Kalilani-Phiri and Per Ashorn and Kenneth Maleta and Antoinette Tshefu-Kitoto and Ivo Mueller and Danielle Stanisic and Jordan Cates and Anna Maria Van Eijk and Maria Ome-Kaius and Elizabeth H. Aitken and Stephen J. Rogerson}, url = {https://pubmed.ncbi.nlm.nih.gov/37365258/}, doi = {10.1038/S41598-023-37431-3}, issn = {2045-2322}, year = {2023}, date = {2023-01-01}, journal = {Scientific reports}, volume = {13}, issue = {1}, publisher = {Sci Rep}, abstract = {In areas of moderate to intense Plasmodium falciparum transmission, malaria in pregnancy remains a significant cause of low birth weight, stillbirth, and severe anaemia. Previously, fetal sex has been identified to modify the risks of maternal asthma, pre-eclampsia, and gestational diabetes. One study demonstrated increased risk of placental malaria in women carrying a female fetus. We investigated the association between fetal sex and malaria in pregnancy in 11 pregnancy studies conducted in sub-Saharan African countries and Papua New Guinea through meta-analysis using log binomial regression fitted to a random-effects model. Malaria infection during pregnancy and delivery was assessed using light microscopy, polymerase chain reaction, and histology. Five studies were observational studies and six were randomised controlled trials. Studies varied in terms of gravidity, gestational age at antenatal enrolment and bed net use. Presence of a female fetus was associated with malaria infection at enrolment by light microscopy (risk ratio 1.14 [95% confidence interval 1.04, 1.24]; P = 0.003; n = 11,729). Fetal sex did not associate with malaria infection when other time points or diagnostic methods were used. There is limited evidence that fetal sex influences the risk of malaria infection in pregnancy.}, keywords = {Anastasia Jessica Hadiprodjo, doi:10.1038/s41598-023-37431-3, Extramural, Falciparum* / complications, Falciparum* / epidemiology, Female, Holger W Unger, Humans, Infant, Low Birth Weight, Malaria, Malaria* / complications, Malaria* / epidemiology, MEDLINE, Meta-Analysis, N.I.H., National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, Newborn, NIH, NLM, Non-U.S. Gov't, placenta, Plasmodium falciparum, PMC10293221, pmid:37365258, Pregnancy, PubMed Abstract, Research Support, Stephen J Rogerson, Stillbirth}, pubstate = {published}, tppubtype = {article} } Close In areas of moderate to intense Plasmodium falciparum transmission, malaria in pregnancy remains a significant cause of low birth weight, stillbirth, and severe anaemia. Previously, fetal sex has been identified to modify the risks of maternal asthma, pre-eclampsia, and gestational diabetes. One study demonstrated increased risk of placental malaria in women carrying a female fetus. We investigated the association between fetal sex and malaria in pregnancy in 11 pregnancy studies conducted in sub-Saharan African countries and Papua New Guinea through meta-analysis using log binomial regression fitted to a random-effects model. Malaria infection during pregnancy and delivery was assessed using light microscopy, polymerase chain reaction, and histology. Five studies were observational studies and six were randomised controlled trials. Studies varied in terms of gravidity, gestational age at antenatal enrolment and bed net use. Presence of a female fetus was associated with malaria infection at enrolment by light microscopy (risk ratio 1.14 [95% confidence interval 1.04, 1.24]; P = 0.003; n = 11,729). Fetal sex did not associate with malaria infection when other time points or diagnostic methods were used. There is limited evidence that fetal sex influences the risk of malaria infection in pregnancy. Close
	Serge Ouoba, Ko Ko, Moussa Lingani, Shintaro Nagashima, Alice N. Guingané, E. Bunthen, Md Razeen Ashraf Hussain, Aya Sugiyama, Tomoyuki Akita, Masayuki Ohisa, Moussa Abdel Sanou, Ousmane Traore, Job Wilfried Nassa, Maimouna Sanou, Kazuaki Takahashi, Halidou Tinto, Junko Tanaka Intermediate hepatitis B virus infection prevalence among 1622 pregnant women in rural Burkina Faso and implications for mother-to-child transmission Journal Article In: Scientific reports, vol. 13, iss. 1, 2023, ISSN: 2045-2322. Abstract \| BibTeX \| Tags: Burkina Faso / epidemiology, Child, DNA, doi:10.1038/s41598-023-32766-3, Female, Hepatitis B e Antigens, Hepatitis B Surface Antigens, Hepatitis B virus / genetics, Hepatitis B* / diagnosis, Humans, Infectious Disease Transmission, Infectious* / epidemiology, Junko Tanaka, Ko Ko, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, PMC10103033, pmid:37059812, Pregnancy, Pregnancy Complications, Pregnant Women, Prevalence, PubMed Abstract, Research Support, Serge Ouoba, Vertical / prevention & control, Viral / genetics \| Links: Close Close @article{Ouoba2023, title = {Intermediate hepatitis B virus infection prevalence among 1622 pregnant women in rural Burkina Faso and implications for mother-to-child transmission}, author = {Serge Ouoba and Ko Ko and Moussa Lingani and Shintaro Nagashima and Alice N. Guingan\'{e} and E. Bunthen and Md Razeen Ashraf Hussain and Aya Sugiyama and Tomoyuki Akita and Masayuki Ohisa and Moussa Abdel Sanou and Ousmane Traore and Job Wilfried Nassa and Maimouna Sanou and Kazuaki Takahashi and Halidou Tinto and Junko Tanaka}, url = {https://pubmed.ncbi.nlm.nih.gov/37059812/}, doi = {10.1038/S41598-023-32766-3}, issn = {2045-2322}, year = {2023}, date = {2023-01-01}, journal = {Scientific reports}, volume = {13}, issue = {1}, publisher = {Sci Rep}, abstract = {In highly endemic countries for hepatitis B virus (HBV) infection, childhood infection, including mother-to-child transmission (MTCT), represents the primary transmission route. High maternal DNA level (viral load ≥ 200,000 IU/mL) is a significant factor for MTCT. We investigated the prevalence of HBsAg, HBeAg, and high HBV DNA among pregnant women in three hospitals in Burkina Faso and assessed the performance of HBeAg to predict high viral load. Consenting pregnant women were interviewed on their sociodemographic characteristics and tested for HBsAg by a rapid diagnostic test, and dried blood spot (DBS) samples were collected for laboratory analyses. Of the 1622 participants, HBsAg prevalence was 6.5% (95% CI, 5.4\textendash7.8%). Among 102 HBsAg-positive pregnant women in DBS samples, HBeAg was positive in 22.6% (95% CI, 14.9\textendash31.9%), and viral load was quantified in 94 cases, with 19.1% having HBV DNA ≥ 200,000 IU/mL. HBV genotypes were identified in 63 samples and predominant genotypes were E (58.7%) and A (36.5%). The sensitivity of HBeAg by using DBS samples to identify high viral load in the 94 cases was 55.6%, and the specificity was 86.8%. These findings highlight the need to implement routine HBV screening and effective MTCT risk assessment for all pregnant women in Burkina Faso to enable early interventions that can effectively reduce MTCT.}, keywords = {Burkina Faso / epidemiology, Child, DNA, doi:10.1038/s41598-023-32766-3, Female, Hepatitis B e Antigens, Hepatitis B Surface Antigens, Hepatitis B virus / genetics, Hepatitis B* / diagnosis, Humans, Infectious Disease Transmission, Infectious* / epidemiology, Junko Tanaka, Ko Ko, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, PMC10103033, pmid:37059812, Pregnancy, Pregnancy Complications, Pregnant Women, Prevalence, PubMed Abstract, Research Support, Serge Ouoba, Vertical / prevention \& control, Viral / genetics}, pubstate = {published}, tppubtype = {article} } Close In highly endemic countries for hepatitis B virus (HBV) infection, childhood infection, including mother-to-child transmission (MTCT), represents the primary transmission route. High maternal DNA level (viral load ≥ 200,000 IU/mL) is a significant factor for MTCT. We investigated the prevalence of HBsAg, HBeAg, and high HBV DNA among pregnant women in three hospitals in Burkina Faso and assessed the performance of HBeAg to predict high viral load. Consenting pregnant women were interviewed on their sociodemographic characteristics and tested for HBsAg by a rapid diagnostic test, and dried blood spot (DBS) samples were collected for laboratory analyses. Of the 1622 participants, HBsAg prevalence was 6.5% (95% CI, 5.4–7.8%). Among 102 HBsAg-positive pregnant women in DBS samples, HBeAg was positive in 22.6% (95% CI, 14.9–31.9%), and viral load was quantified in 94 cases, with 19.1% having HBV DNA ≥ 200,000 IU/mL. HBV genotypes were identified in 63 samples and predominant genotypes were E (58.7%) and A (36.5%). The sensitivity of HBeAg by using DBS samples to identify high viral load in the 94 cases was 55.6%, and the specificity was 86.8%. These findings highlight the need to implement routine HBV screening and effective MTCT risk assessment for all pregnant women in Burkina Faso to enable early interventions that can effectively reduce MTCT. Close
2022
Journal Articles
	Biébo Bihoun, Serge Henri Zango, Maminata Traoré-Coulibaly, Innocent Valea, Raffaella Ravinetto, Jean Pierre Van Geertruyden, Umberto D'Alessandro, Halidou Tinto, Annie Robert Age-modified factors associated with placental malaria in rural Burkina Faso. Journal Article In: BMC pregnancy and childbirth, vol. 22, iss. 1, pp. 248, 2022, ISSN: 1471-2393. Abstract \| BibTeX \| Tags: Malaria, Malaria/epidemiology, Adult, Burkina Faso, Burkina Faso/epidemiology, Falciparum/parasitology, Female, Gravidity, Humans, Malaria, placenta, Placenta/parasitology, Pregnancy, Risk Factors \| Links: Close Close @article{nokey, title = {Age-modified factors associated with placental malaria in rural Burkina Faso.}, author = {Bi\'{e}bo Bihoun and Serge Henri Zango and Maminata Traor\'{e}-Coulibaly and Innocent Valea and Raffaella Ravinetto and Jean Pierre Van Geertruyden and Umberto D'Alessandro and Halidou Tinto and Annie Robert}, doi = {10.1186/s12884-022-04568-4}, issn = {1471-2393}, year = {2022}, date = {2022-03-01}, urldate = {2022-03-01}, journal = {BMC pregnancy and childbirth}, volume = {22}, issue = {1}, pages = {248}, abstract = {BACKGROUND: Malaria in pregnancy can result in placental infection with fetal implications. This study aimed at assessing placental malaria (PM) prevalence and its associated factors in a cohort of pregnant women with peripheral malaria and their offspring. METHOD: The data were collected in the framework of a clinical trial on treatments for malaria in pregnant women . Placental malaria (PM) was diagnosed by histopathological detection of parasites and/or malaria pigment on placenta biopsies taken at delivery. Factors associated with PM were assessed using logistic regression. RESULTS: Out of 745 biopsies examined, PM was diagnosed in 86.8 % of women. Acute, chronic and past PM were retrieved in 11 (1.5 %), 170 (22.8 %), and 466 (62.6 %) women, respectively. A modifying effect was observed in the association of gravidity or anemia at the study start with pooled PM (presence of parasites and/or malaria pigment). In women under 30, gravidity ≤ 2 was associated with an increased prevalence of pooled PM but in women aged 30 years or more, gravidity was no more associated with pooled PM (OR 6.81, 95 % CI 3.18 - 14.60; and OR 0.52, 95 % CI 0.10 - 2.76, respectively). Anemia was associated with pooled PM in women under 30 (OR 1.96, 95 % CI 1.03 - 3.72) but not in women aged 30 years or more (OR 0.68, 95 % CI 0.31 - 1.49). Similarly, the association of gravidity with past-chronic PM depended also on age. A higher prevalence of active PM was observed in women under 30 presenting with symptomatic malaria (OR 3.79, 95 % CI 1.55 - 9.27), while there was no significant increase in the prevalence of active PM (presence of parasites only) in women with symptomatic malaria when aged 30 years or more (OR 0.42, 95 % CI 0.10 - 1.75). In women with chronic PM, the prevalence of low birth weight or prematurity was the highest (31.2 %) as compared with past PM or no PM. CONCLUSION: Despite the rapid diagnosis and efficacious treatment of peripheral infection, the prevalence of placental malaria remained high in women with P. falciparum peripheral infection in Nanoro, especially in younger women This underlines the importance of preventive measures in this specific group.}, keywords = {Malaria, Malaria/epidemiology, Adult, Burkina Faso, Burkina Faso/epidemiology, Falciparum/parasitology, Female, Gravidity, Humans, Malaria, placenta, Placenta/parasitology, Pregnancy, Risk Factors}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Malaria in pregnancy can result in placental infection with fetal implications. This study aimed at assessing placental malaria (PM) prevalence and its associated factors in a cohort of pregnant women with peripheral malaria and their offspring. METHOD: The data were collected in the framework of a clinical trial on treatments for malaria in pregnant women . Placental malaria (PM) was diagnosed by histopathological detection of parasites and/or malaria pigment on placenta biopsies taken at delivery. Factors associated with PM were assessed using logistic regression. RESULTS: Out of 745 biopsies examined, PM was diagnosed in 86.8 % of women. Acute, chronic and past PM were retrieved in 11 (1.5 %), 170 (22.8 %), and 466 (62.6 %) women, respectively. A modifying effect was observed in the association of gravidity or anemia at the study start with pooled PM (presence of parasites and/or malaria pigment). In women under 30, gravidity ≤ 2 was associated with an increased prevalence of pooled PM but in women aged 30 years or more, gravidity was no more associated with pooled PM (OR 6.81, 95 % CI 3.18 - 14.60; and OR 0.52, 95 % CI 0.10 - 2.76, respectively). Anemia was associated with pooled PM in women under 30 (OR 1.96, 95 % CI 1.03 - 3.72) but not in women aged 30 years or more (OR 0.68, 95 % CI 0.31 - 1.49). Similarly, the association of gravidity with past-chronic PM depended also on age. A higher prevalence of active PM was observed in women under 30 presenting with symptomatic malaria (OR 3.79, 95 % CI 1.55 - 9.27), while there was no significant increase in the prevalence of active PM (presence of parasites only) in women with symptomatic malaria when aged 30 years or more (OR 0.42, 95 % CI 0.10 - 1.75). In women with chronic PM, the prevalence of low birth weight or prematurity was the highest (31.2 %) as compared with past PM or no PM. CONCLUSION: Despite the rapid diagnosis and efficacious treatment of peripheral infection, the prevalence of placental malaria remained high in women with P. falciparum peripheral infection in Nanoro, especially in younger women This underlines the importance of preventive measures in this specific group. Close
	Moussa Lingani, Serge Henri Zango, Innocent Valéa, Georges Somé, Maïmouna Sanou, Sékou O. Samadoulougou, Serge Ouoba, Eli Rouamba, Annie Robert, Michèle Dramaix, Philippe Donnen, Halidou Tinto Low birth weight and its associated risk factors in a rural health district of Burkina Faso: a cross sectional study. Journal Article In: BMC pregnancy and childbirth, vol. 22, iss. 1, pp. 228, 2022, ISSN: 1471-2393. Abstract \| BibTeX \| Tags: Antimalarials/therapeutic use, Rural Health, Associated factors, Burkina Faso, Burkina Faso/epidemiology, Cross-Sectional Studies, Female, Humans, Infant, Low Birth Weight, Newborn, Pregnancy, Risk Factors, Rural area \| Links: Close Close @article{nokey, title = {Low birth weight and its associated risk factors in a rural health district of Burkina Faso: a cross sectional study.}, author = {Moussa Lingani and Serge Henri Zango and Innocent Val\'{e}a and Georges Som\'{e} and Ma\"{i}mouna Sanou and S\'{e}kou O. Samadoulougou and Serge Ouoba and Eli Rouamba and Annie Robert and Mich\`{e}le Dramaix and Philippe Donnen and Halidou Tinto}, doi = {10.1186/s12884-022-04554-w}, issn = {1471-2393}, year = {2022}, date = {2022-03-01}, urldate = {2022-03-01}, journal = {BMC pregnancy and childbirth}, volume = {22}, issue = {1}, pages = {228}, abstract = {BACKGROUND: Low birth weight (LBW) is a major factor of neonate mortality that particularly affects developing countries. However, the scarcity of data to support decision making to reduce LBW occurrence is a major obstacle in sub-Saharan Africa. The aim of this research was to determine the prevalence and associated factors of LBW at the Yako health district in a rural area of Burkina Faso. METHODS: A cross sectional survey was conducted at four peripheral health centers among mothers and their newly delivered babies. The mothers' socio-demographic and obstetrical characteristics were collected by face-to-face interview or by review of antenatal care books. Maternal malaria was tested by standard microscopy and neonates' birth weights were documented. Multivariate logistic regression was used to determine factors associated with LBW. A p-value \< 0.05 was considered statistically significant. RESULTS: Of 600 neonates examined, the prevalence of low birth weight was 11.0%. Adjustment for socio-demographic characteristic, medical conditions, obstetrical history, malaria prevention measures by multivariate logistic regression found that being a primigravid mother (aOR = 1.8, [95% CI: 1.1-3.0]), the presence of malaria infection (aOR = 1.9, [95% CI: 1.1-3.5]), the uptake of less than three doses of sulfadoxine-pyrimethamine for the intermittent preventive treatment of malaria in pregnancy (IPTp-SP) (aOR = 2.2, [95% CI: 1.3-3.9]), the presence of maternal fever at the time of delivery (aOR = 2.8, [95% CI: 1.5-5.3]) and being a female neonate (aOR = 1.9, [95% CI: 1.1-3.3]) were independently associated with an increased risk of LBW occurrence. The number of antenatal visits performed by the mother during her pregnancy did not provide any direct protection for low birth weight. CONCLUSION: The prevalence of LBW remained high in the study area. Maternal malaria, fever and low uptake of sulfadoxine-pyrimethamine doses were significantly associated with LBW and should be adequately addressed by public health interventions.}, keywords = {Antimalarials/therapeutic use, Rural Health, Associated factors, Burkina Faso, Burkina Faso/epidemiology, Cross-Sectional Studies, Female, Humans, Infant, Low Birth Weight, Newborn, Pregnancy, Risk Factors, Rural area}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Low birth weight (LBW) is a major factor of neonate mortality that particularly affects developing countries. However, the scarcity of data to support decision making to reduce LBW occurrence is a major obstacle in sub-Saharan Africa. The aim of this research was to determine the prevalence and associated factors of LBW at the Yako health district in a rural area of Burkina Faso. METHODS: A cross sectional survey was conducted at four peripheral health centers among mothers and their newly delivered babies. The mothers' socio-demographic and obstetrical characteristics were collected by face-to-face interview or by review of antenatal care books. Maternal malaria was tested by standard microscopy and neonates' birth weights were documented. Multivariate logistic regression was used to determine factors associated with LBW. A p-value < 0.05 was considered statistically significant. RESULTS: Of 600 neonates examined, the prevalence of low birth weight was 11.0%. Adjustment for socio-demographic characteristic, medical conditions, obstetrical history, malaria prevention measures by multivariate logistic regression found that being a primigravid mother (aOR = 1.8, [95% CI: 1.1-3.0]), the presence of malaria infection (aOR = 1.9, [95% CI: 1.1-3.5]), the uptake of less than three doses of sulfadoxine-pyrimethamine for the intermittent preventive treatment of malaria in pregnancy (IPTp-SP) (aOR = 2.2, [95% CI: 1.3-3.9]), the presence of maternal fever at the time of delivery (aOR = 2.8, [95% CI: 1.5-5.3]) and being a female neonate (aOR = 1.9, [95% CI: 1.1-3.3]) were independently associated with an increased risk of LBW occurrence. The number of antenatal visits performed by the mother during her pregnancy did not provide any direct protection for low birth weight. CONCLUSION: The prevalence of LBW remained high in the study area. Maternal malaria, fever and low uptake of sulfadoxine-pyrimethamine doses were significantly associated with LBW and should be adequately addressed by public health interventions. Close
	Vivi Maketa, Japhet Kabalu, Melissa Kabena, Flory Luzolo, Hypolite Muhindo-Mavoko, Henk D. F. H. Schallig, Kassoum Kayentao, Petra F. Mens, Pascal Lutumba, Halidou Tinto Comparison of intermittent screening (using ultra-sensitive malaria rapid diagnostic test) and treatment (using a newly registered antimalarial pyronaridine-artesunate—PYRAMAX®) to standard intermittent preventive treatment with sulfadoxine-pyrimethamine for the prevention of malaria in pregnant women living in endemic areas: ULTRAPYRAPREG Journal Article In: Trials, vol. 23, iss. 1, pp. 963, 2022, ISSN: 1745-6215. Abstract \| BibTeX \| Tags: IPTp-SP, ISTp, Malaria, Malaria indicators, Pregnancy, Ultra-sensitive RDTs \| Links: Close Close @article{Maketa2022, title = {Comparison of intermittent screening (using ultra-sensitive malaria rapid diagnostic test) and treatment (using a newly registered antimalarial pyronaridine-artesunate\textemdashPYRAMAX®) to standard intermittent preventive treatment with sulfadoxine-pyrimethamine for the prevention of malaria in pregnant women living in endemic areas: ULTRAPYRAPREG}, author = {Vivi Maketa and Japhet Kabalu and Melissa Kabena and Flory Luzolo and Hypolite Muhindo-Mavoko and Henk D. F. H. Schallig and Kassoum Kayentao and Petra F. Mens and Pascal Lutumba and Halidou Tinto}, url = {https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-022-06884-8}, doi = {10.1186/s13063-022-06884-8}, issn = {1745-6215}, year = {2022}, date = {2022-01-01}, journal = {Trials}, volume = {23}, issue = {1}, pages = {963}, abstract = {BACKGROUND Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is an important malaria control strategy in sub-Saharan Africa. Indeed, it overcomes the risk of misdiagnosis due to low peripheral parasitemia during pregnancy by treating women with SP on predetermined schedules. However, over time, the spread of Plasmodium-resistant strains has threatened this strategy in many countries. As an alternative, the intermittent screening and treatment for pregnancy (ISTp) aims at a monthly screening of pregnant women, preferably by using very sensitive tests such as ultrasensitive rapid diagnostic tests (us-RDTs) and the treatment of positive cases with artemisinin-based combination therapy (ACT) regardless of the presence of symptoms. Unlike IPTp-SP, ISTp prevents overuse of antimalarials limiting the drug pressure on parasites, an advantage which can be potentiated by using an ACT like pyronaridine-artesunate (Pyramax®) that is not yet used in pregnant women in the field. METHODS This study aims to compare the non-inferiority of ISTp using us-RDTs and Pyramax® versus IPTp-SP on malaria in pregnancy through a randomized clinical trial performed in Kisenso, Kinshasa, the Democratic Republic of the Congo, a malaria perennial transmission area. DISCUSSION The results will be essential for the National Malaria Control Program to update the malaria prevention policy in pregnant women in the Democratic Republic of the Congo. TRIAL REGISTRATION ClinicalTrials.gov NCT04783051.}, keywords = {IPTp-SP, ISTp, Malaria, Malaria indicators, Pregnancy, Ultra-sensitive RDTs}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is an important malaria control strategy in sub-Saharan Africa. Indeed, it overcomes the risk of misdiagnosis due to low peripheral parasitemia during pregnancy by treating women with SP on predetermined schedules. However, over time, the spread of Plasmodium-resistant strains has threatened this strategy in many countries. As an alternative, the intermittent screening and treatment for pregnancy (ISTp) aims at a monthly screening of pregnant women, preferably by using very sensitive tests such as ultrasensitive rapid diagnostic tests (us-RDTs) and the treatment of positive cases with artemisinin-based combination therapy (ACT) regardless of the presence of symptoms. Unlike IPTp-SP, ISTp prevents overuse of antimalarials limiting the drug pressure on parasites, an advantage which can be potentiated by using an ACT like pyronaridine-artesunate (Pyramax®) that is not yet used in pregnant women in the field. METHODS This study aims to compare the non-inferiority of ISTp using us-RDTs and Pyramax® versus IPTp-SP on malaria in pregnancy through a randomized clinical trial performed in Kisenso, Kinshasa, the Democratic Republic of the Congo, a malaria perennial transmission area. DISCUSSION The results will be essential for the National Malaria Control Program to update the malaria prevention policy in pregnant women in the Democratic Republic of the Congo. TRIAL REGISTRATION ClinicalTrials.gov NCT04783051. Close
	Annelies S. Post, I. Guiraud, M. Peeters, P. Lompo, S. Ombelet, I. Karama, S. Yougbaré, Z. Garba, E. Rouamba, H. Tinto, Jan Jacobs Escherichia coli from urine samples of pregnant women as an indicator for antimicrobial resistance in the community: a field study from rural Burkina Faso Journal Article In: Antimicrobial Resistance & Infection Control, vol. 11, iss. 1, pp. 112, 2022, ISSN: 2047-2994. Abstract \| BibTeX \| Tags: ANC, Antimicrobial resistance, Asymptomatic bacteriuria, Burkina Faso, Community, Escherichia coli, Pregnancy, Rural Africa \| Links: Close Close @article{Post2022, title = {Escherichia coli from urine samples of pregnant women as an indicator for antimicrobial resistance in the community: a field study from rural Burkina Faso}, author = {Annelies S. Post and I. Guiraud and M. Peeters and P. Lompo and S. Ombelet and I. Karama and S. Yougbar\'{e} and Z. Garba and E. Rouamba and H. Tinto and Jan Jacobs}, url = {https://aricjournal.biomedcentral.com/articles/10.1186/s13756-022-01142-7}, doi = {10.1186/s13756-022-01142-7}, issn = {2047-2994}, year = {2022}, date = {2022-01-01}, journal = {Antimicrobial Resistance \& Infection Control}, volume = {11}, issue = {1}, pages = {112}, abstract = {BACKGROUND In low- and middle-income countries, surveillance of antimicrobial resistance (AMR) is mostly hospital-based and, in view of poor access to clinical microbiology, biased to more resistant pathogens. We aimed to assess AMR among Escherichia coli isolates obtained from urine cultures of pregnant women as an indicator for community AMR and compared the AMR results with those from E. coli isolates obtained from febrile patients in previously published clinical surveillance studies conducted within the same population in Nanoro, rural Burkina Faso. We furthermore explored feasibility of adding urine culture to standard antenatal care in a rural sub-Saharan African setting. METHODS Between October 2016-September 2018, midstream urine samples collected as part of routine antenatal care in Nanoro district were cultured by a dipslide method and screened for antibiotic residues. Significant growth was defined as a pure culture of Enterobacterales at counts of ≥ 104 colony forming units/ml. RESULTS Significant growth was observed in 202/5934 (3.4%) cultures; E. coli represented 155 (76.7%) of isolates. Among E. coli isolates, resistance rates to ampicillin, cotrimoxazole and ciprofloxacin were respectively 65.8%, 64.4% 16.2%, compared to 89.5%, 89.5% and 62.5% among E. coli from clinical isolates (n = 48 of which 45 from blood cultures). Proportions of extended spectrum beta-lactamase producers and multidrug resistance were 3.2% and 5.2% among E. coli isolates from urine in pregnant women versus 35.4%, and 60.4% respectively among clinical isolates. CONCLUSIONS The E. coli isolates obtained from healthy pregnant women had significantly lower AMR rates compared to clinical E. coli isolates, probably reflecting the lower antibiotic pressure in the pregnant women population. Adding urine culture to the routine urine analysis (dipstick) of antenatal care was feasible. The dipslide culture method was affordable and user-friendly and allowed on-site inoculation and easy transport; challenges were contamination (midstream urine sampling) and the semi-quantitative reading. Provided confirmation of the present findings in other settings, E. coli from urine samples in pregnant women may be a potential indicator for benchmarking, comparing, and monitoring community AMR rates across populations over different countries and regions.}, keywords = {ANC, Antimicrobial resistance, Asymptomatic bacteriuria, Burkina Faso, Community, Escherichia coli, Pregnancy, Rural Africa}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND In low- and middle-income countries, surveillance of antimicrobial resistance (AMR) is mostly hospital-based and, in view of poor access to clinical microbiology, biased to more resistant pathogens. We aimed to assess AMR among Escherichia coli isolates obtained from urine cultures of pregnant women as an indicator for community AMR and compared the AMR results with those from E. coli isolates obtained from febrile patients in previously published clinical surveillance studies conducted within the same population in Nanoro, rural Burkina Faso. We furthermore explored feasibility of adding urine culture to standard antenatal care in a rural sub-Saharan African setting. METHODS Between October 2016-September 2018, midstream urine samples collected as part of routine antenatal care in Nanoro district were cultured by a dipslide method and screened for antibiotic residues. Significant growth was defined as a pure culture of Enterobacterales at counts of ≥ 104 colony forming units/ml. RESULTS Significant growth was observed in 202/5934 (3.4%) cultures; E. coli represented 155 (76.7%) of isolates. Among E. coli isolates, resistance rates to ampicillin, cotrimoxazole and ciprofloxacin were respectively 65.8%, 64.4% 16.2%, compared to 89.5%, 89.5% and 62.5% among E. coli from clinical isolates (n = 48 of which 45 from blood cultures). Proportions of extended spectrum beta-lactamase producers and multidrug resistance were 3.2% and 5.2% among E. coli isolates from urine in pregnant women versus 35.4%, and 60.4% respectively among clinical isolates. CONCLUSIONS The E. coli isolates obtained from healthy pregnant women had significantly lower AMR rates compared to clinical E. coli isolates, probably reflecting the lower antibiotic pressure in the pregnant women population. Adding urine culture to the routine urine analysis (dipstick) of antenatal care was feasible. The dipslide culture method was affordable and user-friendly and allowed on-site inoculation and easy transport; challenges were contamination (midstream urine sampling) and the semi-quantitative reading. Provided confirmation of the present findings in other settings, E. coli from urine samples in pregnant women may be a potential indicator for benchmarking, comparing, and monitoring community AMR rates across populations over different countries and regions. Close
	Laetitia Duval, Elisa Sicuri, Susana Scott, Maminata Traoré, Bunja Daabo, Halidou Tinto, Koen Peeters Grietens, Umberto d’Alessando, Henk Schallig, Petra Mens, Lesong Conteh Household costs associated with seeking malaria treatment during pregnancy: evidence from Burkina Faso and The Gambia Journal Article In: Cost Effectiveness and Resource Allocation, vol. 20, iss. 1, pp. 42, 2022, ISSN: 1478-7547. Abstract \| BibTeX \| Tags: Burkina Faso, Cost, Gambia, Malaria, Pregnancy, Remittances, sub-Saharan Africa \| Links: Close Close @article{Duval2022, title = {Household costs associated with seeking malaria treatment during pregnancy: evidence from Burkina Faso and The Gambia}, author = {Laetitia Duval and Elisa Sicuri and Susana Scott and Maminata Traor\'{e} and Bunja Daabo and Halidou Tinto and Koen Peeters Grietens and Umberto d’Alessando and Henk Schallig and Petra Mens and Lesong Conteh}, url = {https://resource-allocation.biomedcentral.com/articles/10.1186/s12962-022-00376-x}, doi = {10.1186/s12962-022-00376-x}, issn = {1478-7547}, year = {2022}, date = {2022-01-01}, journal = {Cost Effectiveness and Resource Allocation}, volume = {20}, issue = {1}, pages = {42}, abstract = {BACKGROUND Malaria in pregnancy remains a major health threat in sub-Saharan Africa to both expectant mothers and their unborn children. To date, there have been very few studies focused on the out of pocket costs associated with seeking treatment for malaria during pregnancy. METHODS A cross-sectional survey was undertaken in Burkina Faso and The Gambia to estimate the direct and indirect costs associated with outpatient consultations (OP) and inpatient admissions (IP). Direct costs were broken down into medical (admission fees, drug charges, and laboratory fees), and non-medical (transportation and food). Indirect costs reflected time lost due to illness. In total, 220 pregnant women in Burkina Faso and 263 in The Gambia were interviewed about their treatment seeking decisions, expenditure, time use and financial support associated with each malaria episode. RESULTS In Burkina Faso 6.7% sought treatment elsewhere before their OP visits, and 27.1% before their IP visits. This compares to 1.3% for OP and 25.92% for IP in The Gambia. Once at the facility, the average direct costs (out of pocket) were 3.91US$ for an OP visit and 15.38US$ of an IP visit in Burkina Faso, and 0.80US$ for an OP visit and 9.19US$ for an IP visit in The Gambia. Inpatient direct costs were driven by drug costs (9.27US$) and transportation costs (2.72US$) in Burkina Faso and drug costs (3.44 US$) and food costs (3.44 US$) in The Gambia. Indirect costs of IP visits, valued as the opportunity cost of time lost due to the illness, were estimated at 11.85US$ in Burkina Faso and 4.07US$ in The Gambia. The difference across the two countries was mainly due to the longer time of hospitalization in Burkina Faso compared to The Gambia. In The Gambia, the vast majority of pregnant women reported receiving financial support from family members living abroad, most commonly siblings (65%). CONCLUSIONS High malaria treatment costs are incurred by pregnant women in Burkina Faso and The Gambia. Beyond the medical costs of fees and drugs, costs in terms of transport, food and time are significant drivers. The role of remittances, particularly their effect on accessing health care, needs further investigation.}, keywords = {Burkina Faso, Cost, Gambia, Malaria, Pregnancy, Remittances, sub-Saharan Africa}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND Malaria in pregnancy remains a major health threat in sub-Saharan Africa to both expectant mothers and their unborn children. To date, there have been very few studies focused on the out of pocket costs associated with seeking treatment for malaria during pregnancy. METHODS A cross-sectional survey was undertaken in Burkina Faso and The Gambia to estimate the direct and indirect costs associated with outpatient consultations (OP) and inpatient admissions (IP). Direct costs were broken down into medical (admission fees, drug charges, and laboratory fees), and non-medical (transportation and food). Indirect costs reflected time lost due to illness. In total, 220 pregnant women in Burkina Faso and 263 in The Gambia were interviewed about their treatment seeking decisions, expenditure, time use and financial support associated with each malaria episode. RESULTS In Burkina Faso 6.7% sought treatment elsewhere before their OP visits, and 27.1% before their IP visits. This compares to 1.3% for OP and 25.92% for IP in The Gambia. Once at the facility, the average direct costs (out of pocket) were 3.91US$ for an OP visit and 15.38US$ of an IP visit in Burkina Faso, and 0.80US$ for an OP visit and 9.19US$ for an IP visit in The Gambia. Inpatient direct costs were driven by drug costs (9.27US$) and transportation costs (2.72US$) in Burkina Faso and drug costs (3.44 US$) and food costs (3.44 US$) in The Gambia. Indirect costs of IP visits, valued as the opportunity cost of time lost due to the illness, were estimated at 11.85US$ in Burkina Faso and 4.07US$ in The Gambia. The difference across the two countries was mainly due to the longer time of hospitalization in Burkina Faso compared to The Gambia. In The Gambia, the vast majority of pregnant women reported receiving financial support from family members living abroad, most commonly siblings (65%). CONCLUSIONS High malaria treatment costs are incurred by pregnant women in Burkina Faso and The Gambia. Beyond the medical costs of fees and drugs, costs in terms of transport, food and time are significant drivers. The role of remittances, particularly their effect on accessing health care, needs further investigation. Close
	Moussa Lingani, Serge H. Zango, Innocent Valéa, Maïmouna Sanou, Serge Ouoba, Sékou Samadoulougou, Annie Robert, Halidou Tinto, Michèle Dramaix, Philippe Donnen Prevalence and risk factors of malaria among first antenatal care attendees in rural Burkina Faso Journal Article In: Tropical Medicine and Health, vol. 50, iss. 1, pp. 49, 2022, ISSN: 1349-4147. Abstract \| BibTeX \| Tags: Burkina Faso, First antenatal care visit, Malaria, Pregnancy \| Links: Close Close @article{Lingani2022, title = {Prevalence and risk factors of malaria among first antenatal care attendees in rural Burkina Faso}, author = {Moussa Lingani and Serge H. Zango and Innocent Val\'{e}a and Ma\"{i}mouna Sanou and Serge Ouoba and S\'{e}kou Samadoulougou and Annie Robert and Halidou Tinto and Mich\`{e}le Dramaix and Philippe Donnen}, url = {https://tropmedhealth.biomedcentral.com/articles/10.1186/s41182-022-00442-3}, doi = {10.1186/s41182-022-00442-3}, issn = {1349-4147}, year = {2022}, date = {2022-01-01}, journal = {Tropical Medicine and Health}, volume = {50}, issue = {1}, pages = {49}, abstract = {BACKGROUND The WHO recommends continuous surveillance of malaria in endemic countries to identify areas and populations most in need for targeted interventions. The aim of this study was to assess the prevalence of malaria and its associated factors among first antenatal care (ANC) attendees in rural Burkina Faso. METHODS A cross-sectional survey was conducted between August 2019 and September 2020 at the Yako health district and included 1067 first ANC attendees. Sociodemographic, gyneco-obstetric, and medical characteristics were collected. Malaria was diagnosed by standard microscopy and hemoglobin level was measured by spectrophotometry. A multivariate logistic regression analysis was used to identify factors associated with malaria infection. RESULTS Overall malaria infection prevalence was 16.1% (167/1039). Among malaria-positive women, the geometric mean parasite density was 1204 [95% confidence interval (CI) 934-1552] parasites/µL and the proportion of very low (1-199 parasites/µL), low (200-999 parasites/µL), medium (1000-9999 parasites/µL) and high (≥ 10,000 parasites/µL) parasite densities were 15.0%, 35.3%, 38.3% and 11.4%, respectively. Age \< 20 years (adjusted odds ratio (aOR): 2.2; 95% CI 1.4-3.5), anemia (hemoglobin \< 11 g/deciliter) (aOR: 3.4; 95% CI 2.2-5.5), the non-use of bed net (aOR: 1.8; 95% CI 1.1-2.8), and the absence of intermittent preventive treatment with sulfadoxine-pyrimethamine (aOR: 5.8; 95% CI 2.1-24.5) were positively associated with malaria infection. CONCLUSIONS The study showed that one out of six pregnant women had a microscopy-detected P. falciparum malaria infection at their first ANC visit. Strengthening malaria prevention strategies during the first ANC visit is needed to prevent unfavorable birth outcomes.}, keywords = {Burkina Faso, First antenatal care visit, Malaria, Pregnancy}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND The WHO recommends continuous surveillance of malaria in endemic countries to identify areas and populations most in need for targeted interventions. The aim of this study was to assess the prevalence of malaria and its associated factors among first antenatal care (ANC) attendees in rural Burkina Faso. METHODS A cross-sectional survey was conducted between August 2019 and September 2020 at the Yako health district and included 1067 first ANC attendees. Sociodemographic, gyneco-obstetric, and medical characteristics were collected. Malaria was diagnosed by standard microscopy and hemoglobin level was measured by spectrophotometry. A multivariate logistic regression analysis was used to identify factors associated with malaria infection. RESULTS Overall malaria infection prevalence was 16.1% (167/1039). Among malaria-positive women, the geometric mean parasite density was 1204 [95% confidence interval (CI) 934-1552] parasites/µL and the proportion of very low (1-199 parasites/µL), low (200-999 parasites/µL), medium (1000-9999 parasites/µL) and high (≥ 10,000 parasites/µL) parasite densities were 15.0%, 35.3%, 38.3% and 11.4%, respectively. Age < 20 years (adjusted odds ratio (aOR): 2.2; 95% CI 1.4-3.5), anemia (hemoglobin < 11 g/deciliter) (aOR: 3.4; 95% CI 2.2-5.5), the non-use of bed net (aOR: 1.8; 95% CI 1.1-2.8), and the absence of intermittent preventive treatment with sulfadoxine-pyrimethamine (aOR: 5.8; 95% CI 2.1-24.5) were positively associated with malaria infection. CONCLUSIONS The study showed that one out of six pregnant women had a microscopy-detected P. falciparum malaria infection at their first ANC visit. Strengthening malaria prevention strategies during the first ANC visit is needed to prevent unfavorable birth outcomes. Close
2021
Journal Articles
	Moussa Lingani, Serge H Zango, Innocent Valéa, Massa Dit A Bonko, Sékou O Samadoulougou, Toussaint Rouamba, Marc C Tahita, Ma"imouna Sanou, Annie Robert, Halidou Tinto, Philippe Donnen, Mich`ele Dramaix Malaria and curable sexually transmitted and reproductive tract coinfection among pregnant women in rural Burkina Faso Journal Article In: Trop. Med. Health, vol. 49, no. 1, pp. 90, 2021, ISSN: 1348-8945 1349-4147, (© 2021. The Author(s). PMID: 34736524 PMCID: PMC8567650). Abstract \| BibTeX \| Tags: Bacterial vaginosis, Burkina Faso, Chlamydia, Coinfection, Malaria, Pregnancy, Syphilis \| Links: Close Close @article{Lingani2021-is, title = {Malaria and curable sexually transmitted and reproductive tract coinfection among pregnant women in rural Burkina Faso}, author = {Moussa Lingani and Serge H Zango and Innocent Val\'{e}a and Massa Dit A Bonko and S\'{e}kou O Samadoulougou and Toussaint Rouamba and Marc C Tahita and Ma"imouna Sanou and Annie Robert and Halidou Tinto and Philippe Donnen and Mich`ele Dramaix}, doi = {10.1186/s41182-021-00381-5}, issn = {1348-8945 1349-4147}, year = {2021}, date = {2021-11-01}, urldate = {2021-11-01}, journal = {Trop. Med. Health}, volume = {49}, number = {1}, pages = {90}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Malaria and sexually transmitted/reproductive tract infections (STI/RTI) are leading and preventable causes of low birthweight in sub-Saharan Africa. Reducing their impact on pregnancy outcomes requires efficient interventions that can be easily integrated into the antenatal care package. The paucity of data on malaria and STI/RTI coinfection, however, limits efforts to control these infections. This study aimed to determine the prevalence and associated factors of malaria and STI/RTI coinfection among pregnant women in rural Burkina Faso. METHODS: A cross-sectional survey was conducted among 402 pregnant women attending antenatal clinics at the Yako health district. Sociodemographic and behavioral data were collected, and pregnant women were tested for peripheral malaria by microscopy. Hemoglobin levels were also measured by spectrophotometry and curable bacterial STI/RTI were tested on cervico-vaginal swabs using rapid diagnostic test for chlamydia and syphilis, and Gram staining for bacterial vaginosis. A multivariate logistic regression model was used to assess the association of malaria and STI/RTI coinfection with the characteristics of included pregnant women. RESULTS: The prevalence of malaria and at least one STI/RTI coinfection was 12.9% (95% confidence interval, CI: [9.8-16.7]), malaria and bacterial vaginosis coinfection was 12.2% (95% CI: [9.3-15.9]), malaria and chlamydial coinfection was 1.6% (95% CI: [0.6-3.8]). No coinfection was reported for malaria and syphilis. The individual prevalence was 17.2%, 7.2%, 0.6%, 67.7% and 73.3%, respectively, for malaria infection, chlamydia, syphilis, bacterial vaginosis and STI/RTI combination. Only 10% of coinfections were symptomatic, and thus, 90% of women with coinfection would have been missed by the symptoms-based diagnostic approach. In the multivariate analysis, the first pregnancy (aOR = 2.4 [95% CI: 1.2-4.7]) was the only factor significantly associated with malaria and STI/RTI coinfection. Clinical symptoms were not associated with malaria and STI/RTI coinfection. CONCLUSION: The prevalence of malaria and curable STI/RTI coinfection was high among pregnant women. The poor performance of the clinical symptoms to predict coinfection suggests that alternative interventions are needed.}, note = {© 2021. The Author(s). PMID: 34736524 PMCID: PMC8567650}, keywords = {Bacterial vaginosis, Burkina Faso, Chlamydia, Coinfection, Malaria, Pregnancy, Syphilis}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Malaria and sexually transmitted/reproductive tract infections (STI/RTI) are leading and preventable causes of low birthweight in sub-Saharan Africa. Reducing their impact on pregnancy outcomes requires efficient interventions that can be easily integrated into the antenatal care package. The paucity of data on malaria and STI/RTI coinfection, however, limits efforts to control these infections. This study aimed to determine the prevalence and associated factors of malaria and STI/RTI coinfection among pregnant women in rural Burkina Faso. METHODS: A cross-sectional survey was conducted among 402 pregnant women attending antenatal clinics at the Yako health district. Sociodemographic and behavioral data were collected, and pregnant women were tested for peripheral malaria by microscopy. Hemoglobin levels were also measured by spectrophotometry and curable bacterial STI/RTI were tested on cervico-vaginal swabs using rapid diagnostic test for chlamydia and syphilis, and Gram staining for bacterial vaginosis. A multivariate logistic regression model was used to assess the association of malaria and STI/RTI coinfection with the characteristics of included pregnant women. RESULTS: The prevalence of malaria and at least one STI/RTI coinfection was 12.9% (95% confidence interval, CI: [9.8-16.7]), malaria and bacterial vaginosis coinfection was 12.2% (95% CI: [9.3-15.9]), malaria and chlamydial coinfection was 1.6% (95% CI: [0.6-3.8]). No coinfection was reported for malaria and syphilis. The individual prevalence was 17.2%, 7.2%, 0.6%, 67.7% and 73.3%, respectively, for malaria infection, chlamydia, syphilis, bacterial vaginosis and STI/RTI combination. Only 10% of coinfections were symptomatic, and thus, 90% of women with coinfection would have been missed by the symptoms-based diagnostic approach. In the multivariate analysis, the first pregnancy (aOR = 2.4 [95% CI: 1.2-4.7]) was the only factor significantly associated with malaria and STI/RTI coinfection. Clinical symptoms were not associated with malaria and STI/RTI coinfection. CONCLUSION: The prevalence of malaria and curable STI/RTI coinfection was high among pregnant women. The poor performance of the clinical symptoms to predict coinfection suggests that alternative interventions are needed. Close
	Serge Henri Zango, Moussa Lingani, Innocent Valea, Ouindpanga Sekou Samadoulougou, Biebo Bihoun, Diagniagou Lankoande, Phillipe Donnen, Michele Dramaix, Halidou Tinto, Annie Robert Association of malaria and curable sexually transmitted infections with pregnancy outcomes in rural Burkina Faso Journal Article In: BMC Pregnancy Childbirth, vol. 21, no. 1, pp. 722, 2021, ISSN: 1471-2393, (© 2021. The Author(s). PMID: 34706705 PMCID: PMC8549350). Abstract \| BibTeX \| Tags: Coinfection, Impact, Malaria, Outcome, Pregnancy, STI \| Links: Close Close @article{Zango2021-ti, title = {Association of malaria and curable sexually transmitted infections with pregnancy outcomes in rural Burkina Faso}, author = {Serge Henri Zango and Moussa Lingani and Innocent Valea and Ouindpanga Sekou Samadoulougou and Biebo Bihoun and Diagniagou Lankoande and Phillipe Donnen and Michele Dramaix and Halidou Tinto and Annie Robert}, doi = {10.1186/s12884-021-04205-6}, issn = {1471-2393}, year = {2021}, date = {2021-10-27}, urldate = {2021-10-27}, journal = {BMC Pregnancy Childbirth}, volume = {21}, number = {1}, pages = {722}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Malaria and curable sexually transmitted infections (STIs) are severe infections associated with poor pregnancy outcomes in sub-Saharan countries. These infections are responsible for low birth weight, preterm birth, and miscarriage. In Burkina Faso, many interventions recommended by the World Health Organization were implemented to control the impact of these infections. After decades of intervention, we assessed the impact of these infections on pregnancy outcomes in rural setting of Burkina Faso. METHODS: Antenatal care and delivery data of pregnant women attending health facilities in 2016 and 2017 were collected in two rural districts namely Nanoro and Yako, in Burkina Faso. Regression models with likelihood ratio test were used to assess the association between infections and pregnancy outcomes. RESULTS: During the two years, 31639 pregnant women received antenatal care. Malaria without STI, STI without malaria, and their coinfections were reported for 7359 (23.3%), 881 (2.8 %), and 388 (1.2%) women, respectively. Low birth weight, miscarriage, and stillbirth were observed in 2754 (10.5 %), 547 (2.0 %), and 373 (1.3 %) women, respectively. Our data did not show an association between low birth weight and malaria [Adjusted OR: 0.91 (0.78 - 1.07)], STIs [Adjusted OR: 0.74 (0.51 - 1.07)] and coinfection [Adjusted OR: 1.15 (0.75 - 1.78)]. Low birth weight was strongly associated with primigravidae [Adjusted OR: 3.53 (3.12 - 4.00)]. Both miscarriage and stillbirth were associated with malaria [Adjusted OR: 1.31 (1.07 - 1.59)], curable STI [Adjusted OR: 1.65 (1.06 - 2.59)], and coinfection [Adjusted OR: 2.00 (1.13 - 3.52)]. CONCLUSION: Poor pregnancy outcomes remained frequent in rural Burkina Faso. Malaria, curable STIs, and their coinfections were associated with both miscarriage and stillbirth in rural Burkina. More effort should be done to reduce the proportion of pregnancies lost associated with these curable infections by targeting interventions in primigravidae women.}, note = {© 2021. The Author(s). PMID: 34706705 PMCID: PMC8549350}, keywords = {Coinfection, Impact, Malaria, Outcome, Pregnancy, STI}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Malaria and curable sexually transmitted infections (STIs) are severe infections associated with poor pregnancy outcomes in sub-Saharan countries. These infections are responsible for low birth weight, preterm birth, and miscarriage. In Burkina Faso, many interventions recommended by the World Health Organization were implemented to control the impact of these infections. After decades of intervention, we assessed the impact of these infections on pregnancy outcomes in rural setting of Burkina Faso. METHODS: Antenatal care and delivery data of pregnant women attending health facilities in 2016 and 2017 were collected in two rural districts namely Nanoro and Yako, in Burkina Faso. Regression models with likelihood ratio test were used to assess the association between infections and pregnancy outcomes. RESULTS: During the two years, 31639 pregnant women received antenatal care. Malaria without STI, STI without malaria, and their coinfections were reported for 7359 (23.3%), 881 (2.8 %), and 388 (1.2%) women, respectively. Low birth weight, miscarriage, and stillbirth were observed in 2754 (10.5 %), 547 (2.0 %), and 373 (1.3 %) women, respectively. Our data did not show an association between low birth weight and malaria [Adjusted OR: 0.91 (0.78 - 1.07)], STIs [Adjusted OR: 0.74 (0.51 - 1.07)] and coinfection [Adjusted OR: 1.15 (0.75 - 1.78)]. Low birth weight was strongly associated with primigravidae [Adjusted OR: 3.53 (3.12 - 4.00)]. Both miscarriage and stillbirth were associated with malaria [Adjusted OR: 1.31 (1.07 - 1.59)], curable STI [Adjusted OR: 1.65 (1.06 - 2.59)], and coinfection [Adjusted OR: 2.00 (1.13 - 3.52)]. CONCLUSION: Poor pregnancy outcomes remained frequent in rural Burkina Faso. Malaria, curable STIs, and their coinfections were associated with both miscarriage and stillbirth in rural Burkina. More effort should be done to reduce the proportion of pregnancies lost associated with these curable infections by targeting interventions in primigravidae women. Close
	Stephen A Roberts, Loretta Brabin, Halidou Tinto, Sabine Gies, Salou Diallo, Bernard Brabin Seasonal patterns of malaria, genital infection, nutritional and iron status in non-pregnant and pregnant adolescents in Burkina Faso: a secondary analysis of trial data Journal Article In: BMC Public Health, vol. 21, no. 1, pp. 1764, 2021, ISSN: 1471-2458, (© 2021. The Author(s). PMID: 34579679 PMCID: PMC8477466). Abstract \| BibTeX \| Tags: Abnormal vaginal flora, Adolescents, Bacterial vaginosis, Body Mass Index, Burkina Faso/epidemiology, Child, Female, Humans, Iron, iron biomarkers, Malaria, Malaria/drug therapy/epidemiology, MUAC, Pregnancy, Seasons, Vagina \| Links: Close Close @article{Roberts2021-gg, title = {Seasonal patterns of malaria, genital infection, nutritional and iron status in non-pregnant and pregnant adolescents in Burkina Faso: a secondary analysis of trial data}, author = {Stephen A Roberts and Loretta Brabin and Halidou Tinto and Sabine Gies and Salou Diallo and Bernard Brabin}, doi = {10.1186/s12889-021-11819-0}, issn = {1471-2458}, year = {2021}, date = {2021-09-01}, urldate = {2021-09-01}, journal = {BMC Public Health}, volume = {21}, number = {1}, pages = {1764}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Adolescents are considered at high risk of developing iron deficiency. Studies in children indicate that the prevalence of iron deficiency increased with malaria transmission, suggesting malaria seasonally may drive iron deficiency. This paper examines monthly seasonal infection patterns of malaria, abnormal vaginal flora, chorioamnionitis, antibiotic and antimalarial prescriptions, in relation to changes in iron biomarkers and nutritional indices in adolescents living in a rural area of Burkina Faso, in order to assess the requirement for seasonal infection control and nutrition interventions. METHODS: Data collected between April 2011 and January 2014 were available for an observational seasonal analysis, comprising scheduled visits for 1949 non-pregnant adolescents (≤19 years), (315 of whom subsequently became pregnant), enrolled in a randomised trial of periconceptional iron supplementation. Data from trial arms were combined. Body Iron Stores (BIS) were calculated using an internal regression for ferritin to allow for inflammation. At recruitment 11% had low BIS (\< 0 mg/kg). Continuous outcomes were fitted to a mixed-effects linear model with month, age and pregnancy status as fixed effect covariates and woman as a random effect. Dichotomous infection outcomes were fitted with analogous logistic regression models. RESULTS: Seasonal variation in malaria parasitaemia prevalence ranged between 18 and 70% in non-pregnant adolescents (P \< 0.001), peaking at 81% in those who became pregnant. Seasonal variation occurred in antibiotic prescription rates (0.7-1.8 prescriptions/100 weekly visits, P \< 0.001) and chorioamnionitis prevalence (range 15-68%, P = 0.026). Mucosal vaginal lactoferrin concentration was lower at the end of the wet season (range 2-22 μg/ml, P \< 0.016), when chorioamnionitis was least frequent. BIS fluctuated annually by up to 53.2% per year around the mean BIS (5.1 mg/kg(2), range 4.1-6.8 mg/kg), with low BIS (\< 0 mg/kg) of 8.7% in the dry and 9.8% in the wet seasons (P = 0.36). Median serum transferrin receptor increased during the wet season (P \< 0.001). Higher hepcidin concentration in the wet season corresponded with rising malaria prevalence and use of prescriptions, but with no change in BIS. Mean Body Mass Index and Mid-Upper-Arm-Circumference values peaked mid-dry season (both P \< 0.001). CONCLUSIONS: Our analysis supports preventive treatment of malaria among adolescents 15-19 years to decrease their disease burden, especially asymptomatic malaria. As BIS were adequate in most adolescents despite seasonal malaria, a requirement for programmatic iron supplementation was not substantiated.}, note = {© 2021. The Author(s). PMID: 34579679 PMCID: PMC8477466}, keywords = {Abnormal vaginal flora, Adolescents, Bacterial vaginosis, Body Mass Index, Burkina Faso/epidemiology, Child, Female, Humans, Iron, iron biomarkers, Malaria, Malaria/drug therapy/epidemiology, MUAC, Pregnancy, Seasons, Vagina}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Adolescents are considered at high risk of developing iron deficiency. Studies in children indicate that the prevalence of iron deficiency increased with malaria transmission, suggesting malaria seasonally may drive iron deficiency. This paper examines monthly seasonal infection patterns of malaria, abnormal vaginal flora, chorioamnionitis, antibiotic and antimalarial prescriptions, in relation to changes in iron biomarkers and nutritional indices in adolescents living in a rural area of Burkina Faso, in order to assess the requirement for seasonal infection control and nutrition interventions. METHODS: Data collected between April 2011 and January 2014 were available for an observational seasonal analysis, comprising scheduled visits for 1949 non-pregnant adolescents (≤19 years), (315 of whom subsequently became pregnant), enrolled in a randomised trial of periconceptional iron supplementation. Data from trial arms were combined. Body Iron Stores (BIS) were calculated using an internal regression for ferritin to allow for inflammation. At recruitment 11% had low BIS (< 0 mg/kg). Continuous outcomes were fitted to a mixed-effects linear model with month, age and pregnancy status as fixed effect covariates and woman as a random effect. Dichotomous infection outcomes were fitted with analogous logistic regression models. RESULTS: Seasonal variation in malaria parasitaemia prevalence ranged between 18 and 70% in non-pregnant adolescents (P < 0.001), peaking at 81% in those who became pregnant. Seasonal variation occurred in antibiotic prescription rates (0.7-1.8 prescriptions/100 weekly visits, P < 0.001) and chorioamnionitis prevalence (range 15-68%, P = 0.026). Mucosal vaginal lactoferrin concentration was lower at the end of the wet season (range 2-22 μg/ml, P < 0.016), when chorioamnionitis was least frequent. BIS fluctuated annually by up to 53.2% per year around the mean BIS (5.1 mg/kg(2), range 4.1-6.8 mg/kg), with low BIS (< 0 mg/kg) of 8.7% in the dry and 9.8% in the wet seasons (P = 0.36). Median serum transferrin receptor increased during the wet season (P < 0.001). Higher hepcidin concentration in the wet season corresponded with rising malaria prevalence and use of prescriptions, but with no change in BIS. Mean Body Mass Index and Mid-Upper-Arm-Circumference values peaked mid-dry season (both P < 0.001). CONCLUSIONS: Our analysis supports preventive treatment of malaria among adolescents 15-19 years to decrease their disease burden, especially asymptomatic malaria. As BIS were adequate in most adolescents despite seasonal malaria, a requirement for programmatic iron supplementation was not substantiated. Close
	Adéla"ide Compaoré, Kadija Ouedraogo, Palwende R Boua, Daniella Watson, Sarah H Kehoe, Marie-Louise Newell, Halidou Tinto, Mary Barker, Hermann Sorgho, INPreP group 'Men are not playing their roles', maternal and child nutrition in Nanoro, Burkina Faso Journal Article In: Public Health Nutr., vol. 24, no. 12, pp. 3780–3790, 2021, ISSN: 1475-2727 1368-9800, (Place: England PMID: 33000717). Abstract \| BibTeX \| Tags: Burkina Faso, Child, Child nutrition, Child Nutritional Physiological Phenomena, Community perceptions, Empowerment, Female, Humans, Male, Maternal nutrition, Mothers, Nutritional Status, Pregnancy, Qualitative research \| Links: Close Close @article{Compaore2021-hg, title = {'Men are not playing their roles', maternal and child nutrition in Nanoro, Burkina Faso}, author = {Ad\'{e}la"ide Compaor\'{e} and Kadija Ouedraogo and Palwende R Boua and Daniella Watson and Sarah H Kehoe and Marie-Louise Newell and Halidou Tinto and Mary Barker and Hermann Sorgho and INPreP group}, doi = {10.1017/S1368980020003365}, issn = {1475-2727 1368-9800}, year = {2021}, date = {2021-08-01}, urldate = {2021-08-01}, journal = {Public Health Nutr.}, volume = {24}, number = {12}, pages = {3780--3790}, publisher = {Cambridge University Press (CUP)}, abstract = {OBJECTIVE: To collect context-specific insights into maternal and child health and nutrition issues, and to explore potential solutions in Nanoro, Burkina Faso. DESIGN: Eleven focus groups with men and women from eleven communities, facilitated by local researchers. SETTING: The study took place in the Nanoro Health district, in the West-Central part of Burkina Faso. PARTICIPANTS: Eighty-six men (18-55 years) and women by age group: 18-25; 26-34 and 35-55 years, participated in the group discussions. RESULTS: Participants described barriers to optimal nutrition of mothers and children related to a range of community factors, with gender inequality as central. Major themes in the discussions are related to poverty and challenges generated by socially and culturally determined gender roles. Sub-themes are women lacking access to food whilst pregnant and having limited access to health care and opportunities to generate income. Although communities believe that food donations should be implemented to overcome this, they also pointed out the need for enhancing their own food production, requiring improved agricultural technologies. Given the important role that women could play in reducing malnutrition, these communities felt they needed to be empowered to do so and supported by men. They also felt that this had to be carried out in the context of an enhanced health care system. CONCLUSIONS: Findings reported here highlight the importance of nutrition-sensitive interventions and women's empowerment in improving maternal and child nutrition. There is a need to integrate a sustainable multi-sectorial approach which goes beyond food support.}, note = {Place: England PMID: 33000717}, keywords = {Burkina Faso, Child, Child nutrition, Child Nutritional Physiological Phenomena, Community perceptions, Empowerment, Female, Humans, Male, Maternal nutrition, Mothers, Nutritional Status, Pregnancy, Qualitative research}, pubstate = {published}, tppubtype = {article} } Close OBJECTIVE: To collect context-specific insights into maternal and child health and nutrition issues, and to explore potential solutions in Nanoro, Burkina Faso. DESIGN: Eleven focus groups with men and women from eleven communities, facilitated by local researchers. SETTING: The study took place in the Nanoro Health district, in the West-Central part of Burkina Faso. PARTICIPANTS: Eighty-six men (18-55 years) and women by age group: 18-25; 26-34 and 35-55 years, participated in the group discussions. RESULTS: Participants described barriers to optimal nutrition of mothers and children related to a range of community factors, with gender inequality as central. Major themes in the discussions are related to poverty and challenges generated by socially and culturally determined gender roles. Sub-themes are women lacking access to food whilst pregnant and having limited access to health care and opportunities to generate income. Although communities believe that food donations should be implemented to overcome this, they also pointed out the need for enhancing their own food production, requiring improved agricultural technologies. Given the important role that women could play in reducing malnutrition, these communities felt they needed to be empowered to do so and supported by men. They also felt that this had to be carried out in the context of an enhanced health care system. CONCLUSIONS: Findings reported here highlight the importance of nutrition-sensitive interventions and women's empowerment in improving maternal and child nutrition. There is a need to integrate a sustainable multi-sectorial approach which goes beyond food support. Close
	Toussaint Rouamba, Sékou Samadoulougou, Mady Ouédraogo, Hervé Hien, Halidou Tinto, Fati Kirakoya-Samadoulougou Asymptomatic malaria and anaemia among pregnant women during high and low malaria transmission seasons in Burkina Faso: household-based cross-sectional surveys in Burkina Faso, 2013 and 2017 Journal Article In: Malar. J., vol. 20, no. 1, pp. 211, 2021, ISSN: 1475-2875. Abstract \| BibTeX \| Tags: Adult, Anemia/epidemiology/parasitology, Asymptomatic carriage, Asymptomatic Infections/epidemiology, Burkina Faso/epidemiology, Community, Cross-Sectional Studies, Female, Haemoglobin, Humans, Malaria/epidemiology/parasitology, Parasitic/epidemiology/parasitology, Plasmodium, Pregnancy, Pregnancy Complications, Pregnant, Pregnant Women, Prevalence, Young Adult \| Links: Close Close @article{Rouamba2021-gn, title = {Asymptomatic malaria and anaemia among pregnant women during high and low malaria transmission seasons in Burkina Faso: household-based cross-sectional surveys in Burkina Faso, 2013 and 2017}, author = {Toussaint Rouamba and S\'{e}kou Samadoulougou and Mady Ou\'{e}draogo and Herv\'{e} Hien and Halidou Tinto and Fati Kirakoya-Samadoulougou}, doi = {10.1186/s12936-021-03703-4}, issn = {1475-2875}, year = {2021}, date = {2021-05-01}, urldate = {2021-05-01}, journal = {Malar. J.}, volume = {20}, number = {1}, pages = {211}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Malaria in endemic countries is often asymptomatic during pregnancy, but it has substantial consequences for both the mother and her unborn baby. During pregnancy, anaemia is an important consequence of malaria infection. In Burkina Faso, the intensity of malaria varies according to the season, albeit the prevalence of malaria and anaemia as well as their risk factors, during high and low malaria transmission seasons is underexplored at the household level. METHODS: Data of 1751 pregnant women from October 2013 to March 2014 and 1931 pregnant women from April 2017 to June 2017 were drawn from two cross-sectional household surveys conducted in 24 health districts of Burkina Faso. Pregnant women were tested for malaria in their household after consenting. Asymptomatic carriage was defined as a positive result from malaria rapid diagnostic tests in the absence of clinical symptoms of malaria. Anaemia was defined as haemoglobin level less than 11 g/dL in the first and third trimester and less than 10.5 g/dL in the second trimester of pregnancy. RESULTS: Prevalence of asymptomatic malaria in pregnancy was estimated at 23.9% (95% CI 20.2-28.0) during the high transmission season (October-November) in 2013. During the low transmission season, it was 12.7% (95% CI 10.9-14.7) between December and March in 2013-2014 and halved (6.4%; 95% CI 5.3-7.6) between April and June 2017. Anaemia prevalence was estimated at 59.4% (95% CI 54.8-63.8) during the high transmission season in 2013. During the low transmission season, it was 50.6% (95% CI 47.7-53.4) between December and March 2013-2014 and 65.0% (95% CI 62.8-67.2) between April and June, 2017. CONCLUSION: This study revealed that the prevalence of malaria asymptomatic carriage and anaemia among pregnant women at the community level remain high throughout the year. Thus, more efforts are needed to increase prevention measures such as IPTp-SP coverage in order to reduce anaemia and contribute to preventing low birth weight and poor pregnancy outcomes.}, keywords = {Adult, Anemia/epidemiology/parasitology, Asymptomatic carriage, Asymptomatic Infections/epidemiology, Burkina Faso/epidemiology, Community, Cross-Sectional Studies, Female, Haemoglobin, Humans, Malaria/epidemiology/parasitology, Parasitic/epidemiology/parasitology, Plasmodium, Pregnancy, Pregnancy Complications, Pregnant, Pregnant Women, Prevalence, Young Adult}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Malaria in endemic countries is often asymptomatic during pregnancy, but it has substantial consequences for both the mother and her unborn baby. During pregnancy, anaemia is an important consequence of malaria infection. In Burkina Faso, the intensity of malaria varies according to the season, albeit the prevalence of malaria and anaemia as well as their risk factors, during high and low malaria transmission seasons is underexplored at the household level. METHODS: Data of 1751 pregnant women from October 2013 to March 2014 and 1931 pregnant women from April 2017 to June 2017 were drawn from two cross-sectional household surveys conducted in 24 health districts of Burkina Faso. Pregnant women were tested for malaria in their household after consenting. Asymptomatic carriage was defined as a positive result from malaria rapid diagnostic tests in the absence of clinical symptoms of malaria. Anaemia was defined as haemoglobin level less than 11 g/dL in the first and third trimester and less than 10.5 g/dL in the second trimester of pregnancy. RESULTS: Prevalence of asymptomatic malaria in pregnancy was estimated at 23.9% (95% CI 20.2-28.0) during the high transmission season (October-November) in 2013. During the low transmission season, it was 12.7% (95% CI 10.9-14.7) between December and March in 2013-2014 and halved (6.4%; 95% CI 5.3-7.6) between April and June 2017. Anaemia prevalence was estimated at 59.4% (95% CI 54.8-63.8) during the high transmission season in 2013. During the low transmission season, it was 50.6% (95% CI 47.7-53.4) between December and March 2013-2014 and 65.0% (95% CI 62.8-67.2) between April and June, 2017. CONCLUSION: This study revealed that the prevalence of malaria asymptomatic carriage and anaemia among pregnant women at the community level remain high throughout the year. Thus, more efforts are needed to increase prevention measures such as IPTp-SP coverage in order to reduce anaemia and contribute to preventing low birth weight and poor pregnancy outcomes. Close
	Sabine Gies, Stephen A Roberts, Salou Diallo, Olga M Lompo, Halidou Tinto, Bernard J Brabin Risk of malaria in young children after periconceptional iron supplementation Journal Article In: Matern. Child Nutr., vol. 17, no. 2, pp. e13106, 2021, ISSN: 1740-8709 1740-8695, (© 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd. PMID: 33236840 PMCID: PMC7988873). Abstract \| BibTeX \| Tags: Burkina Faso, child iron, Dietary Supplements/analysis, Female, Folic Acid, Humans, Infant, Malaria, Newborn, periconceptional, placenta, Pregnancy, Premature Birth, Preschool \| Links: Close Close @article{Gies2021-aw, title = {Risk of malaria in young children after periconceptional iron supplementation}, author = {Sabine Gies and Stephen A Roberts and Salou Diallo and Olga M Lompo and Halidou Tinto and Bernard J Brabin}, doi = {10.1111/mcn.13106}, issn = {1740-8709 1740-8695}, year = {2021}, date = {2021-04-01}, urldate = {2021-04-01}, journal = {Matern. Child Nutr.}, volume = {17}, number = {2}, pages = {e13106}, publisher = {Wiley}, abstract = {This study in Burkina Faso investigated whether offspring of young mothers who had received weekly periconceptional iron supplementation in a randomised controlled trial were at increased risk of malaria. A child safety survey was undertaken in the peak month of malaria transmission towards the end of the trial to assess child iron biomarkers, nutritional status, anaemia and malaria outcomes. Antenatal iron biomarkers, preterm birth, fetal growth restriction and placental pathology for malaria and chorioamnionitis were assessed. Data were available for 180 babies surviving to the time of the survey when their median age was 9 months. Prevalence of maternal iron deficiency in the last trimester based on low body iron stores was 16%. Prevalence of active placental malaria infection was 24.8%, past infection 59% and chorioamnionitis 55.6%. Babies of iron supplemented women had lower median gestational age. Four out of five children ≥ 6 months were iron deficient, and 98% were anaemic. At 4 months malaria prevalence was 45%. Child iron biomarkers, anaemia and malaria outcomes did not differ by trial arm. Factors associated with childhood parasitaemia were third trimester C-reactive protein level (OR 2.1; 95% CI 1.1-3.9), active placental malaria (OR 5.8; 1.0-32.5, P = 0.042) and child body iron stores (OR 1.13; 1.04-1.23, P = 0.002). Chorioamnionitis was associated with reduced risk of child parasitaemia (OR 0.4; 0.1-1.0, P = 0.038). Periconceptional iron supplementation of young women did not alter body iron stores of their children. Higher child body iron stores and placental malaria increased risk of childhood parasitaemia.}, note = {© 2020 The Authors. Maternal \& Child Nutrition published by John Wiley \& Sons Ltd. PMID: 33236840 PMCID: PMC7988873}, keywords = {Burkina Faso, child iron, Dietary Supplements/analysis, Female, Folic Acid, Humans, Infant, Malaria, Newborn, periconceptional, placenta, Pregnancy, Premature Birth, Preschool}, pubstate = {published}, tppubtype = {article} } Close This study in Burkina Faso investigated whether offspring of young mothers who had received weekly periconceptional iron supplementation in a randomised controlled trial were at increased risk of malaria. A child safety survey was undertaken in the peak month of malaria transmission towards the end of the trial to assess child iron biomarkers, nutritional status, anaemia and malaria outcomes. Antenatal iron biomarkers, preterm birth, fetal growth restriction and placental pathology for malaria and chorioamnionitis were assessed. Data were available for 180 babies surviving to the time of the survey when their median age was 9 months. Prevalence of maternal iron deficiency in the last trimester based on low body iron stores was 16%. Prevalence of active placental malaria infection was 24.8%, past infection 59% and chorioamnionitis 55.6%. Babies of iron supplemented women had lower median gestational age. Four out of five children ≥ 6 months were iron deficient, and 98% were anaemic. At 4 months malaria prevalence was 45%. Child iron biomarkers, anaemia and malaria outcomes did not differ by trial arm. Factors associated with childhood parasitaemia were third trimester C-reactive protein level (OR 2.1; 95% CI 1.1-3.9), active placental malaria (OR 5.8; 1.0-32.5, P = 0.042) and child body iron stores (OR 1.13; 1.04-1.23, P = 0.002). Chorioamnionitis was associated with reduced risk of child parasitaemia (OR 0.4; 0.1-1.0, P = 0.038). Periconceptional iron supplementation of young women did not alter body iron stores of their children. Higher child body iron stores and placental malaria increased risk of childhood parasitaemia. Close
2015
Journal Articles
	Halidou Tinto, Esperança Sevene, Stephanie Dellicour, Gregory S. Calip, Umberto D'Alessandro, Eusébio Macete, Seydou Nakanabo-Diallo, Adama Kazienga, Innocent Valea, Hermann Sorgho, Anifa Valá, Orvalho Augusto, Maria Ruperez, Clara Menendez, Peter Ouma, Meghna Desai, Feiko Ter Kuile, Andy Stergachis Assessment of the safety of antimalarial drug use during early pregnancy (ASAP): Protocol for a multicenter prospective cohort study in Burkina Faso, Kenya and Mozambique Journal Article In: Reproductive Health, vol. 12, iss. 1, pp. 161-165, 2015, ISSN: 17424755. Abstract \| BibTeX \| Tags: ACTs, Malaria, Pregnancy \| Links: Close Close @article{Tinto2015, title = {Assessment of the safety of antimalarial drug use during early pregnancy (ASAP): Protocol for a multicenter prospective cohort study in Burkina Faso, Kenya and Mozambique}, author = {Halidou Tinto and Esperan\c{c}a Sevene and Stephanie Dellicour and Gregory S. Calip and Umberto D'Alessandro and Eus\'{e}bio Macete and Seydou Nakanabo-Diallo and Adama Kazienga and Innocent Valea and Hermann Sorgho and Anifa Val\'{a} and Orvalho Augusto and Maria Ruperez and Clara Menendez and Peter Ouma and Meghna Desai and Feiko Ter Kuile and Andy Stergachis}, url = {https://www.internationalscholarsjournals.com/abstract/field-evaluation-of-sd-bioline-malaria-antigen-pf-forrnplasmodium-falciparum-malaria-diagnosis-in-nanorornburkina-faso-62349.html}, doi = {10.1186/s12978-015-0101-0}, issn = {17424755}, year = {2015}, date = {2015-01-01}, journal = {Reproductive Health}, volume = {12}, issue = {1}, pages = {161-165}, publisher = {BioMed Central Ltd.}, abstract = {Background: A major unresolved safety concern for malaria case management is the use of artemisinin combination therapies (ACTs) in the first trimester of pregnancy. There is a need for human data to inform policy makers and treatment guidelines on the safety of artemisinin combination therapies (ACT) when used during early pregnancy. Methods: The overall goal of this paper is to describe the methods and implementation of a study aimed at developing surveillance systems for identifying exposures to antimalarials during early pregnancy and for monitoring pregnancy outcomes using health and demographic surveillance platforms. This was a multi-center prospective observational cohort study involving women at health and demographic surveillance sites in three countries in Africa: Burkina Faso, Kenya and Mozambique [(ClinicalTrials.gov Identifier: NCT01232530)]. The study was designed to identify pregnant women with artemisinin exposure in the first trimester and compare them to: 1) pregnant women without malaria, 2) pregnant women treated for malaria, but exposed to other antimalarials, and 3) pregnant women with malaria and treated with artemisinins in the 2nd or 3rd trimesters from the same settings. Pregnant women were recruited through community-based surveys and attendance at health facilities, including antenatal care clinics and followed until delivery. Data from the three sites will be pooled for analysis at the end of the study. Results are forthcoming. Discussion: Despite few limitations, the methods described here are relevant to the development of sustainable pharmacovigilance systems for drugs used by pregnant women in the tropics using health and demographic surveillance sites to prospectively ascertain drug safety in early pregnancy.}, keywords = {ACTs, Malaria, Pregnancy}, pubstate = {published}, tppubtype = {article} } Close Background: A major unresolved safety concern for malaria case management is the use of artemisinin combination therapies (ACTs) in the first trimester of pregnancy. There is a need for human data to inform policy makers and treatment guidelines on the safety of artemisinin combination therapies (ACT) when used during early pregnancy. Methods: The overall goal of this paper is to describe the methods and implementation of a study aimed at developing surveillance systems for identifying exposures to antimalarials during early pregnancy and for monitoring pregnancy outcomes using health and demographic surveillance platforms. This was a multi-center prospective observational cohort study involving women at health and demographic surveillance sites in three countries in Africa: Burkina Faso, Kenya and Mozambique [(ClinicalTrials.gov Identifier: NCT01232530)]. The study was designed to identify pregnant women with artemisinin exposure in the first trimester and compare them to: 1) pregnant women without malaria, 2) pregnant women treated for malaria, but exposed to other antimalarials, and 3) pregnant women with malaria and treated with artemisinins in the 2nd or 3rd trimesters from the same settings. Pregnant women were recruited through community-based surveys and attendance at health facilities, including antenatal care clinics and followed until delivery. Data from the three sites will be pooled for analysis at the end of the study. Results are forthcoming. Discussion: Despite few limitations, the methods described here are relevant to the development of sustainable pharmacovigilance systems for drugs used by pregnant women in the tropics using health and demographic surveillance sites to prospectively ascertain drug safety in early pregnancy. Close

2024
Journal Articles
	Myriam El Gaaloul, Andre Marie Tchouatieu, Kassoum Kayentao, Brice Campo, Benedicte Buffet, Hanu Ramachandruni, Jean Louis Ndiaye, Timothy N. C. Wells, Celine Audibert, Jane Achan, Cristina Donini, Hellen C. Barsosio, Halidou Tinto Chemoprevention of malaria with long-acting oral and injectable drugs: an updated target product profile Journal Article In: Malaria journal, vol. 23, iss. 1, pp. 315, 2024, ISSN: 1475-2875. Abstract \| BibTeX \| Tags: Administration, Andre Marie Tchouatieu, Antimalarials* / administration & dosage, Antimalarials* / therapeutic use, Chemoprevention* / methods, doi:10.1186/s12936-024-05128-1, Female, Halidou Tinto, Humans, Injections, Malaria* / prevention & control, MEDLINE, Myriam El Gaaloul, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Oral, PMC11490162, pmid:39425110, Pregnancy, PubMed Abstract, Review \| Links: Close Close @article{nokey, title = {Chemoprevention of malaria with long-acting oral and injectable drugs: an updated target product profile}, author = {Myriam El Gaaloul and Andre Marie Tchouatieu and Kassoum Kayentao and Brice Campo and Benedicte Buffet and Hanu Ramachandruni and Jean Louis Ndiaye and Timothy N. C. Wells and Celine Audibert and Jane Achan and Cristina Donini and Hellen C. Barsosio and Halidou Tinto}, url = {https://pubmed.ncbi.nlm.nih.gov/39425110/}, doi = {10.1186/S12936-024-05128-1}, issn = {1475-2875}, year = {2024}, date = {2024-01-01}, journal = {Malaria journal}, volume = {23}, issue = {1}, pages = {315}, publisher = {Malar J}, abstract = {\<p\>Malaria is preventable, but the burden of disease remains high with over 249 million cases and 608,000 deaths reported in 2022. Historically, the most important protective interventions have been vector control and chemopreventive medicines with over 50 million children receiving seasonal malaria chemoprevention in the year 2023. Two vaccines are approved and starting to be deployed, bringing additional protection for children up to 36 months. However, the impact of these currently available tools is somewhat limited on various fronts. Vaccines exhibit partial efficacy, are relatively costly, and not accessible in all settings. The challenges encountered with chemoprevention are barriers to acceptability and feasibility, including frequency of dosing, and the lack of options in the first trimester of pregnancy and for women living with HIV. Also, the emergence of resistance against chemopreventive medicines is concerning. To address these limitations, a target product profile (TPP) is proposed as a road map to guide innovation and to boost the quest for novel chemopreventive alternatives. This TPP describes the ideal product attributes, while acknowledging potential trade-offs that may be needed. Critically, it considers the target populations most at risk; primarily infants, children, and pregnant women. Malaria control and elimination requires appropriate chemoprevention, not only in areas of high endemicity and transmission, but also in lower transmission areas where immunity is declining, as well as for travellers from areas where malaria has been eliminated. New medicines should show acceptable safety and tolerability, with high and long protective efficacy. Formulations and costs need to support operational adherence, access, and effectiveness. Next generation long-acting oral and injectable drugs are likely to constitute the backbone of malaria prevention. Therefore, the perspectives of front-line experts in malaria prevention, researchers, and those involved in drug development are captured in the TPP. This inclusive approach aims at concentrating efforts and aligning responses across the community to develop new and transformative medicines.\</p\>}, keywords = {Administration, Andre Marie Tchouatieu, Antimalarials* / administration \& dosage, Antimalarials* / therapeutic use, Chemoprevention* / methods, doi:10.1186/s12936-024-05128-1, Female, Halidou Tinto, Humans, Injections, Malaria* / prevention \& control, MEDLINE, Myriam El Gaaloul, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Oral, PMC11490162, pmid:39425110, Pregnancy, PubMed Abstract, Review}, pubstate = {published}, tppubtype = {article} } Close <p>Malaria is preventable, but the burden of disease remains high with over 249 million cases and 608,000 deaths reported in 2022. Historically, the most important protective interventions have been vector control and chemopreventive medicines with over 50 million children receiving seasonal malaria chemoprevention in the year 2023. Two vaccines are approved and starting to be deployed, bringing additional protection for children up to 36 months. However, the impact of these currently available tools is somewhat limited on various fronts. Vaccines exhibit partial efficacy, are relatively costly, and not accessible in all settings. The challenges encountered with chemoprevention are barriers to acceptability and feasibility, including frequency of dosing, and the lack of options in the first trimester of pregnancy and for women living with HIV. Also, the emergence of resistance against chemopreventive medicines is concerning. To address these limitations, a target product profile (TPP) is proposed as a road map to guide innovation and to boost the quest for novel chemopreventive alternatives. This TPP describes the ideal product attributes, while acknowledging potential trade-offs that may be needed. Critically, it considers the target populations most at risk; primarily infants, children, and pregnant women. Malaria control and elimination requires appropriate chemoprevention, not only in areas of high endemicity and transmission, but also in lower transmission areas where immunity is declining, as well as for travellers from areas where malaria has been eliminated. New medicines should show acceptable safety and tolerability, with high and long protective efficacy. Formulations and costs need to support operational adherence, access, and effectiveness. Next generation long-acting oral and injectable drugs are likely to constitute the backbone of malaria prevention. Therefore, the perspectives of front-line experts in malaria prevention, researchers, and those involved in drug development are captured in the TPP. This inclusive approach aims at concentrating efforts and aligning responses across the community to develop new and transformative medicines.</p> Close
	Irene Molina–de Fuente, Marc Christian Tahita, Kabore Bérenger, Thuy Huong Ta Tang, Luz García, Vicenta González, Agustín Benito, Judith M. Hübschen, Halidou Tinto, Pedro Berzosa Malaria diagnosis challenges and pfhrp2 and pfhrp3 gene deletions using pregnant women as sentinel population in Nanoro region, Burkina Faso Journal Article In: Pathogens and global health, vol. 118, iss. 6, 2024, ISSN: 2047-7732. Abstract \| BibTeX \| Tags: Adolescent, Adult, Antigens, Burkina Faso / epidemiology, Diagnostic Tests, doi:10.1080/20477724.2024.2388489, Falciparum* / diagnosis, Falciparum* / epidemiology, Falciparum* / parasitology, Female, Gene Deletion, Humans, Irene Molina-de la Fuente, Malaria, Marc Christian Tahita, MEDLINE, Microscopy, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Parasitic / diagnosis, Parasitic / epidemiology, Pedro Berzosa, Plasmodium falciparum / genetics, Plasmodium falciparum* / isolation & purification, PMC11441055, pmid:39140699, Pregnancy, Pregnancy Complications, Protozoan Proteins* / genetics, Protozoan* / genetics, PubMed Abstract, Research Support, Routine* / methods, Sensitivity and Specificity, Young Adult \| Links: Close Close @article{nokey, title = {Malaria diagnosis challenges and pfhrp2 and pfhrp3 gene deletions using pregnant women as sentinel population in Nanoro region, Burkina Faso}, author = {Irene Molina\textendashde Fuente and Marc Christian Tahita and Kabore B\'{e}renger and Thuy Huong Ta Tang and Luz Garc\'{i}a and Vicenta Gonz\'{a}lez and Agust\'{i}n Benito and Judith M. H\"{u}bschen and Halidou Tinto and Pedro Berzosa}, url = {https://pubmed.ncbi.nlm.nih.gov/39140699/}, doi = {10.1080/20477724.2024.2388489}, issn = {2047-7732}, year = {2024}, date = {2024-01-01}, journal = {Pathogens and global health}, volume = {118}, issue = {6}, publisher = {Pathog Glob Health}, abstract = {Malaria in pregnancy causes adverse consequences and prompt and accurate diagnosis is essential for case management. In malaria endemic countries, diagnosis is mainly based on rapid diagnostic tests (RDT) and microscopy. However, increasing reports of false negatives caused by low parasitemia and pfhrp2/3 deletions raise concerns about HRP2-based RDT usefulness. This study aimed to assess RDT and microscopy performance and to describe pfhrp2/3 deletions in a cohort of 418 pregnant women in Burkina Faso. Malaria was diagnosed using RDT and microscopy and blood samples were collected during antenatal care visits. Diagnostic results were compared to PCR as gold standard. Pfhrp2 and pfhrp3 deletions were characterized for patients with confirmed P. falciparum infection. RDT had better sensitivity (76%) but lower specificity (83%) than microscopy (sensitivity = 57%; specificity = 98%). Low parasitemia (\<150 parasites/µL), especially in multigravidae, was the principal factor causing false negatives by both methods. Moreover, pfhrp2 deletion frequency among overall false negatives by RDT was 21.43%. Higher frequency of deletions was found among all samples, independently of RDT result, for example around 2% of samples had double deletions meaning that the majority of deletions had no effect on RDT testing. Finally, it was found higher pfhrp2 deletion in women with lower uterine height during the first trimester. Wider and National surveillance study of deletions is recommended among pregnant women and in Burkina Faso.}, keywords = {Adolescent, Adult, Antigens, Burkina Faso / epidemiology, Diagnostic Tests, doi:10.1080/20477724.2024.2388489, Falciparum / diagnosis, Falciparum* / epidemiology, Falciparum* / parasitology, Female, Gene Deletion, Humans, Irene Molina-de la Fuente, Malaria, Marc Christian Tahita, MEDLINE, Microscopy, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Parasitic / diagnosis, Parasitic / epidemiology, Pedro Berzosa, Plasmodium falciparum / genetics, Plasmodium falciparum* / isolation \& purification, PMC11441055, pmid:39140699, Pregnancy, Pregnancy Complications, Protozoan Proteins* / genetics, Protozoan* / genetics, PubMed Abstract, Research Support, Routine* / methods, Sensitivity and Specificity*, Young Adult}, pubstate = {published}, tppubtype = {article} } Close Malaria in pregnancy causes adverse consequences and prompt and accurate diagnosis is essential for case management. In malaria endemic countries, diagnosis is mainly based on rapid diagnostic tests (RDT) and microscopy. However, increasing reports of false negatives caused by low parasitemia and pfhrp2/3 deletions raise concerns about HRP2-based RDT usefulness. This study aimed to assess RDT and microscopy performance and to describe pfhrp2/3 deletions in a cohort of 418 pregnant women in Burkina Faso. Malaria was diagnosed using RDT and microscopy and blood samples were collected during antenatal care visits. Diagnostic results were compared to PCR as gold standard. Pfhrp2 and pfhrp3 deletions were characterized for patients with confirmed P. falciparum infection. RDT had better sensitivity (76%) but lower specificity (83%) than microscopy (sensitivity = 57%; specificity = 98%). Low parasitemia (<150 parasites/µL), especially in multigravidae, was the principal factor causing false negatives by both methods. Moreover, pfhrp2 deletion frequency among overall false negatives by RDT was 21.43%. Higher frequency of deletions was found among all samples, independently of RDT result, for example around 2% of samples had double deletions meaning that the majority of deletions had no effect on RDT testing. Finally, it was found higher pfhrp2 deletion in women with lower uterine height during the first trimester. Wider and National surveillance study of deletions is recommended among pregnant women and in Burkina Faso. Close
	Ulugbek Khudayberdievich Mirzaev, Serge Ouoba, Ko Ko, Zayar Phyo, Chanroth Chhoung, Akuffo Golda Ataa, Aya Sugiyama, Tomoyuki Akita, Junko Tanaka Systematic review and meta-analysis of hepatitis E seroprevalence in Southeast Asia: a comprehensive assessment of epidemiological patterns Journal Article In: BMC infectious diseases, vol. 24, iss. 1, 2024, ISSN: 1471-2334. Abstract \| BibTeX \| Tags: Asia, doi:10.1186/s12879-024-09349-2, Female, Hepatitis Antibodies* / blood, Hepatitis E virus* / immunology, Hepatitis E* / blood, Hepatitis E* / epidemiology, Humans, Immunoglobulin G* / blood, Immunoglobulin M* / blood, Junko Tanaka, Male, MEDLINE, Meta-Analysis, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11127338, pmid:38789918, Pregnancy, Prevalence, PubMed Abstract, Risk Factors, Serge Ouoba, Seroepidemiologic Studies, Southeastern / epidemiology, Systematic review, Ulugbek Khudayberdievich Mirzaev \| Links: Close Close @article{Mirzaev2024, title = {Systematic review and meta-analysis of hepatitis E seroprevalence in Southeast Asia: a comprehensive assessment of epidemiological patterns}, author = {Ulugbek Khudayberdievich Mirzaev and Serge Ouoba and Ko Ko and Zayar Phyo and Chanroth Chhoung and Akuffo Golda Ataa and Aya Sugiyama and Tomoyuki Akita and Junko Tanaka}, url = {https://pubmed.ncbi.nlm.nih.gov/38789918/}, doi = {10.1186/S12879-024-09349-2}, issn = {1471-2334}, year = {2024}, date = {2024-01-01}, journal = {BMC infectious diseases}, volume = {24}, issue = {1}, publisher = {BMC Infect Dis}, abstract = {The burden of hepatitis E in Southeast Asia is substantial, influenced by its distinct socio-economic and environmental factors, as well as variations in healthcare systems. The aim of this study was to assess the pooled seroprevalence of hepatitis E across countries within the Southeast Asian region by the UN division. The study analyzed 66 papers across PubMed, Web of Science, and Scopus databases, encompassing data from of 44,850 individuals focusing on anti-HEV seroprevalence. The investigation spanned nine countries, excluding Brunei and East Timor due to lack of data. The pooled prevalence of anti-HEV IgG was determined to be 21.03%, with the highest prevalence observed in Myanmar (33.46%) and the lowest in Malaysia (5.93%). IgM prevalence was highest in Indonesia (12.43%) and lowest in Malaysia (0.91%). The study stratified populations into high-risk (farm workers, chronic patients) and low-risk groups (general population, blood donors, pregnant women, hospital patients). It revealed a higher IgG\textemdash28.9%, IgM\textemdash4.42% prevalence in the former group, while the latter group exhibited figures of 17.86% and 3.15%, respectively, indicating occupational and health-related vulnerabilities to HEV. A temporal analysis (1987\textendash2023), indicated an upward trend in both IgG and IgM prevalence, suggesting an escalating HEV burden. These findings contribute to a better understanding of HEV seroprevalence in Southeast Asia, shedding light on important public health implications and suggesting directions for further research and intervention strategies. Key points Research Question Investigate the seroprevalence of hepatitis E virus (HEV) in Southeast Asian countries focusing on different patterns, timelines, and population cohorts. Findings Sporadic Transmission of IgG and IgM Prevalence: • Pooled anti-HEV IgG prevalence: 21.03% • Pooled anti-HEV IgM prevalence: 3.49% Seroprevalence among specific groups: High-risk group (farm workers and chronic patients): • anti-HEV IgG: 28.9% • anti-HEV IgM: 4.42% Low-risk group (general population, blood donors, pregnant women, hospital patients): • anti-HEV IgG: 17.86% • anti-HEV IgM: 3.15% Temporal Seroprevalence of HEV: Anti-HEV IgG prevalence increased over decades (1987\textendash1999; 2000\textendash2010; 2011\textendash2023): 12.47%, 18.43%, 29.17% as an anti-HEV IgM prevalence: 1.92%, 2.44%, 5.27% Importance Provides a comprehensive overview of HEV seroprevalence in Southeast Asia. Highlights variation in seroprevalence among different population groups. Reveals increasing trend in HEV seroprevalence over the years. Distinguishes between sporadic and epidemic cases for a better understanding of transmission dynamics.}, keywords = {Asia, doi:10.1186/s12879-024-09349-2, Female, Hepatitis Antibodies* / blood, Hepatitis E virus* / immunology, Hepatitis E* / blood, Hepatitis E* / epidemiology, Humans, Immunoglobulin G* / blood, Immunoglobulin M* / blood, Junko Tanaka, Male, MEDLINE, Meta-Analysis, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11127338, pmid:38789918, Pregnancy, Prevalence, PubMed Abstract, Risk Factors, Serge Ouoba, Seroepidemiologic Studies, Southeastern / epidemiology, Systematic review, Ulugbek Khudayberdievich Mirzaev}, pubstate = {published}, tppubtype = {article} } Close The burden of hepatitis E in Southeast Asia is substantial, influenced by its distinct socio-economic and environmental factors, as well as variations in healthcare systems. The aim of this study was to assess the pooled seroprevalence of hepatitis E across countries within the Southeast Asian region by the UN division. The study analyzed 66 papers across PubMed, Web of Science, and Scopus databases, encompassing data from of 44,850 individuals focusing on anti-HEV seroprevalence. The investigation spanned nine countries, excluding Brunei and East Timor due to lack of data. The pooled prevalence of anti-HEV IgG was determined to be 21.03%, with the highest prevalence observed in Myanmar (33.46%) and the lowest in Malaysia (5.93%). IgM prevalence was highest in Indonesia (12.43%) and lowest in Malaysia (0.91%). The study stratified populations into high-risk (farm workers, chronic patients) and low-risk groups (general population, blood donors, pregnant women, hospital patients). It revealed a higher IgG—28.9%, IgM—4.42% prevalence in the former group, while the latter group exhibited figures of 17.86% and 3.15%, respectively, indicating occupational and health-related vulnerabilities to HEV. A temporal analysis (1987–2023), indicated an upward trend in both IgG and IgM prevalence, suggesting an escalating HEV burden. These findings contribute to a better understanding of HEV seroprevalence in Southeast Asia, shedding light on important public health implications and suggesting directions for further research and intervention strategies. Key points Research Question Investigate the seroprevalence of hepatitis E virus (HEV) in Southeast Asian countries focusing on different patterns, timelines, and population cohorts. Findings Sporadic Transmission of IgG and IgM Prevalence: • Pooled anti-HEV IgG prevalence: 21.03% • Pooled anti-HEV IgM prevalence: 3.49% Seroprevalence among specific groups: High-risk group (farm workers and chronic patients): • anti-HEV IgG: 28.9% • anti-HEV IgM: 4.42% Low-risk group (general population, blood donors, pregnant women, hospital patients): • anti-HEV IgG: 17.86% • anti-HEV IgM: 3.15% Temporal Seroprevalence of HEV: Anti-HEV IgG prevalence increased over decades (1987–1999; 2000–2010; 2011–2023): 12.47%, 18.43%, 29.17% as an anti-HEV IgM prevalence: 1.92%, 2.44%, 5.27% Importance Provides a comprehensive overview of HEV seroprevalence in Southeast Asia. Highlights variation in seroprevalence among different population groups. Reveals increasing trend in HEV seroprevalence over the years. Distinguishes between sporadic and epidemic cases for a better understanding of transmission dynamics. Close
	Kadiatou Koita, Joel D. Bognini, Efundem Agboraw, Mahamadou Dembélé, Seydou Yabré, Biébo Bihoun, Oumou Coulibaly, Hamidou Niangaly, Jean Batiste N’Takpé, Maia Lesosky, Dario Scaramuzzi, Eve Worrall, Jenny Hill, Valérie Briand, Halidou Tinto, Kassoum Kayentao Increasing the uptake of Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) through seasonal malaria chemoprevention channel delivery: protocol of a multicenter cluster randomized implementation trial in Mali and Burkina Faso Journal Article In: BMC public health, vol. 24, iss. 1, 2024, ISSN: 1471-2458. Abstract \| BibTeX \| Tags: Antimalarials* / therapeutic use, Burkina Faso, Chemoprevention, Child, Clinical Trial Protocol, doi:10.1186/s12889-023-17529-z, Drug Combinations, Female, Humans, Joel D Bognini, Kadiatou Koita, Kassoum Kayentao, Malaria* / drug therapy, Malaria* / prevention & control, Mali, MEDLINE, Multicenter Studies as Topic, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Parasitic* / prevention & control, PMC10763117, pmid:38166711, Pregnancy, Pregnancy Complications, Preschool, PubMed Abstract, Pyrimethamine / therapeutic use, Randomized Controlled Trials as Topic, Research Support, Seasons, Sulfadoxine / therapeutic use \| Links: Close Close @article{Koita2024, title = {Increasing the uptake of Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) through seasonal malaria chemoprevention channel delivery: protocol of a multicenter cluster randomized implementation trial in Mali and Burkina Faso}, author = {Kadiatou Koita and Joel D. Bognini and Efundem Agboraw and Mahamadou Demb\'{e}l\'{e} and Seydou Yabr\'{e} and Bi\'{e}bo Bihoun and Oumou Coulibaly and Hamidou Niangaly and Jean Batiste N’Takp\'{e} and Maia Lesosky and Dario Scaramuzzi and Eve Worrall and Jenny Hill and Val\'{e}rie Briand and Halidou Tinto and Kassoum Kayentao}, url = {https://pubmed.ncbi.nlm.nih.gov/38166711/}, doi = {10.1186/S12889-023-17529-Z}, issn = {1471-2458}, year = {2024}, date = {2024-01-01}, journal = {BMC public health}, volume = {24}, issue = {1}, publisher = {BMC Public Health}, abstract = {Background: The uptake of Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) remains unacceptably low, with more than two-thirds of pregnant women in sub-Saharan Africa still not accessing the three or more doses recommended by the World Health Organisation (WHO). In contrast, the coverage of Seasonal Malaria Chemoprevention (SMC), a more recent strategy recommended by the WHO for malaria prevention in children under five years living in Sahelian countries with seasonal transmission, including Mali and Burkina-Faso, is high (up to 90%). We hypothesized that IPTp-SP delivery to pregnant women through SMC alongside antenatal care (ANC) will increase IPTp-SP coverage, boost ANC attendance, and increase public health impact. This protocol describes the approach to assess acceptability, feasibility, effectiveness, and cost-effectiveness of the integrated strategy. Methods and analysis: This is a multicentre, cluster-randomized, implementation trial of IPTp-SP delivery through ANC + SMC vs ANC alone in 40 health facilities and their catchment populations (20 clusters per arm). The intervention will consist of monthly administration of IPTp-SP through four monthly rounds of SMC during the malaria transmission season (July to October), for two consecutive years. Effectiveness of the strategy to increase coverage of three or more doses of IPTp-SP (IPTp3 +) will be assessed using household surveys and ANC exit interviews. Statistical analysis of IPT3 + and four or more ANC uptake will use a generalized linear mixed model. Feasibility and acceptability will be assessed through in-depth interviews and focus group discussions with health workers, pregnant women, and women with a child \< 12 months. Discussion: This multicentre cluster randomized implementation trial powered to detect a 45% and 22% increase in IPTp-SP3 + uptake in Mali and Burkina-Faso, respectively, will generate evidence on the feasibility, acceptability, effectiveness, and cost-effectiveness of IPTp-SP delivered through the ANC + SMC channel. The intervention is designed to facilitate scalability and translation into policy by leveraging existing resources, while strengthening local capacities in research, health, and community institutions. Findings will inform the local national malaria control policies. Trial registration: Retrospectively registered on August 11th, 2022; registration # PACTR202208844472053. Protocol v4.0 dated September 04, 2023. Trail sponsor: University of Sciences Techniques and Technologies of Bamako (USTTB), Mali.}, keywords = {Antimalarials* / therapeutic use, Burkina Faso, Chemoprevention, Child, Clinical Trial Protocol, doi:10.1186/s12889-023-17529-z, Drug Combinations, Female, Humans, Joel D Bognini, Kadiatou Koita, Kassoum Kayentao, Malaria* / drug therapy, Malaria* / prevention \& control, Mali, MEDLINE, Multicenter Studies as Topic, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Parasitic* / prevention \& control, PMC10763117, pmid:38166711, Pregnancy, Pregnancy Complications, Preschool, PubMed Abstract, Pyrimethamine / therapeutic use, Randomized Controlled Trials as Topic, Research Support, Seasons, Sulfadoxine / therapeutic use}, pubstate = {published}, tppubtype = {article} } Close Background: The uptake of Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) remains unacceptably low, with more than two-thirds of pregnant women in sub-Saharan Africa still not accessing the three or more doses recommended by the World Health Organisation (WHO). In contrast, the coverage of Seasonal Malaria Chemoprevention (SMC), a more recent strategy recommended by the WHO for malaria prevention in children under five years living in Sahelian countries with seasonal transmission, including Mali and Burkina-Faso, is high (up to 90%). We hypothesized that IPTp-SP delivery to pregnant women through SMC alongside antenatal care (ANC) will increase IPTp-SP coverage, boost ANC attendance, and increase public health impact. This protocol describes the approach to assess acceptability, feasibility, effectiveness, and cost-effectiveness of the integrated strategy. Methods and analysis: This is a multicentre, cluster-randomized, implementation trial of IPTp-SP delivery through ANC + SMC vs ANC alone in 40 health facilities and their catchment populations (20 clusters per arm). The intervention will consist of monthly administration of IPTp-SP through four monthly rounds of SMC during the malaria transmission season (July to October), for two consecutive years. Effectiveness of the strategy to increase coverage of three or more doses of IPTp-SP (IPTp3 +) will be assessed using household surveys and ANC exit interviews. Statistical analysis of IPT3 + and four or more ANC uptake will use a generalized linear mixed model. Feasibility and acceptability will be assessed through in-depth interviews and focus group discussions with health workers, pregnant women, and women with a child < 12 months. Discussion: This multicentre cluster randomized implementation trial powered to detect a 45% and 22% increase in IPTp-SP3 + uptake in Mali and Burkina-Faso, respectively, will generate evidence on the feasibility, acceptability, effectiveness, and cost-effectiveness of IPTp-SP delivered through the ANC + SMC channel. The intervention is designed to facilitate scalability and translation into policy by leveraging existing resources, while strengthening local capacities in research, health, and community institutions. Findings will inform the local national malaria control policies. Trial registration: Retrospectively registered on August 11th, 2022; registration # PACTR202208844472053. Protocol v4.0 dated September 04, 2023. Trail sponsor: University of Sciences Techniques and Technologies of Bamako (USTTB), Mali. Close
2023
Journal Articles
	Japhet Kabalu Tshiongo, Flory Luzolo, Melissa Kabena, Lise Kuseke, Moussa Djimde, Patrick Mitashi, Crispin Lumbala, Kassoum Kayentao, Sandra Menting, Petra F. Mens, Henk D. F. H. Schallig, Pascal Lutumba, Halidou Tinto, Hypolite Muhindo Mavoko, Vivi Maketa Performance of ultra-sensitive malaria rapid diagnostic test to detect Plasmodium falciparum infection in pregnant women in Kinshasa, the Democratic Republic of the Congo Journal Article In: Malaria journal, vol. 22, iss. 1, 2023, ISSN: 1475-2875. Abstract \| BibTeX \| Tags: Antigens, Democratic Republic of the Congo, Diagnostic Tests, doi:10.1186/s12936-023-04749-2, Falciparum* / epidemiology, Female, Flory Luzolo, Humans, Japhet Kabalu Tshiongo, Malaria, Malaria, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Plasmodium falciparum, PMC10594769, pmid:37872634, Pregnancy, Pregnant Women, Protozoan, PubMed Abstract, Rapid diagnostic tests, Routine / methods, Sensitivity and Specificity, Vivi Maketa \| Links: Close Close @article{nokey, title = {Performance of ultra-sensitive malaria rapid diagnostic test to detect Plasmodium falciparum infection in pregnant women in Kinshasa, the Democratic Republic of the Congo}, author = {Japhet Kabalu Tshiongo and Flory Luzolo and Melissa Kabena and Lise Kuseke and Moussa Djimde and Patrick Mitashi and Crispin Lumbala and Kassoum Kayentao and Sandra Menting and Petra F. Mens and Henk D. F. H. Schallig and Pascal Lutumba and Halidou Tinto and Hypolite Muhindo Mavoko and Vivi Maketa}, url = {https://pubmed.ncbi.nlm.nih.gov/37872634/}, doi = {10.1186/S12936-023-04749-2}, issn = {1475-2875}, year = {2023}, date = {2023-01-01}, journal = {Malaria journal}, volume = {22}, issue = {1}, publisher = {Malar J}, abstract = {Background: Low peripheral parasitaemia caused by sequestration of Plasmodium falciparum in the placenta hampers the diagnosis of malaria in pregnant women, leading to microscopy or conventional rapid diagnostic tests (RDTs) false-negative results. Although mainly asymptomatic, maternal malaria remains harmful to pregnant women and their offspring in endemic settings and must be adequately diagnosed. Ultra-sensitive RDTs (uRDTs) are thought to be more sensitive than RDTs, and their diagnostic performance was assessed in the current study in pregnant women living in Kinshasa, a stable malaria transmission area in the Democratic Republic of the Congo. Methods: To assess and compare the diagnostic performances of both RDTs and uRDTs, 497 peripheral blood samples were tested using microscopy and quantitative polymerase chain reaction (qPCR) as the index and the reference tests, respectively. The agreement between the different diagnostic tests assessed was estimated by Cohen's Kappa test. Results: The median parasite density by qPCR was 292 p/μL of blood [IQR (49.7\textendash1137)]. Using qPCR as the reference diagnostic test, the sensitivities of microscopy, RDT and uRDT were respectively [55.7% (95% CI 47.6\textendash63.6)], [81.7% (95%CI 74.7\textendash87.3)] and [88% (95% CI 81.9\textendash92.6)]. The specificities of the tests were calculated at 98.5% (95% CI 96.6\textendash99.5), 95.2% (95% CI 92.5\textendash97.2) and 94.4% (95% CI 91.4\textendash96.6) for microscopy, RDT and uRDT, respectively. The agreement between qPCR and uRDT was almost perfect (Kappa = 0.82). For parasite density (qPCR) below 100 p/µL, the sensitivity of RDT was 62% (95% CI 47.1\textendash75.3) compared to 68% (95% CI 53.3\textendash80.4) for uRDT. Between 100 and 200 p/µL, the sensitivity of RDT was higher, but still lower compared to uRDT: 89.4% (95% CI 66.8\textendash98.7) for RDT versus 100% (95% CI 82.3\textendash100) for uRDT. In both cases, microscopy was lower, with 20% (95% CI 10\textendash33.7) and 47.3% (95% CI 24.4\textendash71.1) respectively. Conclusions: uRDT has the potential to improve malaria management in pregnant women as it has been found to be slightly more sensitive than RDT in the detection of malaria in pregnant women but the difference was not significant. Microscopy has a more limited value for the diagnosis of malaria during the pregnancy, because of its lower sensitivity.}, keywords = {Antigens, Democratic Republic of the Congo, Diagnostic Tests, doi:10.1186/s12936-023-04749-2, Falciparum / epidemiology, Female, Flory Luzolo, Humans, Japhet Kabalu Tshiongo, Malaria, Malaria*, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Plasmodium falciparum, PMC10594769, pmid:37872634, Pregnancy, Pregnant Women, Protozoan, PubMed Abstract, Rapid diagnostic tests, Routine / methods, Sensitivity and Specificity, Vivi Maketa}, pubstate = {published}, tppubtype = {article} } Close Background: Low peripheral parasitaemia caused by sequestration of Plasmodium falciparum in the placenta hampers the diagnosis of malaria in pregnant women, leading to microscopy or conventional rapid diagnostic tests (RDTs) false-negative results. Although mainly asymptomatic, maternal malaria remains harmful to pregnant women and their offspring in endemic settings and must be adequately diagnosed. Ultra-sensitive RDTs (uRDTs) are thought to be more sensitive than RDTs, and their diagnostic performance was assessed in the current study in pregnant women living in Kinshasa, a stable malaria transmission area in the Democratic Republic of the Congo. Methods: To assess and compare the diagnostic performances of both RDTs and uRDTs, 497 peripheral blood samples were tested using microscopy and quantitative polymerase chain reaction (qPCR) as the index and the reference tests, respectively. The agreement between the different diagnostic tests assessed was estimated by Cohen's Kappa test. Results: The median parasite density by qPCR was 292 p/μL of blood [IQR (49.7–1137)]. Using qPCR as the reference diagnostic test, the sensitivities of microscopy, RDT and uRDT were respectively [55.7% (95% CI 47.6–63.6)], [81.7% (95%CI 74.7–87.3)] and [88% (95% CI 81.9–92.6)]. The specificities of the tests were calculated at 98.5% (95% CI 96.6–99.5), 95.2% (95% CI 92.5–97.2) and 94.4% (95% CI 91.4–96.6) for microscopy, RDT and uRDT, respectively. The agreement between qPCR and uRDT was almost perfect (Kappa = 0.82). For parasite density (qPCR) below 100 p/µL, the sensitivity of RDT was 62% (95% CI 47.1–75.3) compared to 68% (95% CI 53.3–80.4) for uRDT. Between 100 and 200 p/µL, the sensitivity of RDT was higher, but still lower compared to uRDT: 89.4% (95% CI 66.8–98.7) for RDT versus 100% (95% CI 82.3–100) for uRDT. In both cases, microscopy was lower, with 20% (95% CI 10–33.7) and 47.3% (95% CI 24.4–71.1) respectively. Conclusions: uRDT has the potential to improve malaria management in pregnant women as it has been found to be slightly more sensitive than RDT in the detection of malaria in pregnant women but the difference was not significant. Microscopy has a more limited value for the diagnosis of malaria during the pregnancy, because of its lower sensitivity. Close
	Hamtandi Magloire Natama, Gemma Moncunill, Marta Vidal, Toussaint Rouamba, Ruth Aguilar, Rebeca Santano, Eduard Rovira-Vallbona, Alfons Jiménez, M. Athanase Somé, Hermann Sorgho, Innocent Valéa, Maminata Coulibaly-Traoré, Ross L. Coppel, David Cavanagh, Chetan E. Chitnis, James G. Beeson, Evelina Angov, Sheetij Dutta, Benoit Gamain, Luis Izquierdo, Petra F. Mens, Henk D. F. H. Schallig, Halidou Tinto, Anna Rosanas-Urgell, Carlota Dobaño Associations between prenatal malaria exposure, maternal antibodies at birth, and malaria susceptibility during the first year of life in Burkina Faso Journal Article In: Infection and immunity, vol. 91, iss. 10, pp. 290, 2023, ISSN: 1098-5522. Abstract \| BibTeX \| Tags: Antibodies, Antigens, Burkina Faso / epidemiology, Carlota Dobaño, Child, Cohort Studies, doi:10.1128/iai.00268-23, Falciparum, Female, Gemma Moncunill, Hamtandi Magloire Natama, Humans, Immunoglobulin G, Infant, Malaria, Malaria / epidemiology, Maternal Exposure, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, Newborn, NIH, NLM, placenta, Plasmodium falciparum, PMC10580994, pmid:37754682, Pregnancy, Preschool, Protozoan, PubMed Abstract \| Links: Close Close @article{Natama2023, title = {Associations between prenatal malaria exposure, maternal antibodies at birth, and malaria susceptibility during the first year of life in Burkina Faso}, author = {Hamtandi Magloire Natama and Gemma Moncunill and Marta Vidal and Toussaint Rouamba and Ruth Aguilar and Rebeca Santano and Eduard Rovira-Vallbona and Alfons Jim\'{e}nez and M. Athanase Som\'{e} and Hermann Sorgho and Innocent Val\'{e}a and Maminata Coulibaly-Traor\'{e} and Ross L. Coppel and David Cavanagh and Chetan E. Chitnis and James G. Beeson and Evelina Angov and Sheetij Dutta and Benoit Gamain and Luis Izquierdo and Petra F. Mens and Henk D. F. H. Schallig and Halidou Tinto and Anna Rosanas-Urgell and Carlota Doba\~{n}o}, url = {https://pubmed.ncbi.nlm.nih.gov/37754682/}, doi = {10.1128/IAI.00268-23}, issn = {1098-5522}, year = {2023}, date = {2023-01-01}, journal = {Infection and immunity}, volume = {91}, issue = {10}, pages = {290}, publisher = {Infect Immun}, abstract = {In this study, we investigated how different categories of prenatal malaria exposure (PME) influence levels of maternal antibodies in cord blood samples and the subsequent risk of malaria in early childhood in a birth cohort study (N = 661) nested within the COSMIC clinical trial (NCT01941264) in Burkina Faso. Plasmodium falciparum infections during pregnancy and infants’ clinical malaria episodes detected during the first year of life were recorded. The levels of maternal IgG and IgG1-4 to 15 P. falciparum antigens were measured in cord blood by quantitative suspension array technology. Results showed a significant variation in the magnitude of maternal antibody levels in cord blood, depending on the PME category, with past placental malaria (PM) more frequently associated with significant increases of IgG and/or subclass levels across three groups of antigens defined as pre-erythrocytic, erythrocytic, and markers of PM, as compared to those from the cord of non-exposed control infants. High levels of antibodies to certain erythrocytic antigens (i.e., IgG to EBA140 and EBA175, IgG1 to EBA175 and MSP142, and IgG3 to EBA140 and MSP5) were independent predictors of protection from clinical malaria during the first year of life. By contrast, high levels of IgG, IgG1, and IgG2 to the VAR2CSA DBL1-2 and IgG4 to DBL3-4 were significantly associated with an increased risk of clinical malaria. These findings indicate that PME categories have different effects on the levels of maternal-derived antibodies to malaria antigens in children at birth, and this might drive heterogeneity to clinical malaria susceptibility in early childhood.}, keywords = {Antibodies, Antigens, Burkina Faso / epidemiology, Carlota Doba\~{n}o, Child, Cohort Studies, doi:10.1128/iai.00268-23, Falciparum, Female, Gemma Moncunill, Hamtandi Magloire Natama, Humans, Immunoglobulin G, Infant, Malaria, Malaria / epidemiology, Maternal Exposure, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, Newborn, NIH, NLM, placenta, Plasmodium falciparum, PMC10580994, pmid:37754682, Pregnancy, Preschool, Protozoan, PubMed Abstract}, pubstate = {published}, tppubtype = {article} } Close In this study, we investigated how different categories of prenatal malaria exposure (PME) influence levels of maternal antibodies in cord blood samples and the subsequent risk of malaria in early childhood in a birth cohort study (N = 661) nested within the COSMIC clinical trial (NCT01941264) in Burkina Faso. Plasmodium falciparum infections during pregnancy and infants’ clinical malaria episodes detected during the first year of life were recorded. The levels of maternal IgG and IgG1-4 to 15 P. falciparum antigens were measured in cord blood by quantitative suspension array technology. Results showed a significant variation in the magnitude of maternal antibody levels in cord blood, depending on the PME category, with past placental malaria (PM) more frequently associated with significant increases of IgG and/or subclass levels across three groups of antigens defined as pre-erythrocytic, erythrocytic, and markers of PM, as compared to those from the cord of non-exposed control infants. High levels of antibodies to certain erythrocytic antigens (i.e., IgG to EBA140 and EBA175, IgG1 to EBA175 and MSP142, and IgG3 to EBA140 and MSP5) were independent predictors of protection from clinical malaria during the first year of life. By contrast, high levels of IgG, IgG1, and IgG2 to the VAR2CSA DBL1-2 and IgG4 to DBL3-4 were significantly associated with an increased risk of clinical malaria. These findings indicate that PME categories have different effects on the levels of maternal-derived antibodies to malaria antigens in children at birth, and this might drive heterogeneity to clinical malaria susceptibility in early childhood. Close
	Moussa Djimde, Japhet Kabalu Tshiongo, Hypolite Mavoko Muhindo, Halidou Tinto, Esperanca Sevene, Maminata Traore, Anifa Vala, Salesio MacUacua, Berenger Kabore, Edgard Diniba Dabira, Annette Erhart, Hamadoun Diakite, Mohamed Keita, Mireia Piqueras, Raquel González, Clara Menendez, Thomas P. C. Dorlo, Issaka Sagara, Petra Mens, Henk Schallig, Umberto D'Alessandro, Kassoum Kayentao Efficacy and safety of pyronaridine-artesunate (PYRAMAX) for the treatment of P. falciparum uncomplicated malaria in African pregnant women (PYRAPREG): study protocol for a phase 3, non-inferiority, randomised open-label clinical trial Journal Article In: BMJ open, vol. 13, iss. 10, 2023, ISSN: 2044-6055. Abstract \| BibTeX \| Tags: Antimalarials* / adverse effects, Artemether, Artemether / therapeutic use, Artemisinins* / adverse effects, Clinical Trial Protocol, Clinical Trials, doi:10.1136/bmjopen-2022-065295, Drug Combinations, Falciparum* / drug therapy, Female, Humans, Infant, Japhet Kabalu Tshiongo, Kassoum Kayentao, Lumefantrine Drug Combination / therapeutic use, Malaria, Malaria* / drug therapy, MEDLINE, Moussa Djimde, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Phase III as Topic, PMC10565244, pmid:37813539, Pregnancy, Pregnant Women, PubMed Abstract, Randomized Controlled Trials as Topic, Research Support, Sub-Saharan African People, Treatment Outcome \| Links: Close Close @article{Djimde2023, title = {Efficacy and safety of pyronaridine-artesunate (PYRAMAX) for the treatment of P. falciparum uncomplicated malaria in African pregnant women (PYRAPREG): study protocol for a phase 3, non-inferiority, randomised open-label clinical trial}, author = {Moussa Djimde and Japhet Kabalu Tshiongo and Hypolite Mavoko Muhindo and Halidou Tinto and Esperanca Sevene and Maminata Traore and Anifa Vala and Salesio MacUacua and Berenger Kabore and Edgard Diniba Dabira and Annette Erhart and Hamadoun Diakite and Mohamed Keita and Mireia Piqueras and Raquel Gonz\'{a}lez and Clara Menendez and Thomas P. C. Dorlo and Issaka Sagara and Petra Mens and Henk Schallig and Umberto D'Alessandro and Kassoum Kayentao}, url = {https://pubmed.ncbi.nlm.nih.gov/37813539/}, doi = {10.1136/BMJOPEN-2022-065295}, issn = {2044-6055}, year = {2023}, date = {2023-01-01}, journal = {BMJ open}, volume = {13}, issue = {10}, publisher = {BMJ Open}, abstract = {Introduction Malaria infection during pregnancy increases the risk of low birth weight and infant mortality and should be prevented and treated. Artemisinin-based combination treatments are generally well tolerated, safe and effective; the most used being artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP). Pyronaridine-artesunate (PA) is a new artemisinin-based combination. The main objective of this study is to determine the efficacy and safety of PA versus AL or DP when administered to pregnant women with confirmed Plasmodium falciparum infection in the second or third trimester. The primary hypothesis is the pairwise non-inferiority of PA as compared with either AL or DP. Methods and analysis A phase 3, non-inferiority, randomised, open-label clinical trial to determine the safety and efficacy of AL, DP and PA in pregnant women with malaria in five sub-Saharan, malaria-endemic countries (Burkina Faso, Democratic Republic of the Congo, Mali, Mozambique and the Gambia). A total of 1875 pregnant women will be randomised to one of the treatment arms. Women will be actively monitored until Day 63 post-treatment, at delivery and 4-6 weeks after delivery, and infants' health will be checked on their first birthday. The primary endpoint is the PCR-adjusted rate of adequate clinical and parasitological response at Day 42 in the per-protocol population. Ethics and dissemination This protocol has been approved by the Ethics Committee for Health Research in Burkina Faso, the National Health Ethics Committee in the Democratic Republic of Congo, the Ethics Committee of the Faculty of Medicine and Odontostomatology/Faculty of Pharmacy in Mali, the Gambia Government/MRCG Joint Ethics Committee and the National Bioethics Committee for Health in Mozambique. Written informed consent will be obtained from each individual prior to her participation in the study. The results will be published in peer-reviewed open access journals and presented at (inter)national conferences and meetings. Trial registration number PACTR202011812241529.}, keywords = {Antimalarials* / adverse effects, Artemether, Artemether / therapeutic use, Artemisinins* / adverse effects, Clinical Trial Protocol, Clinical Trials, doi:10.1136/bmjopen-2022-065295, Drug Combinations, Falciparum* / drug therapy, Female, Humans, Infant, Japhet Kabalu Tshiongo, Kassoum Kayentao, Lumefantrine Drug Combination / therapeutic use, Malaria, Malaria* / drug therapy, MEDLINE, Moussa Djimde, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Phase III as Topic, PMC10565244, pmid:37813539, Pregnancy, Pregnant Women, PubMed Abstract, Randomized Controlled Trials as Topic, Research Support, Sub-Saharan African People, Treatment Outcome}, pubstate = {published}, tppubtype = {article} } Close Introduction Malaria infection during pregnancy increases the risk of low birth weight and infant mortality and should be prevented and treated. Artemisinin-based combination treatments are generally well tolerated, safe and effective; the most used being artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP). Pyronaridine-artesunate (PA) is a new artemisinin-based combination. The main objective of this study is to determine the efficacy and safety of PA versus AL or DP when administered to pregnant women with confirmed Plasmodium falciparum infection in the second or third trimester. The primary hypothesis is the pairwise non-inferiority of PA as compared with either AL or DP. Methods and analysis A phase 3, non-inferiority, randomised, open-label clinical trial to determine the safety and efficacy of AL, DP and PA in pregnant women with malaria in five sub-Saharan, malaria-endemic countries (Burkina Faso, Democratic Republic of the Congo, Mali, Mozambique and the Gambia). A total of 1875 pregnant women will be randomised to one of the treatment arms. Women will be actively monitored until Day 63 post-treatment, at delivery and 4-6 weeks after delivery, and infants' health will be checked on their first birthday. The primary endpoint is the PCR-adjusted rate of adequate clinical and parasitological response at Day 42 in the per-protocol population. Ethics and dissemination This protocol has been approved by the Ethics Committee for Health Research in Burkina Faso, the National Health Ethics Committee in the Democratic Republic of Congo, the Ethics Committee of the Faculty of Medicine and Odontostomatology/Faculty of Pharmacy in Mali, the Gambia Government/MRCG Joint Ethics Committee and the National Bioethics Committee for Health in Mozambique. Written informed consent will be obtained from each individual prior to her participation in the study. The results will be published in peer-reviewed open access journals and presented at (inter)national conferences and meetings. Trial registration number PACTR202011812241529. Close
	Anna Maria Eijk, Kasia Stepniewska, Jenny Hill, Steve M. Taylor, Stephen J. Rogerson, Gilles Cottrell, R. Matthew Chico, Julie R. Gutman, Halidou Tinto, Holger W. Unger, Stephanie K. Yanow, Steven R. Meshnick, Feiko O. Kuile, Alfredo Mayor, Steve M. Taylor, Stephen J. Rogerson, R. Matthew Chico, Julie R. Gutman, Hallidou Tinto, Holger W. Unger, Stephanie K. Yanow, Manfred Accrombessi, Ayola A. Adegnika, Rukhsana Ahmed, Eliana María Arango-Flórez, Myriam Arevalo-Herrera, Emmanual Arinaitwe, Paulo Arnaldo, Per Ashorn, Ulla Ashorn, Azucena Bardaji, Inoni Betuela, Praveen K. Bharti, Francis Bohissou, Camila Bôtto-Menezes, Vera Braun, Valerie Briand, Jessica Briggs, María Eugenia Castellanos, Daniel Chandramohan, Enesia Banda Chaponda, Chetan Chitnis, Lauren M. Cohee, Michel Cot, Umberto d'Alessandro, Lise Denoeud-Ndam, Meghna Desai, Alassane Dicko, Xavier Ding, Grant Dorsey, Patrick E. Duffy, Maha A. Elbadry, Sonia M. Enosse, Yue Fan, Nadine Fievet, Michal Fried, Blaise Genton, Raquel Gonzalez, Brian Greenwood, Linda Kalilani, Johanna H. Kattenberg, Kassoum Kayentao, Carole Khairallah, Christopher L. King, Dhanpat Kumar Kochar, Swati Kochar, Felix Koukouikila-Koussounda, Sarah H. Landis, Miriam K. Laufer, Rose F. Leke, Eusebio Macete, Sonia Maculuve, Mwayiwawo Madanitsa, Almahamoudou Mahamar, Ken Maleta, Indu Malhotra, Rella Zoleko Manego, Flor Ernestina Martinez-Espinosa, Achille Massougbodji, Don Mathanga, Michela Menegon, Clara Menendez, Petra Mens, Martin Meremikwu, Frank P. Mockenhaupt, Ghyslain Mombo-Ngoma, Dominic Mosha, Ivo Mueller, Alain Nahum, Paul Natureeba, Nicaise Ndam, Francine Ntoumi, Olabisi A. Oduwole, Bernard A. Okech, Maria Ome-Kaius, Kephas Otieno, Norma Padilla, Michal Ramharter, Rosemary Rochford, Anna Rosanas-Urgell, Maria Ruperez, Katherine R. Sabourin, Sergi Sanz, Henk D. Schallig, Susana Scott, Esperanca Sevene, Carlo Severini, Harry Tagbor, Diane Wallace Taylor, Maminata Traore Coulibaly, Ana Vasquez, Annie Walker-Abbey, Blair J. Wylie, Djimon M. Zannou, Stephen R. Meshnick Prevalence of and risk factors for microscopic and submicroscopic malaria infections in pregnancy: a systematic review and meta-analysis Journal Article In: The Lancet. Global health, vol. 11, iss. 7, pp. e1061-e1074, 2023, ISSN: 2214-109X. Abstract \| BibTeX \| Tags: {Adult, Anna Maria van Eijk, Antimalarials* / therapeutic use, Author(firstnames='Achille', Author(firstnames='Alain', Author(firstnames='Alassane', Author(firstnames='Alfredo', Author(firstnames='Almahamoudou', Author(firstnames='Ana', Author(firstnames='Anna', Author(firstnames='Annie', Author(firstnames='Ayola A', Author(firstnames='Azucena', Author(firstnames='Bernard A', Author(firstnames='Blair J', Author(firstnames='Blaise', Author(firstnames='Brian', Author(firstnames='Camila', Author(firstnames='Carlo', Author(firstnames='Carole', Author(firstnames='Chetan', Author(firstnames='Christopher L', Author(firstnames='Clara', Author(firstnames='Daniel', Author(firstnames='Dhanpat Kumar', Author(firstnames='Diane Wallace', Author(firstnames='Djimon M', Author(firstnames='Dominic', Author(firstnames='Don', Author(firstnames='Eliana María', Author(firstnames='Emmanual', Author(firstnames='Enesia Banda', Author(firstnames='Esperanca', Author(firstnames='Eusebio', Author(firstnames='Feiko O', Author(firstnames='Felix', Author(firstnames='Flor Ernestina', Author(firstnames='Francine', Author(firstnames='Francis', Author(firstnames='Frank P', Author(firstnames='Ghyslain', Author(firstnames='Gilles', Author(firstnames='Grant', Author(firstnames='Hallidou', Author(firstnames='Harry', Author(firstnames='Henk D', Author(firstnames='Holger W', Author(firstnames='Indu', Author(firstnames='Inoni', Author(firstnames='Ivo', Author(firstnames='Jenny', Author(firstnames='Jessica', Author(firstnames='Johanna H', Author(firstnames='Julie R', Author(firstnames='Kasia', Author(firstnames='Kassoum', Author(firstnames='Katherine R', Author(firstnames='Ken', Author(firstnames='Kephas', Author(firstnames='Lauren M', Author(firstnames='Linda', Author(firstnames='Lise', Author(firstnames='Maha A', Author(firstnames='Maminata', Author(firstnames='Manfred', Author(firstnames='María Eugenia', Author(firstnames='Maria', Author(firstnames='Martin', Author(firstnames='Meghna', Author(firstnames='Michal', Author(firstnames='Michel', Author(firstnames='Michela', Author(firstnames='Miriam K', Author(firstnames='Mwayiwawo', Author(firstnames='Myriam', Author(firstnames='Nadine', Author(firstnames='Nicaise', Author(firstnames='Norma', Author(firstnames='Olabisi A', Author(firstnames='Patrick E', Author(firstnames='Paul', Author(firstnames='Paulo', Author(firstnames='Per', Author(firstnames='Petra', Author(firstnames='Praveen K', Author(firstnames='R Matthew', Author(firstnames='Raquel', Author(firstnames='Rella', Author(firstnames='Rose F', Author(firstnames='Rosemary', Author(firstnames='Rukhsana', Author(firstnames='Sarah H', Author(firstnames='Sergi', Author(firstnames='Sonia M', Author(firstnames='Sonia', Author(firstnames='Stephanie K', Author(firstnames='Stephen J', Author(firstnames='Stephen R', Author(firstnames='Steve M', Author(firstnames='Susana', Author(firstnames='Swati', Author(firstnames='Ulla', Author(firstnames='Umberto', Author(firstnames='Valerie', Author(firstnames='Vera', Author(firstnames='Xavier', Author(firstnames='Yue', CollabAuthor(name='Subpatent Malaria in Pregnancy Group', Falciparum* / drug therapy, Female, Humans, Kasia Stepniewska, Malaria, Malaria* / prevention & control, MEDLINE, Meta-Analysis, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, P.H.S., PMC10880462, Pregnancy, Prevalence, PubMed Abstract, Research Support, Risk Factors, Systematic review, U.S. Gov't \| Links: Close Close @article{nokey, title = {Prevalence of and risk factors for microscopic and submicroscopic malaria infections in pregnancy: a systematic review and meta-analysis}, author = {Anna Maria Eijk and Kasia Stepniewska and Jenny Hill and Steve M. Taylor and Stephen J. Rogerson and Gilles Cottrell and R. Matthew Chico and Julie R. Gutman and Halidou Tinto and Holger W. Unger and Stephanie K. Yanow and Steven R. Meshnick and Feiko O. Kuile and Alfredo Mayor and Steve M. Taylor and Stephen J. Rogerson and R. Matthew Chico and Julie R. Gutman and Hallidou Tinto and Holger W. Unger and Stephanie K. Yanow and Manfred Accrombessi and Ayola A. Adegnika and Rukhsana Ahmed and Eliana Mar\'{i}a Arango-Fl\'{o}rez and Myriam Arevalo-Herrera and Emmanual Arinaitwe and Paulo Arnaldo and Per Ashorn and Ulla Ashorn and Azucena Bardaji and Inoni Betuela and Praveen K. Bharti and Francis Bohissou and Camila B\^{o}tto-Menezes and Vera Braun and Valerie Briand and Jessica Briggs and Mar\'{i}a Eugenia Castellanos and Daniel Chandramohan and Enesia Banda Chaponda and Chetan Chitnis and Lauren M. Cohee and Michel Cot and Umberto d'Alessandro and Lise Denoeud-Ndam and Meghna Desai and Alassane Dicko and Xavier Ding and Grant Dorsey and Patrick E. Duffy and Maha A. Elbadry and Sonia M. Enosse and Yue Fan and Nadine Fievet and Michal Fried and Blaise Genton and Raquel Gonzalez and Brian Greenwood and Linda Kalilani and Johanna H. Kattenberg and Kassoum Kayentao and Carole Khairallah and Christopher L. King and Dhanpat Kumar Kochar and Swati Kochar and Felix Koukouikila-Koussounda and Sarah H. Landis and Miriam K. Laufer and Rose F. Leke and Eusebio Macete and Sonia Maculuve and Mwayiwawo Madanitsa and Almahamoudou Mahamar and Ken Maleta and Indu Malhotra and Rella Zoleko Manego and Flor Ernestina Martinez-Espinosa and Achille Massougbodji and Don Mathanga and Michela Menegon and Clara Menendez and Petra Mens and Martin Meremikwu and Frank P. Mockenhaupt and Ghyslain Mombo-Ngoma and Dominic Mosha and Ivo Mueller and Alain Nahum and Paul Natureeba and Nicaise Ndam and Francine Ntoumi and Olabisi A. Oduwole and Bernard A. Okech and Maria Ome-Kaius and Kephas Otieno and Norma Padilla and Michal Ramharter and Rosemary Rochford and Anna Rosanas-Urgell and Maria Ruperez and Katherine R. Sabourin and Sergi Sanz and Henk D. Schallig and Susana Scott and Esperanca Sevene and Carlo Severini and Harry Tagbor and Diane Wallace Taylor and Maminata Traore Coulibaly and Ana Vasquez and Annie Walker-Abbey and Blair J. Wylie and Djimon M. Zannou and Stephen R. Meshnick}, url = {https://pubmed.ncbi.nlm.nih.gov/37276878/}, doi = {10.1016/S2214-109X(23)00194-8}, issn = {2214-109X}, year = {2023}, date = {2023-01-01}, journal = {The Lancet. Global health}, volume = {11}, issue = {7}, pages = {e1061-e1074}, publisher = {Lancet Glob Health}, abstract = {Background: Malaria infections during pregnancy can cause adverse birth outcomes, yet many infections are undetected by microscopy. We aimed to describe the epidemiology of submicroscopic malaria infections in pregnant women in Asia, the Americas, and Africa using aggregated and individual participant data (IPD). Methods: For this systematic review and meta-analysis, studies (published Jan 1, 1997 to Nov 10, 2021) with information on both microscopic and submicroscopic infections during pregnancy from Asia, the Americas, or Africa, identified in the Malaria-in-Pregnancy Library, were eligible. Studies (or subgroups or study groups) that selected participants on the basis of the presence of fever or a positive blood smear were excluded to avoid selection bias. We obtained IPD (when available) and aggregated data. Estimates of malaria transmission intensity and sulfadoxine\textendashpyrimethamine resistance, matched by study location and year, were obtained using publicly available data. One-stage multivariable logit and multinomial models with random intercepts for study site were used in meta-analysis to assess prevalence of and risk factors for submicroscopic infections during pregnancy and at delivery. This study is registered with PROSPERO, number CRD42015027342. Findings: The search identified 87 eligible studies, 68 (78%) of which contributed to the analyses. Of these 68 studies, 45 (66%) studies contributed IPD (48 869 participants) and 23 (34%) studies contributed aggregated data (11 863 participants). During pregnancy, median prevalence estimates were 13·5% (range 0·0\textendash55·9, 66 substudies) for submicroscopic and 8·0% (0·0\textendash50·6, 66 substudies) for microscopic malaria. Among women with positive Plasmodium nucleic acid amplification tests (NAATs), the median proportion of submicroscopic infections was 58·7% (range 0·0\textendash100); this proportion was highest in the Americas (73·3%, 0·0\textendash100), followed by Asia (67·2%, 36·4\textendash100) and Africa (56·5%, 20·5\textendash97·7). In individual patient data analysis, compared with women with no malaria infections, those with submicroscopic infections were more likely to present with fever in Africa (adjusted odds ratio 1·32, 95% CI 1·02\textendash1·72; p=0·038) but not in other regions. Among women with NAAT-positive infections in Asia and the Americas, Plasmodium vivax infections were more likely to be submicroscopic than Plasmodium falciparum infections (3·69, 2·45\textendash5·54; p\<0·0001). Risk factors for submicroscopic infections among women with NAAT-positive infections in Africa included older age (age ≥30 years), multigravidity, and no HIV infection. Interpretation: During pregnancy, submicroscopic infections are more common than microscopic infections and are associated with fever in Africa. Malaria control in pregnancy should target both microscopic and submicroscopic infections. Funding: Bill \& Melinda Gates Foundation through the Worldwide Antimalarial Resistance Network.}, keywords = {{Adult, Anna Maria van Eijk, Antimalarials* / therapeutic use, Author(firstnames='Achille', Author(firstnames='Alain', Author(firstnames='Alassane', Author(firstnames='Alfredo', Author(firstnames='Almahamoudou', Author(firstnames='Ana', Author(firstnames='Anna', Author(firstnames='Annie', Author(firstnames='Ayola A', Author(firstnames='Azucena', Author(firstnames='Bernard A', Author(firstnames='Blair J', Author(firstnames='Blaise', Author(firstnames='Brian', Author(firstnames='Camila', Author(firstnames='Carlo', Author(firstnames='Carole', Author(firstnames='Chetan', Author(firstnames='Christopher L', Author(firstnames='Clara', Author(firstnames='Daniel', Author(firstnames='Dhanpat Kumar', Author(firstnames='Diane Wallace', Author(firstnames='Djimon M', Author(firstnames='Dominic', Author(firstnames='Don', Author(firstnames='Eliana Mar\'{i}a', Author(firstnames='Emmanual', Author(firstnames='Enesia Banda', Author(firstnames='Esperanca', Author(firstnames='Eusebio', Author(firstnames='Feiko O', Author(firstnames='Felix', Author(firstnames='Flor Ernestina', Author(firstnames='Francine', Author(firstnames='Francis', Author(firstnames='Frank P', Author(firstnames='Ghyslain', Author(firstnames='Gilles', Author(firstnames='Grant', Author(firstnames='Hallidou', Author(firstnames='Harry', Author(firstnames='Henk D', Author(firstnames='Holger W', Author(firstnames='Indu', Author(firstnames='Inoni', Author(firstnames='Ivo', Author(firstnames='Jenny', Author(firstnames='Jessica', Author(firstnames='Johanna H', Author(firstnames='Julie R', Author(firstnames='Kasia', Author(firstnames='Kassoum', Author(firstnames='Katherine R', Author(firstnames='Ken', Author(firstnames='Kephas', Author(firstnames='Lauren M', Author(firstnames='Linda', Author(firstnames='Lise', Author(firstnames='Maha A', Author(firstnames='Maminata', Author(firstnames='Manfred', Author(firstnames='Mar\'{i}a Eugenia', Author(firstnames='Maria', Author(firstnames='Martin', Author(firstnames='Meghna', Author(firstnames='Michal', Author(firstnames='Michel', Author(firstnames='Michela', Author(firstnames='Miriam K', Author(firstnames='Mwayiwawo', Author(firstnames='Myriam', Author(firstnames='Nadine', Author(firstnames='Nicaise', Author(firstnames='Norma', Author(firstnames='Olabisi A', Author(firstnames='Patrick E', Author(firstnames='Paul', Author(firstnames='Paulo', Author(firstnames='Per', Author(firstnames='Petra', Author(firstnames='Praveen K', Author(firstnames='R Matthew', Author(firstnames='Raquel', Author(firstnames='Rella', Author(firstnames='Rose F', Author(firstnames='Rosemary', Author(firstnames='Rukhsana', Author(firstnames='Sarah H', Author(firstnames='Sergi', Author(firstnames='Sonia M', Author(firstnames='Sonia', Author(firstnames='Stephanie K', Author(firstnames='Stephen J', Author(firstnames='Stephen R', Author(firstnames='Steve M', Author(firstnames='Susana', Author(firstnames='Swati', Author(firstnames='Ulla', Author(firstnames='Umberto', Author(firstnames='Valerie', Author(firstnames='Vera', Author(firstnames='Xavier', Author(firstnames='Yue', CollabAuthor(name='Subpatent Malaria in Pregnancy Group', Falciparum* / drug therapy, Female, Humans, Kasia Stepniewska, Malaria, Malaria* / prevention \& control, MEDLINE, Meta-Analysis, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, P.H.S., PMC10880462, Pregnancy, Prevalence, PubMed Abstract, Research Support, Risk Factors, Systematic review, U.S. Gov't}, pubstate = {published}, tppubtype = {article} } Close Background: Malaria infections during pregnancy can cause adverse birth outcomes, yet many infections are undetected by microscopy. We aimed to describe the epidemiology of submicroscopic malaria infections in pregnant women in Asia, the Americas, and Africa using aggregated and individual participant data (IPD). Methods: For this systematic review and meta-analysis, studies (published Jan 1, 1997 to Nov 10, 2021) with information on both microscopic and submicroscopic infections during pregnancy from Asia, the Americas, or Africa, identified in the Malaria-in-Pregnancy Library, were eligible. Studies (or subgroups or study groups) that selected participants on the basis of the presence of fever or a positive blood smear were excluded to avoid selection bias. We obtained IPD (when available) and aggregated data. Estimates of malaria transmission intensity and sulfadoxine–pyrimethamine resistance, matched by study location and year, were obtained using publicly available data. One-stage multivariable logit and multinomial models with random intercepts for study site were used in meta-analysis to assess prevalence of and risk factors for submicroscopic infections during pregnancy and at delivery. This study is registered with PROSPERO, number CRD42015027342. Findings: The search identified 87 eligible studies, 68 (78%) of which contributed to the analyses. Of these 68 studies, 45 (66%) studies contributed IPD (48 869 participants) and 23 (34%) studies contributed aggregated data (11 863 participants). During pregnancy, median prevalence estimates were 13·5% (range 0·0–55·9, 66 substudies) for submicroscopic and 8·0% (0·0–50·6, 66 substudies) for microscopic malaria. Among women with positive Plasmodium nucleic acid amplification tests (NAATs), the median proportion of submicroscopic infections was 58·7% (range 0·0–100); this proportion was highest in the Americas (73·3%, 0·0–100), followed by Asia (67·2%, 36·4–100) and Africa (56·5%, 20·5–97·7). In individual patient data analysis, compared with women with no malaria infections, those with submicroscopic infections were more likely to present with fever in Africa (adjusted odds ratio 1·32, 95% CI 1·02–1·72; p=0·038) but not in other regions. Among women with NAAT-positive infections in Asia and the Americas, Plasmodium vivax infections were more likely to be submicroscopic than Plasmodium falciparum infections (3·69, 2·45–5·54; p<0·0001). Risk factors for submicroscopic infections among women with NAAT-positive infections in Africa included older age (age ≥30 years), multigravidity, and no HIV infection. Interpretation: During pregnancy, submicroscopic infections are more common than microscopic infections and are associated with fever in Africa. Malaria control in pregnancy should target both microscopic and submicroscopic infections. Funding: Bill & Melinda Gates Foundation through the Worldwide Antimalarial Resistance Network. Close
	Holger W. Unger, Anastasia Jessica Hadiprodjo, Julie R. Gutman, Valerie Briand, Nadine Fievet, Innocent Valea, Halidou Tinto, Umberto D’Alessandro, Sarah H. Landis, Feiko Ter Kuile, Peter Ouma, Martina Oneko, Victor Mwapasa, Laurence Slutsker, Dianne J. Terlouw, Simon Kariuki, John Ayisi, Bernard Nahlen, Meghna Desai, Mwayi Madanitsa, Linda Kalilani-Phiri, Per Ashorn, Kenneth Maleta, Antoinette Tshefu-Kitoto, Ivo Mueller, Danielle Stanisic, Jordan Cates, Anna Maria Van Eijk, Maria Ome-Kaius, Elizabeth H. Aitken, Stephen J. Rogerson Fetal sex and risk of pregnancy-associated malaria in Plasmodium falciparum-endemic regions: a meta-analysis Journal Article In: Scientific reports, vol. 13, iss. 1, 2023, ISSN: 2045-2322. Abstract \| BibTeX \| Tags: Anastasia Jessica Hadiprodjo, doi:10.1038/s41598-023-37431-3, Extramural, Falciparum* / complications, Falciparum* / epidemiology, Female, Holger W Unger, Humans, Infant, Low Birth Weight, Malaria, Malaria* / complications, Malaria* / epidemiology, MEDLINE, Meta-Analysis, N.I.H., National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, Newborn, NIH, NLM, Non-U.S. Gov't, placenta, Plasmodium falciparum, PMC10293221, pmid:37365258, Pregnancy, PubMed Abstract, Research Support, Stephen J Rogerson, Stillbirth \| Links: Close Close @article{Unger2023, title = {Fetal sex and risk of pregnancy-associated malaria in Plasmodium falciparum-endemic regions: a meta-analysis}, author = {Holger W. Unger and Anastasia Jessica Hadiprodjo and Julie R. Gutman and Valerie Briand and Nadine Fievet and Innocent Valea and Halidou Tinto and Umberto D’Alessandro and Sarah H. Landis and Feiko Ter Kuile and Peter Ouma and Martina Oneko and Victor Mwapasa and Laurence Slutsker and Dianne J. Terlouw and Simon Kariuki and John Ayisi and Bernard Nahlen and Meghna Desai and Mwayi Madanitsa and Linda Kalilani-Phiri and Per Ashorn and Kenneth Maleta and Antoinette Tshefu-Kitoto and Ivo Mueller and Danielle Stanisic and Jordan Cates and Anna Maria Van Eijk and Maria Ome-Kaius and Elizabeth H. Aitken and Stephen J. Rogerson}, url = {https://pubmed.ncbi.nlm.nih.gov/37365258/}, doi = {10.1038/S41598-023-37431-3}, issn = {2045-2322}, year = {2023}, date = {2023-01-01}, journal = {Scientific reports}, volume = {13}, issue = {1}, publisher = {Sci Rep}, abstract = {In areas of moderate to intense Plasmodium falciparum transmission, malaria in pregnancy remains a significant cause of low birth weight, stillbirth, and severe anaemia. Previously, fetal sex has been identified to modify the risks of maternal asthma, pre-eclampsia, and gestational diabetes. One study demonstrated increased risk of placental malaria in women carrying a female fetus. We investigated the association between fetal sex and malaria in pregnancy in 11 pregnancy studies conducted in sub-Saharan African countries and Papua New Guinea through meta-analysis using log binomial regression fitted to a random-effects model. Malaria infection during pregnancy and delivery was assessed using light microscopy, polymerase chain reaction, and histology. Five studies were observational studies and six were randomised controlled trials. Studies varied in terms of gravidity, gestational age at antenatal enrolment and bed net use. Presence of a female fetus was associated with malaria infection at enrolment by light microscopy (risk ratio 1.14 [95% confidence interval 1.04, 1.24]; P = 0.003; n = 11,729). Fetal sex did not associate with malaria infection when other time points or diagnostic methods were used. There is limited evidence that fetal sex influences the risk of malaria infection in pregnancy.}, keywords = {Anastasia Jessica Hadiprodjo, doi:10.1038/s41598-023-37431-3, Extramural, Falciparum* / complications, Falciparum* / epidemiology, Female, Holger W Unger, Humans, Infant, Low Birth Weight, Malaria, Malaria* / complications, Malaria* / epidemiology, MEDLINE, Meta-Analysis, N.I.H., National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, Newborn, NIH, NLM, Non-U.S. Gov't, placenta, Plasmodium falciparum, PMC10293221, pmid:37365258, Pregnancy, PubMed Abstract, Research Support, Stephen J Rogerson, Stillbirth}, pubstate = {published}, tppubtype = {article} } Close In areas of moderate to intense Plasmodium falciparum transmission, malaria in pregnancy remains a significant cause of low birth weight, stillbirth, and severe anaemia. Previously, fetal sex has been identified to modify the risks of maternal asthma, pre-eclampsia, and gestational diabetes. One study demonstrated increased risk of placental malaria in women carrying a female fetus. We investigated the association between fetal sex and malaria in pregnancy in 11 pregnancy studies conducted in sub-Saharan African countries and Papua New Guinea through meta-analysis using log binomial regression fitted to a random-effects model. Malaria infection during pregnancy and delivery was assessed using light microscopy, polymerase chain reaction, and histology. Five studies were observational studies and six were randomised controlled trials. Studies varied in terms of gravidity, gestational age at antenatal enrolment and bed net use. Presence of a female fetus was associated with malaria infection at enrolment by light microscopy (risk ratio 1.14 [95% confidence interval 1.04, 1.24]; P = 0.003; n = 11,729). Fetal sex did not associate with malaria infection when other time points or diagnostic methods were used. There is limited evidence that fetal sex influences the risk of malaria infection in pregnancy. Close
	Serge Ouoba, Ko Ko, Moussa Lingani, Shintaro Nagashima, Alice N. Guingané, E. Bunthen, Md Razeen Ashraf Hussain, Aya Sugiyama, Tomoyuki Akita, Masayuki Ohisa, Moussa Abdel Sanou, Ousmane Traore, Job Wilfried Nassa, Maimouna Sanou, Kazuaki Takahashi, Halidou Tinto, Junko Tanaka Intermediate hepatitis B virus infection prevalence among 1622 pregnant women in rural Burkina Faso and implications for mother-to-child transmission Journal Article In: Scientific reports, vol. 13, iss. 1, 2023, ISSN: 2045-2322. Abstract \| BibTeX \| Tags: Burkina Faso / epidemiology, Child, DNA, doi:10.1038/s41598-023-32766-3, Female, Hepatitis B e Antigens, Hepatitis B Surface Antigens, Hepatitis B virus / genetics, Hepatitis B* / diagnosis, Humans, Infectious Disease Transmission, Infectious* / epidemiology, Junko Tanaka, Ko Ko, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, PMC10103033, pmid:37059812, Pregnancy, Pregnancy Complications, Pregnant Women, Prevalence, PubMed Abstract, Research Support, Serge Ouoba, Vertical / prevention & control, Viral / genetics \| Links: Close Close @article{Ouoba2023, title = {Intermediate hepatitis B virus infection prevalence among 1622 pregnant women in rural Burkina Faso and implications for mother-to-child transmission}, author = {Serge Ouoba and Ko Ko and Moussa Lingani and Shintaro Nagashima and Alice N. Guingan\'{e} and E. Bunthen and Md Razeen Ashraf Hussain and Aya Sugiyama and Tomoyuki Akita and Masayuki Ohisa and Moussa Abdel Sanou and Ousmane Traore and Job Wilfried Nassa and Maimouna Sanou and Kazuaki Takahashi and Halidou Tinto and Junko Tanaka}, url = {https://pubmed.ncbi.nlm.nih.gov/37059812/}, doi = {10.1038/S41598-023-32766-3}, issn = {2045-2322}, year = {2023}, date = {2023-01-01}, journal = {Scientific reports}, volume = {13}, issue = {1}, publisher = {Sci Rep}, abstract = {In highly endemic countries for hepatitis B virus (HBV) infection, childhood infection, including mother-to-child transmission (MTCT), represents the primary transmission route. High maternal DNA level (viral load ≥ 200,000 IU/mL) is a significant factor for MTCT. We investigated the prevalence of HBsAg, HBeAg, and high HBV DNA among pregnant women in three hospitals in Burkina Faso and assessed the performance of HBeAg to predict high viral load. Consenting pregnant women were interviewed on their sociodemographic characteristics and tested for HBsAg by a rapid diagnostic test, and dried blood spot (DBS) samples were collected for laboratory analyses. Of the 1622 participants, HBsAg prevalence was 6.5% (95% CI, 5.4\textendash7.8%). Among 102 HBsAg-positive pregnant women in DBS samples, HBeAg was positive in 22.6% (95% CI, 14.9\textendash31.9%), and viral load was quantified in 94 cases, with 19.1% having HBV DNA ≥ 200,000 IU/mL. HBV genotypes were identified in 63 samples and predominant genotypes were E (58.7%) and A (36.5%). The sensitivity of HBeAg by using DBS samples to identify high viral load in the 94 cases was 55.6%, and the specificity was 86.8%. These findings highlight the need to implement routine HBV screening and effective MTCT risk assessment for all pregnant women in Burkina Faso to enable early interventions that can effectively reduce MTCT.}, keywords = {Burkina Faso / epidemiology, Child, DNA, doi:10.1038/s41598-023-32766-3, Female, Hepatitis B e Antigens, Hepatitis B Surface Antigens, Hepatitis B virus / genetics, Hepatitis B* / diagnosis, Humans, Infectious Disease Transmission, Infectious* / epidemiology, Junko Tanaka, Ko Ko, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, PMC10103033, pmid:37059812, Pregnancy, Pregnancy Complications, Pregnant Women, Prevalence, PubMed Abstract, Research Support, Serge Ouoba, Vertical / prevention \& control, Viral / genetics}, pubstate = {published}, tppubtype = {article} } Close In highly endemic countries for hepatitis B virus (HBV) infection, childhood infection, including mother-to-child transmission (MTCT), represents the primary transmission route. High maternal DNA level (viral load ≥ 200,000 IU/mL) is a significant factor for MTCT. We investigated the prevalence of HBsAg, HBeAg, and high HBV DNA among pregnant women in three hospitals in Burkina Faso and assessed the performance of HBeAg to predict high viral load. Consenting pregnant women were interviewed on their sociodemographic characteristics and tested for HBsAg by a rapid diagnostic test, and dried blood spot (DBS) samples were collected for laboratory analyses. Of the 1622 participants, HBsAg prevalence was 6.5% (95% CI, 5.4–7.8%). Among 102 HBsAg-positive pregnant women in DBS samples, HBeAg was positive in 22.6% (95% CI, 14.9–31.9%), and viral load was quantified in 94 cases, with 19.1% having HBV DNA ≥ 200,000 IU/mL. HBV genotypes were identified in 63 samples and predominant genotypes were E (58.7%) and A (36.5%). The sensitivity of HBeAg by using DBS samples to identify high viral load in the 94 cases was 55.6%, and the specificity was 86.8%. These findings highlight the need to implement routine HBV screening and effective MTCT risk assessment for all pregnant women in Burkina Faso to enable early interventions that can effectively reduce MTCT. Close
2022
Journal Articles
	Biébo Bihoun, Serge Henri Zango, Maminata Traoré-Coulibaly, Innocent Valea, Raffaella Ravinetto, Jean Pierre Van Geertruyden, Umberto D'Alessandro, Halidou Tinto, Annie Robert Age-modified factors associated with placental malaria in rural Burkina Faso. Journal Article In: BMC pregnancy and childbirth, vol. 22, iss. 1, pp. 248, 2022, ISSN: 1471-2393. Abstract \| BibTeX \| Tags: Malaria, Malaria/epidemiology, Adult, Burkina Faso, Burkina Faso/epidemiology, Falciparum/parasitology, Female, Gravidity, Humans, Malaria, placenta, Placenta/parasitology, Pregnancy, Risk Factors \| Links: Close Close @article{nokey, title = {Age-modified factors associated with placental malaria in rural Burkina Faso.}, author = {Bi\'{e}bo Bihoun and Serge Henri Zango and Maminata Traor\'{e}-Coulibaly and Innocent Valea and Raffaella Ravinetto and Jean Pierre Van Geertruyden and Umberto D'Alessandro and Halidou Tinto and Annie Robert}, doi = {10.1186/s12884-022-04568-4}, issn = {1471-2393}, year = {2022}, date = {2022-03-01}, urldate = {2022-03-01}, journal = {BMC pregnancy and childbirth}, volume = {22}, issue = {1}, pages = {248}, abstract = {BACKGROUND: Malaria in pregnancy can result in placental infection with fetal implications. This study aimed at assessing placental malaria (PM) prevalence and its associated factors in a cohort of pregnant women with peripheral malaria and their offspring. METHOD: The data were collected in the framework of a clinical trial on treatments for malaria in pregnant women . Placental malaria (PM) was diagnosed by histopathological detection of parasites and/or malaria pigment on placenta biopsies taken at delivery. Factors associated with PM were assessed using logistic regression. RESULTS: Out of 745 biopsies examined, PM was diagnosed in 86.8 % of women. Acute, chronic and past PM were retrieved in 11 (1.5 %), 170 (22.8 %), and 466 (62.6 %) women, respectively. A modifying effect was observed in the association of gravidity or anemia at the study start with pooled PM (presence of parasites and/or malaria pigment). In women under 30, gravidity ≤ 2 was associated with an increased prevalence of pooled PM but in women aged 30 years or more, gravidity was no more associated with pooled PM (OR 6.81, 95 % CI 3.18 - 14.60; and OR 0.52, 95 % CI 0.10 - 2.76, respectively). Anemia was associated with pooled PM in women under 30 (OR 1.96, 95 % CI 1.03 - 3.72) but not in women aged 30 years or more (OR 0.68, 95 % CI 0.31 - 1.49). Similarly, the association of gravidity with past-chronic PM depended also on age. A higher prevalence of active PM was observed in women under 30 presenting with symptomatic malaria (OR 3.79, 95 % CI 1.55 - 9.27), while there was no significant increase in the prevalence of active PM (presence of parasites only) in women with symptomatic malaria when aged 30 years or more (OR 0.42, 95 % CI 0.10 - 1.75). In women with chronic PM, the prevalence of low birth weight or prematurity was the highest (31.2 %) as compared with past PM or no PM. CONCLUSION: Despite the rapid diagnosis and efficacious treatment of peripheral infection, the prevalence of placental malaria remained high in women with P. falciparum peripheral infection in Nanoro, especially in younger women This underlines the importance of preventive measures in this specific group.}, keywords = {Malaria, Malaria/epidemiology, Adult, Burkina Faso, Burkina Faso/epidemiology, Falciparum/parasitology, Female, Gravidity, Humans, Malaria, placenta, Placenta/parasitology, Pregnancy, Risk Factors}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Malaria in pregnancy can result in placental infection with fetal implications. This study aimed at assessing placental malaria (PM) prevalence and its associated factors in a cohort of pregnant women with peripheral malaria and their offspring. METHOD: The data were collected in the framework of a clinical trial on treatments for malaria in pregnant women . Placental malaria (PM) was diagnosed by histopathological detection of parasites and/or malaria pigment on placenta biopsies taken at delivery. Factors associated with PM were assessed using logistic regression. RESULTS: Out of 745 biopsies examined, PM was diagnosed in 86.8 % of women. Acute, chronic and past PM were retrieved in 11 (1.5 %), 170 (22.8 %), and 466 (62.6 %) women, respectively. A modifying effect was observed in the association of gravidity or anemia at the study start with pooled PM (presence of parasites and/or malaria pigment). In women under 30, gravidity ≤ 2 was associated with an increased prevalence of pooled PM but in women aged 30 years or more, gravidity was no more associated with pooled PM (OR 6.81, 95 % CI 3.18 - 14.60; and OR 0.52, 95 % CI 0.10 - 2.76, respectively). Anemia was associated with pooled PM in women under 30 (OR 1.96, 95 % CI 1.03 - 3.72) but not in women aged 30 years or more (OR 0.68, 95 % CI 0.31 - 1.49). Similarly, the association of gravidity with past-chronic PM depended also on age. A higher prevalence of active PM was observed in women under 30 presenting with symptomatic malaria (OR 3.79, 95 % CI 1.55 - 9.27), while there was no significant increase in the prevalence of active PM (presence of parasites only) in women with symptomatic malaria when aged 30 years or more (OR 0.42, 95 % CI 0.10 - 1.75). In women with chronic PM, the prevalence of low birth weight or prematurity was the highest (31.2 %) as compared with past PM or no PM. CONCLUSION: Despite the rapid diagnosis and efficacious treatment of peripheral infection, the prevalence of placental malaria remained high in women with P. falciparum peripheral infection in Nanoro, especially in younger women This underlines the importance of preventive measures in this specific group. Close
	Moussa Lingani, Serge Henri Zango, Innocent Valéa, Georges Somé, Maïmouna Sanou, Sékou O. Samadoulougou, Serge Ouoba, Eli Rouamba, Annie Robert, Michèle Dramaix, Philippe Donnen, Halidou Tinto Low birth weight and its associated risk factors in a rural health district of Burkina Faso: a cross sectional study. Journal Article In: BMC pregnancy and childbirth, vol. 22, iss. 1, pp. 228, 2022, ISSN: 1471-2393. Abstract \| BibTeX \| Tags: Antimalarials/therapeutic use, Rural Health, Associated factors, Burkina Faso, Burkina Faso/epidemiology, Cross-Sectional Studies, Female, Humans, Infant, Low Birth Weight, Newborn, Pregnancy, Risk Factors, Rural area \| Links: Close Close @article{nokey, title = {Low birth weight and its associated risk factors in a rural health district of Burkina Faso: a cross sectional study.}, author = {Moussa Lingani and Serge Henri Zango and Innocent Val\'{e}a and Georges Som\'{e} and Ma\"{i}mouna Sanou and S\'{e}kou O. Samadoulougou and Serge Ouoba and Eli Rouamba and Annie Robert and Mich\`{e}le Dramaix and Philippe Donnen and Halidou Tinto}, doi = {10.1186/s12884-022-04554-w}, issn = {1471-2393}, year = {2022}, date = {2022-03-01}, urldate = {2022-03-01}, journal = {BMC pregnancy and childbirth}, volume = {22}, issue = {1}, pages = {228}, abstract = {BACKGROUND: Low birth weight (LBW) is a major factor of neonate mortality that particularly affects developing countries. However, the scarcity of data to support decision making to reduce LBW occurrence is a major obstacle in sub-Saharan Africa. The aim of this research was to determine the prevalence and associated factors of LBW at the Yako health district in a rural area of Burkina Faso. METHODS: A cross sectional survey was conducted at four peripheral health centers among mothers and their newly delivered babies. The mothers' socio-demographic and obstetrical characteristics were collected by face-to-face interview or by review of antenatal care books. Maternal malaria was tested by standard microscopy and neonates' birth weights were documented. Multivariate logistic regression was used to determine factors associated with LBW. A p-value \< 0.05 was considered statistically significant. RESULTS: Of 600 neonates examined, the prevalence of low birth weight was 11.0%. Adjustment for socio-demographic characteristic, medical conditions, obstetrical history, malaria prevention measures by multivariate logistic regression found that being a primigravid mother (aOR = 1.8, [95% CI: 1.1-3.0]), the presence of malaria infection (aOR = 1.9, [95% CI: 1.1-3.5]), the uptake of less than three doses of sulfadoxine-pyrimethamine for the intermittent preventive treatment of malaria in pregnancy (IPTp-SP) (aOR = 2.2, [95% CI: 1.3-3.9]), the presence of maternal fever at the time of delivery (aOR = 2.8, [95% CI: 1.5-5.3]) and being a female neonate (aOR = 1.9, [95% CI: 1.1-3.3]) were independently associated with an increased risk of LBW occurrence. The number of antenatal visits performed by the mother during her pregnancy did not provide any direct protection for low birth weight. CONCLUSION: The prevalence of LBW remained high in the study area. Maternal malaria, fever and low uptake of sulfadoxine-pyrimethamine doses were significantly associated with LBW and should be adequately addressed by public health interventions.}, keywords = {Antimalarials/therapeutic use, Rural Health, Associated factors, Burkina Faso, Burkina Faso/epidemiology, Cross-Sectional Studies, Female, Humans, Infant, Low Birth Weight, Newborn, Pregnancy, Risk Factors, Rural area}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Low birth weight (LBW) is a major factor of neonate mortality that particularly affects developing countries. However, the scarcity of data to support decision making to reduce LBW occurrence is a major obstacle in sub-Saharan Africa. The aim of this research was to determine the prevalence and associated factors of LBW at the Yako health district in a rural area of Burkina Faso. METHODS: A cross sectional survey was conducted at four peripheral health centers among mothers and their newly delivered babies. The mothers' socio-demographic and obstetrical characteristics were collected by face-to-face interview or by review of antenatal care books. Maternal malaria was tested by standard microscopy and neonates' birth weights were documented. Multivariate logistic regression was used to determine factors associated with LBW. A p-value < 0.05 was considered statistically significant. RESULTS: Of 600 neonates examined, the prevalence of low birth weight was 11.0%. Adjustment for socio-demographic characteristic, medical conditions, obstetrical history, malaria prevention measures by multivariate logistic regression found that being a primigravid mother (aOR = 1.8, [95% CI: 1.1-3.0]), the presence of malaria infection (aOR = 1.9, [95% CI: 1.1-3.5]), the uptake of less than three doses of sulfadoxine-pyrimethamine for the intermittent preventive treatment of malaria in pregnancy (IPTp-SP) (aOR = 2.2, [95% CI: 1.3-3.9]), the presence of maternal fever at the time of delivery (aOR = 2.8, [95% CI: 1.5-5.3]) and being a female neonate (aOR = 1.9, [95% CI: 1.1-3.3]) were independently associated with an increased risk of LBW occurrence. The number of antenatal visits performed by the mother during her pregnancy did not provide any direct protection for low birth weight. CONCLUSION: The prevalence of LBW remained high in the study area. Maternal malaria, fever and low uptake of sulfadoxine-pyrimethamine doses were significantly associated with LBW and should be adequately addressed by public health interventions. Close
	Vivi Maketa, Japhet Kabalu, Melissa Kabena, Flory Luzolo, Hypolite Muhindo-Mavoko, Henk D. F. H. Schallig, Kassoum Kayentao, Petra F. Mens, Pascal Lutumba, Halidou Tinto Comparison of intermittent screening (using ultra-sensitive malaria rapid diagnostic test) and treatment (using a newly registered antimalarial pyronaridine-artesunate—PYRAMAX®) to standard intermittent preventive treatment with sulfadoxine-pyrimethamine for the prevention of malaria in pregnant women living in endemic areas: ULTRAPYRAPREG Journal Article In: Trials, vol. 23, iss. 1, pp. 963, 2022, ISSN: 1745-6215. Abstract \| BibTeX \| Tags: IPTp-SP, ISTp, Malaria, Malaria indicators, Pregnancy, Ultra-sensitive RDTs \| Links: Close Close @article{Maketa2022, title = {Comparison of intermittent screening (using ultra-sensitive malaria rapid diagnostic test) and treatment (using a newly registered antimalarial pyronaridine-artesunate\textemdashPYRAMAX®) to standard intermittent preventive treatment with sulfadoxine-pyrimethamine for the prevention of malaria in pregnant women living in endemic areas: ULTRAPYRAPREG}, author = {Vivi Maketa and Japhet Kabalu and Melissa Kabena and Flory Luzolo and Hypolite Muhindo-Mavoko and Henk D. F. H. Schallig and Kassoum Kayentao and Petra F. Mens and Pascal Lutumba and Halidou Tinto}, url = {https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-022-06884-8}, doi = {10.1186/s13063-022-06884-8}, issn = {1745-6215}, year = {2022}, date = {2022-01-01}, journal = {Trials}, volume = {23}, issue = {1}, pages = {963}, abstract = {BACKGROUND Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is an important malaria control strategy in sub-Saharan Africa. Indeed, it overcomes the risk of misdiagnosis due to low peripheral parasitemia during pregnancy by treating women with SP on predetermined schedules. However, over time, the spread of Plasmodium-resistant strains has threatened this strategy in many countries. As an alternative, the intermittent screening and treatment for pregnancy (ISTp) aims at a monthly screening of pregnant women, preferably by using very sensitive tests such as ultrasensitive rapid diagnostic tests (us-RDTs) and the treatment of positive cases with artemisinin-based combination therapy (ACT) regardless of the presence of symptoms. Unlike IPTp-SP, ISTp prevents overuse of antimalarials limiting the drug pressure on parasites, an advantage which can be potentiated by using an ACT like pyronaridine-artesunate (Pyramax®) that is not yet used in pregnant women in the field. METHODS This study aims to compare the non-inferiority of ISTp using us-RDTs and Pyramax® versus IPTp-SP on malaria in pregnancy through a randomized clinical trial performed in Kisenso, Kinshasa, the Democratic Republic of the Congo, a malaria perennial transmission area. DISCUSSION The results will be essential for the National Malaria Control Program to update the malaria prevention policy in pregnant women in the Democratic Republic of the Congo. TRIAL REGISTRATION ClinicalTrials.gov NCT04783051.}, keywords = {IPTp-SP, ISTp, Malaria, Malaria indicators, Pregnancy, Ultra-sensitive RDTs}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is an important malaria control strategy in sub-Saharan Africa. Indeed, it overcomes the risk of misdiagnosis due to low peripheral parasitemia during pregnancy by treating women with SP on predetermined schedules. However, over time, the spread of Plasmodium-resistant strains has threatened this strategy in many countries. As an alternative, the intermittent screening and treatment for pregnancy (ISTp) aims at a monthly screening of pregnant women, preferably by using very sensitive tests such as ultrasensitive rapid diagnostic tests (us-RDTs) and the treatment of positive cases with artemisinin-based combination therapy (ACT) regardless of the presence of symptoms. Unlike IPTp-SP, ISTp prevents overuse of antimalarials limiting the drug pressure on parasites, an advantage which can be potentiated by using an ACT like pyronaridine-artesunate (Pyramax®) that is not yet used in pregnant women in the field. METHODS This study aims to compare the non-inferiority of ISTp using us-RDTs and Pyramax® versus IPTp-SP on malaria in pregnancy through a randomized clinical trial performed in Kisenso, Kinshasa, the Democratic Republic of the Congo, a malaria perennial transmission area. DISCUSSION The results will be essential for the National Malaria Control Program to update the malaria prevention policy in pregnant women in the Democratic Republic of the Congo. TRIAL REGISTRATION ClinicalTrials.gov NCT04783051. Close
	Annelies S. Post, I. Guiraud, M. Peeters, P. Lompo, S. Ombelet, I. Karama, S. Yougbaré, Z. Garba, E. Rouamba, H. Tinto, Jan Jacobs Escherichia coli from urine samples of pregnant women as an indicator for antimicrobial resistance in the community: a field study from rural Burkina Faso Journal Article In: Antimicrobial Resistance & Infection Control, vol. 11, iss. 1, pp. 112, 2022, ISSN: 2047-2994. Abstract \| BibTeX \| Tags: ANC, Antimicrobial resistance, Asymptomatic bacteriuria, Burkina Faso, Community, Escherichia coli, Pregnancy, Rural Africa \| Links: Close Close @article{Post2022, title = {Escherichia coli from urine samples of pregnant women as an indicator for antimicrobial resistance in the community: a field study from rural Burkina Faso}, author = {Annelies S. Post and I. Guiraud and M. Peeters and P. Lompo and S. Ombelet and I. Karama and S. Yougbar\'{e} and Z. Garba and E. Rouamba and H. Tinto and Jan Jacobs}, url = {https://aricjournal.biomedcentral.com/articles/10.1186/s13756-022-01142-7}, doi = {10.1186/s13756-022-01142-7}, issn = {2047-2994}, year = {2022}, date = {2022-01-01}, journal = {Antimicrobial Resistance \& Infection Control}, volume = {11}, issue = {1}, pages = {112}, abstract = {BACKGROUND In low- and middle-income countries, surveillance of antimicrobial resistance (AMR) is mostly hospital-based and, in view of poor access to clinical microbiology, biased to more resistant pathogens. We aimed to assess AMR among Escherichia coli isolates obtained from urine cultures of pregnant women as an indicator for community AMR and compared the AMR results with those from E. coli isolates obtained from febrile patients in previously published clinical surveillance studies conducted within the same population in Nanoro, rural Burkina Faso. We furthermore explored feasibility of adding urine culture to standard antenatal care in a rural sub-Saharan African setting. METHODS Between October 2016-September 2018, midstream urine samples collected as part of routine antenatal care in Nanoro district were cultured by a dipslide method and screened for antibiotic residues. Significant growth was defined as a pure culture of Enterobacterales at counts of ≥ 104 colony forming units/ml. RESULTS Significant growth was observed in 202/5934 (3.4%) cultures; E. coli represented 155 (76.7%) of isolates. Among E. coli isolates, resistance rates to ampicillin, cotrimoxazole and ciprofloxacin were respectively 65.8%, 64.4% 16.2%, compared to 89.5%, 89.5% and 62.5% among E. coli from clinical isolates (n = 48 of which 45 from blood cultures). Proportions of extended spectrum beta-lactamase producers and multidrug resistance were 3.2% and 5.2% among E. coli isolates from urine in pregnant women versus 35.4%, and 60.4% respectively among clinical isolates. CONCLUSIONS The E. coli isolates obtained from healthy pregnant women had significantly lower AMR rates compared to clinical E. coli isolates, probably reflecting the lower antibiotic pressure in the pregnant women population. Adding urine culture to the routine urine analysis (dipstick) of antenatal care was feasible. The dipslide culture method was affordable and user-friendly and allowed on-site inoculation and easy transport; challenges were contamination (midstream urine sampling) and the semi-quantitative reading. Provided confirmation of the present findings in other settings, E. coli from urine samples in pregnant women may be a potential indicator for benchmarking, comparing, and monitoring community AMR rates across populations over different countries and regions.}, keywords = {ANC, Antimicrobial resistance, Asymptomatic bacteriuria, Burkina Faso, Community, Escherichia coli, Pregnancy, Rural Africa}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND In low- and middle-income countries, surveillance of antimicrobial resistance (AMR) is mostly hospital-based and, in view of poor access to clinical microbiology, biased to more resistant pathogens. We aimed to assess AMR among Escherichia coli isolates obtained from urine cultures of pregnant women as an indicator for community AMR and compared the AMR results with those from E. coli isolates obtained from febrile patients in previously published clinical surveillance studies conducted within the same population in Nanoro, rural Burkina Faso. We furthermore explored feasibility of adding urine culture to standard antenatal care in a rural sub-Saharan African setting. METHODS Between October 2016-September 2018, midstream urine samples collected as part of routine antenatal care in Nanoro district were cultured by a dipslide method and screened for antibiotic residues. Significant growth was defined as a pure culture of Enterobacterales at counts of ≥ 104 colony forming units/ml. RESULTS Significant growth was observed in 202/5934 (3.4%) cultures; E. coli represented 155 (76.7%) of isolates. Among E. coli isolates, resistance rates to ampicillin, cotrimoxazole and ciprofloxacin were respectively 65.8%, 64.4% 16.2%, compared to 89.5%, 89.5% and 62.5% among E. coli from clinical isolates (n = 48 of which 45 from blood cultures). Proportions of extended spectrum beta-lactamase producers and multidrug resistance were 3.2% and 5.2% among E. coli isolates from urine in pregnant women versus 35.4%, and 60.4% respectively among clinical isolates. CONCLUSIONS The E. coli isolates obtained from healthy pregnant women had significantly lower AMR rates compared to clinical E. coli isolates, probably reflecting the lower antibiotic pressure in the pregnant women population. Adding urine culture to the routine urine analysis (dipstick) of antenatal care was feasible. The dipslide culture method was affordable and user-friendly and allowed on-site inoculation and easy transport; challenges were contamination (midstream urine sampling) and the semi-quantitative reading. Provided confirmation of the present findings in other settings, E. coli from urine samples in pregnant women may be a potential indicator for benchmarking, comparing, and monitoring community AMR rates across populations over different countries and regions. Close
	Laetitia Duval, Elisa Sicuri, Susana Scott, Maminata Traoré, Bunja Daabo, Halidou Tinto, Koen Peeters Grietens, Umberto d’Alessando, Henk Schallig, Petra Mens, Lesong Conteh Household costs associated with seeking malaria treatment during pregnancy: evidence from Burkina Faso and The Gambia Journal Article In: Cost Effectiveness and Resource Allocation, vol. 20, iss. 1, pp. 42, 2022, ISSN: 1478-7547. Abstract \| BibTeX \| Tags: Burkina Faso, Cost, Gambia, Malaria, Pregnancy, Remittances, sub-Saharan Africa \| Links: Close Close @article{Duval2022, title = {Household costs associated with seeking malaria treatment during pregnancy: evidence from Burkina Faso and The Gambia}, author = {Laetitia Duval and Elisa Sicuri and Susana Scott and Maminata Traor\'{e} and Bunja Daabo and Halidou Tinto and Koen Peeters Grietens and Umberto d’Alessando and Henk Schallig and Petra Mens and Lesong Conteh}, url = {https://resource-allocation.biomedcentral.com/articles/10.1186/s12962-022-00376-x}, doi = {10.1186/s12962-022-00376-x}, issn = {1478-7547}, year = {2022}, date = {2022-01-01}, journal = {Cost Effectiveness and Resource Allocation}, volume = {20}, issue = {1}, pages = {42}, abstract = {BACKGROUND Malaria in pregnancy remains a major health threat in sub-Saharan Africa to both expectant mothers and their unborn children. To date, there have been very few studies focused on the out of pocket costs associated with seeking treatment for malaria during pregnancy. METHODS A cross-sectional survey was undertaken in Burkina Faso and The Gambia to estimate the direct and indirect costs associated with outpatient consultations (OP) and inpatient admissions (IP). Direct costs were broken down into medical (admission fees, drug charges, and laboratory fees), and non-medical (transportation and food). Indirect costs reflected time lost due to illness. In total, 220 pregnant women in Burkina Faso and 263 in The Gambia were interviewed about their treatment seeking decisions, expenditure, time use and financial support associated with each malaria episode. RESULTS In Burkina Faso 6.7% sought treatment elsewhere before their OP visits, and 27.1% before their IP visits. This compares to 1.3% for OP and 25.92% for IP in The Gambia. Once at the facility, the average direct costs (out of pocket) were 3.91US$ for an OP visit and 15.38US$ of an IP visit in Burkina Faso, and 0.80US$ for an OP visit and 9.19US$ for an IP visit in The Gambia. Inpatient direct costs were driven by drug costs (9.27US$) and transportation costs (2.72US$) in Burkina Faso and drug costs (3.44 US$) and food costs (3.44 US$) in The Gambia. Indirect costs of IP visits, valued as the opportunity cost of time lost due to the illness, were estimated at 11.85US$ in Burkina Faso and 4.07US$ in The Gambia. The difference across the two countries was mainly due to the longer time of hospitalization in Burkina Faso compared to The Gambia. In The Gambia, the vast majority of pregnant women reported receiving financial support from family members living abroad, most commonly siblings (65%). CONCLUSIONS High malaria treatment costs are incurred by pregnant women in Burkina Faso and The Gambia. Beyond the medical costs of fees and drugs, costs in terms of transport, food and time are significant drivers. The role of remittances, particularly their effect on accessing health care, needs further investigation.}, keywords = {Burkina Faso, Cost, Gambia, Malaria, Pregnancy, Remittances, sub-Saharan Africa}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND Malaria in pregnancy remains a major health threat in sub-Saharan Africa to both expectant mothers and their unborn children. To date, there have been very few studies focused on the out of pocket costs associated with seeking treatment for malaria during pregnancy. METHODS A cross-sectional survey was undertaken in Burkina Faso and The Gambia to estimate the direct and indirect costs associated with outpatient consultations (OP) and inpatient admissions (IP). Direct costs were broken down into medical (admission fees, drug charges, and laboratory fees), and non-medical (transportation and food). Indirect costs reflected time lost due to illness. In total, 220 pregnant women in Burkina Faso and 263 in The Gambia were interviewed about their treatment seeking decisions, expenditure, time use and financial support associated with each malaria episode. RESULTS In Burkina Faso 6.7% sought treatment elsewhere before their OP visits, and 27.1% before their IP visits. This compares to 1.3% for OP and 25.92% for IP in The Gambia. Once at the facility, the average direct costs (out of pocket) were 3.91US$ for an OP visit and 15.38US$ of an IP visit in Burkina Faso, and 0.80US$ for an OP visit and 9.19US$ for an IP visit in The Gambia. Inpatient direct costs were driven by drug costs (9.27US$) and transportation costs (2.72US$) in Burkina Faso and drug costs (3.44 US$) and food costs (3.44 US$) in The Gambia. Indirect costs of IP visits, valued as the opportunity cost of time lost due to the illness, were estimated at 11.85US$ in Burkina Faso and 4.07US$ in The Gambia. The difference across the two countries was mainly due to the longer time of hospitalization in Burkina Faso compared to The Gambia. In The Gambia, the vast majority of pregnant women reported receiving financial support from family members living abroad, most commonly siblings (65%). CONCLUSIONS High malaria treatment costs are incurred by pregnant women in Burkina Faso and The Gambia. Beyond the medical costs of fees and drugs, costs in terms of transport, food and time are significant drivers. The role of remittances, particularly their effect on accessing health care, needs further investigation. Close
	Moussa Lingani, Serge H. Zango, Innocent Valéa, Maïmouna Sanou, Serge Ouoba, Sékou Samadoulougou, Annie Robert, Halidou Tinto, Michèle Dramaix, Philippe Donnen Prevalence and risk factors of malaria among first antenatal care attendees in rural Burkina Faso Journal Article In: Tropical Medicine and Health, vol. 50, iss. 1, pp. 49, 2022, ISSN: 1349-4147. Abstract \| BibTeX \| Tags: Burkina Faso, First antenatal care visit, Malaria, Pregnancy \| Links: Close Close @article{Lingani2022, title = {Prevalence and risk factors of malaria among first antenatal care attendees in rural Burkina Faso}, author = {Moussa Lingani and Serge H. Zango and Innocent Val\'{e}a and Ma\"{i}mouna Sanou and Serge Ouoba and S\'{e}kou Samadoulougou and Annie Robert and Halidou Tinto and Mich\`{e}le Dramaix and Philippe Donnen}, url = {https://tropmedhealth.biomedcentral.com/articles/10.1186/s41182-022-00442-3}, doi = {10.1186/s41182-022-00442-3}, issn = {1349-4147}, year = {2022}, date = {2022-01-01}, journal = {Tropical Medicine and Health}, volume = {50}, issue = {1}, pages = {49}, abstract = {BACKGROUND The WHO recommends continuous surveillance of malaria in endemic countries to identify areas and populations most in need for targeted interventions. The aim of this study was to assess the prevalence of malaria and its associated factors among first antenatal care (ANC) attendees in rural Burkina Faso. METHODS A cross-sectional survey was conducted between August 2019 and September 2020 at the Yako health district and included 1067 first ANC attendees. Sociodemographic, gyneco-obstetric, and medical characteristics were collected. Malaria was diagnosed by standard microscopy and hemoglobin level was measured by spectrophotometry. A multivariate logistic regression analysis was used to identify factors associated with malaria infection. RESULTS Overall malaria infection prevalence was 16.1% (167/1039). Among malaria-positive women, the geometric mean parasite density was 1204 [95% confidence interval (CI) 934-1552] parasites/µL and the proportion of very low (1-199 parasites/µL), low (200-999 parasites/µL), medium (1000-9999 parasites/µL) and high (≥ 10,000 parasites/µL) parasite densities were 15.0%, 35.3%, 38.3% and 11.4%, respectively. Age \< 20 years (adjusted odds ratio (aOR): 2.2; 95% CI 1.4-3.5), anemia (hemoglobin \< 11 g/deciliter) (aOR: 3.4; 95% CI 2.2-5.5), the non-use of bed net (aOR: 1.8; 95% CI 1.1-2.8), and the absence of intermittent preventive treatment with sulfadoxine-pyrimethamine (aOR: 5.8; 95% CI 2.1-24.5) were positively associated with malaria infection. CONCLUSIONS The study showed that one out of six pregnant women had a microscopy-detected P. falciparum malaria infection at their first ANC visit. Strengthening malaria prevention strategies during the first ANC visit is needed to prevent unfavorable birth outcomes.}, keywords = {Burkina Faso, First antenatal care visit, Malaria, Pregnancy}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND The WHO recommends continuous surveillance of malaria in endemic countries to identify areas and populations most in need for targeted interventions. The aim of this study was to assess the prevalence of malaria and its associated factors among first antenatal care (ANC) attendees in rural Burkina Faso. METHODS A cross-sectional survey was conducted between August 2019 and September 2020 at the Yako health district and included 1067 first ANC attendees. Sociodemographic, gyneco-obstetric, and medical characteristics were collected. Malaria was diagnosed by standard microscopy and hemoglobin level was measured by spectrophotometry. A multivariate logistic regression analysis was used to identify factors associated with malaria infection. RESULTS Overall malaria infection prevalence was 16.1% (167/1039). Among malaria-positive women, the geometric mean parasite density was 1204 [95% confidence interval (CI) 934-1552] parasites/µL and the proportion of very low (1-199 parasites/µL), low (200-999 parasites/µL), medium (1000-9999 parasites/µL) and high (≥ 10,000 parasites/µL) parasite densities were 15.0%, 35.3%, 38.3% and 11.4%, respectively. Age < 20 years (adjusted odds ratio (aOR): 2.2; 95% CI 1.4-3.5), anemia (hemoglobin < 11 g/deciliter) (aOR: 3.4; 95% CI 2.2-5.5), the non-use of bed net (aOR: 1.8; 95% CI 1.1-2.8), and the absence of intermittent preventive treatment with sulfadoxine-pyrimethamine (aOR: 5.8; 95% CI 2.1-24.5) were positively associated with malaria infection. CONCLUSIONS The study showed that one out of six pregnant women had a microscopy-detected P. falciparum malaria infection at their first ANC visit. Strengthening malaria prevention strategies during the first ANC visit is needed to prevent unfavorable birth outcomes. Close
2021
Journal Articles
	Moussa Lingani, Serge H Zango, Innocent Valéa, Massa Dit A Bonko, Sékou O Samadoulougou, Toussaint Rouamba, Marc C Tahita, Ma"imouna Sanou, Annie Robert, Halidou Tinto, Philippe Donnen, Mich`ele Dramaix Malaria and curable sexually transmitted and reproductive tract coinfection among pregnant women in rural Burkina Faso Journal Article In: Trop. Med. Health, vol. 49, no. 1, pp. 90, 2021, ISSN: 1348-8945 1349-4147, (© 2021. The Author(s). PMID: 34736524 PMCID: PMC8567650). Abstract \| BibTeX \| Tags: Bacterial vaginosis, Burkina Faso, Chlamydia, Coinfection, Malaria, Pregnancy, Syphilis \| Links: Close Close @article{Lingani2021-is, title = {Malaria and curable sexually transmitted and reproductive tract coinfection among pregnant women in rural Burkina Faso}, author = {Moussa Lingani and Serge H Zango and Innocent Val\'{e}a and Massa Dit A Bonko and S\'{e}kou O Samadoulougou and Toussaint Rouamba and Marc C Tahita and Ma"imouna Sanou and Annie Robert and Halidou Tinto and Philippe Donnen and Mich`ele Dramaix}, doi = {10.1186/s41182-021-00381-5}, issn = {1348-8945 1349-4147}, year = {2021}, date = {2021-11-01}, urldate = {2021-11-01}, journal = {Trop. Med. Health}, volume = {49}, number = {1}, pages = {90}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Malaria and sexually transmitted/reproductive tract infections (STI/RTI) are leading and preventable causes of low birthweight in sub-Saharan Africa. Reducing their impact on pregnancy outcomes requires efficient interventions that can be easily integrated into the antenatal care package. The paucity of data on malaria and STI/RTI coinfection, however, limits efforts to control these infections. This study aimed to determine the prevalence and associated factors of malaria and STI/RTI coinfection among pregnant women in rural Burkina Faso. METHODS: A cross-sectional survey was conducted among 402 pregnant women attending antenatal clinics at the Yako health district. Sociodemographic and behavioral data were collected, and pregnant women were tested for peripheral malaria by microscopy. Hemoglobin levels were also measured by spectrophotometry and curable bacterial STI/RTI were tested on cervico-vaginal swabs using rapid diagnostic test for chlamydia and syphilis, and Gram staining for bacterial vaginosis. A multivariate logistic regression model was used to assess the association of malaria and STI/RTI coinfection with the characteristics of included pregnant women. RESULTS: The prevalence of malaria and at least one STI/RTI coinfection was 12.9% (95% confidence interval, CI: [9.8-16.7]), malaria and bacterial vaginosis coinfection was 12.2% (95% CI: [9.3-15.9]), malaria and chlamydial coinfection was 1.6% (95% CI: [0.6-3.8]). No coinfection was reported for malaria and syphilis. The individual prevalence was 17.2%, 7.2%, 0.6%, 67.7% and 73.3%, respectively, for malaria infection, chlamydia, syphilis, bacterial vaginosis and STI/RTI combination. Only 10% of coinfections were symptomatic, and thus, 90% of women with coinfection would have been missed by the symptoms-based diagnostic approach. In the multivariate analysis, the first pregnancy (aOR = 2.4 [95% CI: 1.2-4.7]) was the only factor significantly associated with malaria and STI/RTI coinfection. Clinical symptoms were not associated with malaria and STI/RTI coinfection. CONCLUSION: The prevalence of malaria and curable STI/RTI coinfection was high among pregnant women. The poor performance of the clinical symptoms to predict coinfection suggests that alternative interventions are needed.}, note = {© 2021. The Author(s). PMID: 34736524 PMCID: PMC8567650}, keywords = {Bacterial vaginosis, Burkina Faso, Chlamydia, Coinfection, Malaria, Pregnancy, Syphilis}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Malaria and sexually transmitted/reproductive tract infections (STI/RTI) are leading and preventable causes of low birthweight in sub-Saharan Africa. Reducing their impact on pregnancy outcomes requires efficient interventions that can be easily integrated into the antenatal care package. The paucity of data on malaria and STI/RTI coinfection, however, limits efforts to control these infections. This study aimed to determine the prevalence and associated factors of malaria and STI/RTI coinfection among pregnant women in rural Burkina Faso. METHODS: A cross-sectional survey was conducted among 402 pregnant women attending antenatal clinics at the Yako health district. Sociodemographic and behavioral data were collected, and pregnant women were tested for peripheral malaria by microscopy. Hemoglobin levels were also measured by spectrophotometry and curable bacterial STI/RTI were tested on cervico-vaginal swabs using rapid diagnostic test for chlamydia and syphilis, and Gram staining for bacterial vaginosis. A multivariate logistic regression model was used to assess the association of malaria and STI/RTI coinfection with the characteristics of included pregnant women. RESULTS: The prevalence of malaria and at least one STI/RTI coinfection was 12.9% (95% confidence interval, CI: [9.8-16.7]), malaria and bacterial vaginosis coinfection was 12.2% (95% CI: [9.3-15.9]), malaria and chlamydial coinfection was 1.6% (95% CI: [0.6-3.8]). No coinfection was reported for malaria and syphilis. The individual prevalence was 17.2%, 7.2%, 0.6%, 67.7% and 73.3%, respectively, for malaria infection, chlamydia, syphilis, bacterial vaginosis and STI/RTI combination. Only 10% of coinfections were symptomatic, and thus, 90% of women with coinfection would have been missed by the symptoms-based diagnostic approach. In the multivariate analysis, the first pregnancy (aOR = 2.4 [95% CI: 1.2-4.7]) was the only factor significantly associated with malaria and STI/RTI coinfection. Clinical symptoms were not associated with malaria and STI/RTI coinfection. CONCLUSION: The prevalence of malaria and curable STI/RTI coinfection was high among pregnant women. The poor performance of the clinical symptoms to predict coinfection suggests that alternative interventions are needed. Close
	Serge Henri Zango, Moussa Lingani, Innocent Valea, Ouindpanga Sekou Samadoulougou, Biebo Bihoun, Diagniagou Lankoande, Phillipe Donnen, Michele Dramaix, Halidou Tinto, Annie Robert Association of malaria and curable sexually transmitted infections with pregnancy outcomes in rural Burkina Faso Journal Article In: BMC Pregnancy Childbirth, vol. 21, no. 1, pp. 722, 2021, ISSN: 1471-2393, (© 2021. The Author(s). PMID: 34706705 PMCID: PMC8549350). Abstract \| BibTeX \| Tags: Coinfection, Impact, Malaria, Outcome, Pregnancy, STI \| Links: Close Close @article{Zango2021-ti, title = {Association of malaria and curable sexually transmitted infections with pregnancy outcomes in rural Burkina Faso}, author = {Serge Henri Zango and Moussa Lingani and Innocent Valea and Ouindpanga Sekou Samadoulougou and Biebo Bihoun and Diagniagou Lankoande and Phillipe Donnen and Michele Dramaix and Halidou Tinto and Annie Robert}, doi = {10.1186/s12884-021-04205-6}, issn = {1471-2393}, year = {2021}, date = {2021-10-27}, urldate = {2021-10-27}, journal = {BMC Pregnancy Childbirth}, volume = {21}, number = {1}, pages = {722}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Malaria and curable sexually transmitted infections (STIs) are severe infections associated with poor pregnancy outcomes in sub-Saharan countries. These infections are responsible for low birth weight, preterm birth, and miscarriage. In Burkina Faso, many interventions recommended by the World Health Organization were implemented to control the impact of these infections. After decades of intervention, we assessed the impact of these infections on pregnancy outcomes in rural setting of Burkina Faso. METHODS: Antenatal care and delivery data of pregnant women attending health facilities in 2016 and 2017 were collected in two rural districts namely Nanoro and Yako, in Burkina Faso. Regression models with likelihood ratio test were used to assess the association between infections and pregnancy outcomes. RESULTS: During the two years, 31639 pregnant women received antenatal care. Malaria without STI, STI without malaria, and their coinfections were reported for 7359 (23.3%), 881 (2.8 %), and 388 (1.2%) women, respectively. Low birth weight, miscarriage, and stillbirth were observed in 2754 (10.5 %), 547 (2.0 %), and 373 (1.3 %) women, respectively. Our data did not show an association between low birth weight and malaria [Adjusted OR: 0.91 (0.78 - 1.07)], STIs [Adjusted OR: 0.74 (0.51 - 1.07)] and coinfection [Adjusted OR: 1.15 (0.75 - 1.78)]. Low birth weight was strongly associated with primigravidae [Adjusted OR: 3.53 (3.12 - 4.00)]. Both miscarriage and stillbirth were associated with malaria [Adjusted OR: 1.31 (1.07 - 1.59)], curable STI [Adjusted OR: 1.65 (1.06 - 2.59)], and coinfection [Adjusted OR: 2.00 (1.13 - 3.52)]. CONCLUSION: Poor pregnancy outcomes remained frequent in rural Burkina Faso. Malaria, curable STIs, and their coinfections were associated with both miscarriage and stillbirth in rural Burkina. More effort should be done to reduce the proportion of pregnancies lost associated with these curable infections by targeting interventions in primigravidae women.}, note = {© 2021. The Author(s). PMID: 34706705 PMCID: PMC8549350}, keywords = {Coinfection, Impact, Malaria, Outcome, Pregnancy, STI}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Malaria and curable sexually transmitted infections (STIs) are severe infections associated with poor pregnancy outcomes in sub-Saharan countries. These infections are responsible for low birth weight, preterm birth, and miscarriage. In Burkina Faso, many interventions recommended by the World Health Organization were implemented to control the impact of these infections. After decades of intervention, we assessed the impact of these infections on pregnancy outcomes in rural setting of Burkina Faso. METHODS: Antenatal care and delivery data of pregnant women attending health facilities in 2016 and 2017 were collected in two rural districts namely Nanoro and Yako, in Burkina Faso. Regression models with likelihood ratio test were used to assess the association between infections and pregnancy outcomes. RESULTS: During the two years, 31639 pregnant women received antenatal care. Malaria without STI, STI without malaria, and their coinfections were reported for 7359 (23.3%), 881 (2.8 %), and 388 (1.2%) women, respectively. Low birth weight, miscarriage, and stillbirth were observed in 2754 (10.5 %), 547 (2.0 %), and 373 (1.3 %) women, respectively. Our data did not show an association between low birth weight and malaria [Adjusted OR: 0.91 (0.78 - 1.07)], STIs [Adjusted OR: 0.74 (0.51 - 1.07)] and coinfection [Adjusted OR: 1.15 (0.75 - 1.78)]. Low birth weight was strongly associated with primigravidae [Adjusted OR: 3.53 (3.12 - 4.00)]. Both miscarriage and stillbirth were associated with malaria [Adjusted OR: 1.31 (1.07 - 1.59)], curable STI [Adjusted OR: 1.65 (1.06 - 2.59)], and coinfection [Adjusted OR: 2.00 (1.13 - 3.52)]. CONCLUSION: Poor pregnancy outcomes remained frequent in rural Burkina Faso. Malaria, curable STIs, and their coinfections were associated with both miscarriage and stillbirth in rural Burkina. More effort should be done to reduce the proportion of pregnancies lost associated with these curable infections by targeting interventions in primigravidae women. Close
	Stephen A Roberts, Loretta Brabin, Halidou Tinto, Sabine Gies, Salou Diallo, Bernard Brabin Seasonal patterns of malaria, genital infection, nutritional and iron status in non-pregnant and pregnant adolescents in Burkina Faso: a secondary analysis of trial data Journal Article In: BMC Public Health, vol. 21, no. 1, pp. 1764, 2021, ISSN: 1471-2458, (© 2021. The Author(s). PMID: 34579679 PMCID: PMC8477466). Abstract \| BibTeX \| Tags: Abnormal vaginal flora, Adolescents, Bacterial vaginosis, Body Mass Index, Burkina Faso/epidemiology, Child, Female, Humans, Iron, iron biomarkers, Malaria, Malaria/drug therapy/epidemiology, MUAC, Pregnancy, Seasons, Vagina \| Links: Close Close @article{Roberts2021-gg, title = {Seasonal patterns of malaria, genital infection, nutritional and iron status in non-pregnant and pregnant adolescents in Burkina Faso: a secondary analysis of trial data}, author = {Stephen A Roberts and Loretta Brabin and Halidou Tinto and Sabine Gies and Salou Diallo and Bernard Brabin}, doi = {10.1186/s12889-021-11819-0}, issn = {1471-2458}, year = {2021}, date = {2021-09-01}, urldate = {2021-09-01}, journal = {BMC Public Health}, volume = {21}, number = {1}, pages = {1764}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Adolescents are considered at high risk of developing iron deficiency. Studies in children indicate that the prevalence of iron deficiency increased with malaria transmission, suggesting malaria seasonally may drive iron deficiency. This paper examines monthly seasonal infection patterns of malaria, abnormal vaginal flora, chorioamnionitis, antibiotic and antimalarial prescriptions, in relation to changes in iron biomarkers and nutritional indices in adolescents living in a rural area of Burkina Faso, in order to assess the requirement for seasonal infection control and nutrition interventions. METHODS: Data collected between April 2011 and January 2014 were available for an observational seasonal analysis, comprising scheduled visits for 1949 non-pregnant adolescents (≤19 years), (315 of whom subsequently became pregnant), enrolled in a randomised trial of periconceptional iron supplementation. Data from trial arms were combined. Body Iron Stores (BIS) were calculated using an internal regression for ferritin to allow for inflammation. At recruitment 11% had low BIS (\< 0 mg/kg). Continuous outcomes were fitted to a mixed-effects linear model with month, age and pregnancy status as fixed effect covariates and woman as a random effect. Dichotomous infection outcomes were fitted with analogous logistic regression models. RESULTS: Seasonal variation in malaria parasitaemia prevalence ranged between 18 and 70% in non-pregnant adolescents (P \< 0.001), peaking at 81% in those who became pregnant. Seasonal variation occurred in antibiotic prescription rates (0.7-1.8 prescriptions/100 weekly visits, P \< 0.001) and chorioamnionitis prevalence (range 15-68%, P = 0.026). Mucosal vaginal lactoferrin concentration was lower at the end of the wet season (range 2-22 μg/ml, P \< 0.016), when chorioamnionitis was least frequent. BIS fluctuated annually by up to 53.2% per year around the mean BIS (5.1 mg/kg(2), range 4.1-6.8 mg/kg), with low BIS (\< 0 mg/kg) of 8.7% in the dry and 9.8% in the wet seasons (P = 0.36). Median serum transferrin receptor increased during the wet season (P \< 0.001). Higher hepcidin concentration in the wet season corresponded with rising malaria prevalence and use of prescriptions, but with no change in BIS. Mean Body Mass Index and Mid-Upper-Arm-Circumference values peaked mid-dry season (both P \< 0.001). CONCLUSIONS: Our analysis supports preventive treatment of malaria among adolescents 15-19 years to decrease their disease burden, especially asymptomatic malaria. As BIS were adequate in most adolescents despite seasonal malaria, a requirement for programmatic iron supplementation was not substantiated.}, note = {© 2021. The Author(s). PMID: 34579679 PMCID: PMC8477466}, keywords = {Abnormal vaginal flora, Adolescents, Bacterial vaginosis, Body Mass Index, Burkina Faso/epidemiology, Child, Female, Humans, Iron, iron biomarkers, Malaria, Malaria/drug therapy/epidemiology, MUAC, Pregnancy, Seasons, Vagina}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Adolescents are considered at high risk of developing iron deficiency. Studies in children indicate that the prevalence of iron deficiency increased with malaria transmission, suggesting malaria seasonally may drive iron deficiency. This paper examines monthly seasonal infection patterns of malaria, abnormal vaginal flora, chorioamnionitis, antibiotic and antimalarial prescriptions, in relation to changes in iron biomarkers and nutritional indices in adolescents living in a rural area of Burkina Faso, in order to assess the requirement for seasonal infection control and nutrition interventions. METHODS: Data collected between April 2011 and January 2014 were available for an observational seasonal analysis, comprising scheduled visits for 1949 non-pregnant adolescents (≤19 years), (315 of whom subsequently became pregnant), enrolled in a randomised trial of periconceptional iron supplementation. Data from trial arms were combined. Body Iron Stores (BIS) were calculated using an internal regression for ferritin to allow for inflammation. At recruitment 11% had low BIS (< 0 mg/kg). Continuous outcomes were fitted to a mixed-effects linear model with month, age and pregnancy status as fixed effect covariates and woman as a random effect. Dichotomous infection outcomes were fitted with analogous logistic regression models. RESULTS: Seasonal variation in malaria parasitaemia prevalence ranged between 18 and 70% in non-pregnant adolescents (P < 0.001), peaking at 81% in those who became pregnant. Seasonal variation occurred in antibiotic prescription rates (0.7-1.8 prescriptions/100 weekly visits, P < 0.001) and chorioamnionitis prevalence (range 15-68%, P = 0.026). Mucosal vaginal lactoferrin concentration was lower at the end of the wet season (range 2-22 μg/ml, P < 0.016), when chorioamnionitis was least frequent. BIS fluctuated annually by up to 53.2% per year around the mean BIS (5.1 mg/kg(2), range 4.1-6.8 mg/kg), with low BIS (< 0 mg/kg) of 8.7% in the dry and 9.8% in the wet seasons (P = 0.36). Median serum transferrin receptor increased during the wet season (P < 0.001). Higher hepcidin concentration in the wet season corresponded with rising malaria prevalence and use of prescriptions, but with no change in BIS. Mean Body Mass Index and Mid-Upper-Arm-Circumference values peaked mid-dry season (both P < 0.001). CONCLUSIONS: Our analysis supports preventive treatment of malaria among adolescents 15-19 years to decrease their disease burden, especially asymptomatic malaria. As BIS were adequate in most adolescents despite seasonal malaria, a requirement for programmatic iron supplementation was not substantiated. Close
	Adéla"ide Compaoré, Kadija Ouedraogo, Palwende R Boua, Daniella Watson, Sarah H Kehoe, Marie-Louise Newell, Halidou Tinto, Mary Barker, Hermann Sorgho, INPreP group 'Men are not playing their roles', maternal and child nutrition in Nanoro, Burkina Faso Journal Article In: Public Health Nutr., vol. 24, no. 12, pp. 3780–3790, 2021, ISSN: 1475-2727 1368-9800, (Place: England PMID: 33000717). Abstract \| BibTeX \| Tags: Burkina Faso, Child, Child nutrition, Child Nutritional Physiological Phenomena, Community perceptions, Empowerment, Female, Humans, Male, Maternal nutrition, Mothers, Nutritional Status, Pregnancy, Qualitative research \| Links: Close Close @article{Compaore2021-hg, title = {'Men are not playing their roles', maternal and child nutrition in Nanoro, Burkina Faso}, author = {Ad\'{e}la"ide Compaor\'{e} and Kadija Ouedraogo and Palwende R Boua and Daniella Watson and Sarah H Kehoe and Marie-Louise Newell and Halidou Tinto and Mary Barker and Hermann Sorgho and INPreP group}, doi = {10.1017/S1368980020003365}, issn = {1475-2727 1368-9800}, year = {2021}, date = {2021-08-01}, urldate = {2021-08-01}, journal = {Public Health Nutr.}, volume = {24}, number = {12}, pages = {3780--3790}, publisher = {Cambridge University Press (CUP)}, abstract = {OBJECTIVE: To collect context-specific insights into maternal and child health and nutrition issues, and to explore potential solutions in Nanoro, Burkina Faso. DESIGN: Eleven focus groups with men and women from eleven communities, facilitated by local researchers. SETTING: The study took place in the Nanoro Health district, in the West-Central part of Burkina Faso. PARTICIPANTS: Eighty-six men (18-55 years) and women by age group: 18-25; 26-34 and 35-55 years, participated in the group discussions. RESULTS: Participants described barriers to optimal nutrition of mothers and children related to a range of community factors, with gender inequality as central. Major themes in the discussions are related to poverty and challenges generated by socially and culturally determined gender roles. Sub-themes are women lacking access to food whilst pregnant and having limited access to health care and opportunities to generate income. Although communities believe that food donations should be implemented to overcome this, they also pointed out the need for enhancing their own food production, requiring improved agricultural technologies. Given the important role that women could play in reducing malnutrition, these communities felt they needed to be empowered to do so and supported by men. They also felt that this had to be carried out in the context of an enhanced health care system. CONCLUSIONS: Findings reported here highlight the importance of nutrition-sensitive interventions and women's empowerment in improving maternal and child nutrition. There is a need to integrate a sustainable multi-sectorial approach which goes beyond food support.}, note = {Place: England PMID: 33000717}, keywords = {Burkina Faso, Child, Child nutrition, Child Nutritional Physiological Phenomena, Community perceptions, Empowerment, Female, Humans, Male, Maternal nutrition, Mothers, Nutritional Status, Pregnancy, Qualitative research}, pubstate = {published}, tppubtype = {article} } Close OBJECTIVE: To collect context-specific insights into maternal and child health and nutrition issues, and to explore potential solutions in Nanoro, Burkina Faso. DESIGN: Eleven focus groups with men and women from eleven communities, facilitated by local researchers. SETTING: The study took place in the Nanoro Health district, in the West-Central part of Burkina Faso. PARTICIPANTS: Eighty-six men (18-55 years) and women by age group: 18-25; 26-34 and 35-55 years, participated in the group discussions. RESULTS: Participants described barriers to optimal nutrition of mothers and children related to a range of community factors, with gender inequality as central. Major themes in the discussions are related to poverty and challenges generated by socially and culturally determined gender roles. Sub-themes are women lacking access to food whilst pregnant and having limited access to health care and opportunities to generate income. Although communities believe that food donations should be implemented to overcome this, they also pointed out the need for enhancing their own food production, requiring improved agricultural technologies. Given the important role that women could play in reducing malnutrition, these communities felt they needed to be empowered to do so and supported by men. They also felt that this had to be carried out in the context of an enhanced health care system. CONCLUSIONS: Findings reported here highlight the importance of nutrition-sensitive interventions and women's empowerment in improving maternal and child nutrition. There is a need to integrate a sustainable multi-sectorial approach which goes beyond food support. Close
	Toussaint Rouamba, Sékou Samadoulougou, Mady Ouédraogo, Hervé Hien, Halidou Tinto, Fati Kirakoya-Samadoulougou Asymptomatic malaria and anaemia among pregnant women during high and low malaria transmission seasons in Burkina Faso: household-based cross-sectional surveys in Burkina Faso, 2013 and 2017 Journal Article In: Malar. J., vol. 20, no. 1, pp. 211, 2021, ISSN: 1475-2875. Abstract \| BibTeX \| Tags: Adult, Anemia/epidemiology/parasitology, Asymptomatic carriage, Asymptomatic Infections/epidemiology, Burkina Faso/epidemiology, Community, Cross-Sectional Studies, Female, Haemoglobin, Humans, Malaria/epidemiology/parasitology, Parasitic/epidemiology/parasitology, Plasmodium, Pregnancy, Pregnancy Complications, Pregnant, Pregnant Women, Prevalence, Young Adult \| Links: Close Close @article{Rouamba2021-gn, title = {Asymptomatic malaria and anaemia among pregnant women during high and low malaria transmission seasons in Burkina Faso: household-based cross-sectional surveys in Burkina Faso, 2013 and 2017}, author = {Toussaint Rouamba and S\'{e}kou Samadoulougou and Mady Ou\'{e}draogo and Herv\'{e} Hien and Halidou Tinto and Fati Kirakoya-Samadoulougou}, doi = {10.1186/s12936-021-03703-4}, issn = {1475-2875}, year = {2021}, date = {2021-05-01}, urldate = {2021-05-01}, journal = {Malar. J.}, volume = {20}, number = {1}, pages = {211}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Malaria in endemic countries is often asymptomatic during pregnancy, but it has substantial consequences for both the mother and her unborn baby. During pregnancy, anaemia is an important consequence of malaria infection. In Burkina Faso, the intensity of malaria varies according to the season, albeit the prevalence of malaria and anaemia as well as their risk factors, during high and low malaria transmission seasons is underexplored at the household level. METHODS: Data of 1751 pregnant women from October 2013 to March 2014 and 1931 pregnant women from April 2017 to June 2017 were drawn from two cross-sectional household surveys conducted in 24 health districts of Burkina Faso. Pregnant women were tested for malaria in their household after consenting. Asymptomatic carriage was defined as a positive result from malaria rapid diagnostic tests in the absence of clinical symptoms of malaria. Anaemia was defined as haemoglobin level less than 11 g/dL in the first and third trimester and less than 10.5 g/dL in the second trimester of pregnancy. RESULTS: Prevalence of asymptomatic malaria in pregnancy was estimated at 23.9% (95% CI 20.2-28.0) during the high transmission season (October-November) in 2013. During the low transmission season, it was 12.7% (95% CI 10.9-14.7) between December and March in 2013-2014 and halved (6.4%; 95% CI 5.3-7.6) between April and June 2017. Anaemia prevalence was estimated at 59.4% (95% CI 54.8-63.8) during the high transmission season in 2013. During the low transmission season, it was 50.6% (95% CI 47.7-53.4) between December and March 2013-2014 and 65.0% (95% CI 62.8-67.2) between April and June, 2017. CONCLUSION: This study revealed that the prevalence of malaria asymptomatic carriage and anaemia among pregnant women at the community level remain high throughout the year. Thus, more efforts are needed to increase prevention measures such as IPTp-SP coverage in order to reduce anaemia and contribute to preventing low birth weight and poor pregnancy outcomes.}, keywords = {Adult, Anemia/epidemiology/parasitology, Asymptomatic carriage, Asymptomatic Infections/epidemiology, Burkina Faso/epidemiology, Community, Cross-Sectional Studies, Female, Haemoglobin, Humans, Malaria/epidemiology/parasitology, Parasitic/epidemiology/parasitology, Plasmodium, Pregnancy, Pregnancy Complications, Pregnant, Pregnant Women, Prevalence, Young Adult}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Malaria in endemic countries is often asymptomatic during pregnancy, but it has substantial consequences for both the mother and her unborn baby. During pregnancy, anaemia is an important consequence of malaria infection. In Burkina Faso, the intensity of malaria varies according to the season, albeit the prevalence of malaria and anaemia as well as their risk factors, during high and low malaria transmission seasons is underexplored at the household level. METHODS: Data of 1751 pregnant women from October 2013 to March 2014 and 1931 pregnant women from April 2017 to June 2017 were drawn from two cross-sectional household surveys conducted in 24 health districts of Burkina Faso. Pregnant women were tested for malaria in their household after consenting. Asymptomatic carriage was defined as a positive result from malaria rapid diagnostic tests in the absence of clinical symptoms of malaria. Anaemia was defined as haemoglobin level less than 11 g/dL in the first and third trimester and less than 10.5 g/dL in the second trimester of pregnancy. RESULTS: Prevalence of asymptomatic malaria in pregnancy was estimated at 23.9% (95% CI 20.2-28.0) during the high transmission season (October-November) in 2013. During the low transmission season, it was 12.7% (95% CI 10.9-14.7) between December and March in 2013-2014 and halved (6.4%; 95% CI 5.3-7.6) between April and June 2017. Anaemia prevalence was estimated at 59.4% (95% CI 54.8-63.8) during the high transmission season in 2013. During the low transmission season, it was 50.6% (95% CI 47.7-53.4) between December and March 2013-2014 and 65.0% (95% CI 62.8-67.2) between April and June, 2017. CONCLUSION: This study revealed that the prevalence of malaria asymptomatic carriage and anaemia among pregnant women at the community level remain high throughout the year. Thus, more efforts are needed to increase prevention measures such as IPTp-SP coverage in order to reduce anaemia and contribute to preventing low birth weight and poor pregnancy outcomes. Close
	Sabine Gies, Stephen A Roberts, Salou Diallo, Olga M Lompo, Halidou Tinto, Bernard J Brabin Risk of malaria in young children after periconceptional iron supplementation Journal Article In: Matern. Child Nutr., vol. 17, no. 2, pp. e13106, 2021, ISSN: 1740-8709 1740-8695, (© 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd. PMID: 33236840 PMCID: PMC7988873). Abstract \| BibTeX \| Tags: Burkina Faso, child iron, Dietary Supplements/analysis, Female, Folic Acid, Humans, Infant, Malaria, Newborn, periconceptional, placenta, Pregnancy, Premature Birth, Preschool \| Links: Close Close @article{Gies2021-aw, title = {Risk of malaria in young children after periconceptional iron supplementation}, author = {Sabine Gies and Stephen A Roberts and Salou Diallo and Olga M Lompo and Halidou Tinto and Bernard J Brabin}, doi = {10.1111/mcn.13106}, issn = {1740-8709 1740-8695}, year = {2021}, date = {2021-04-01}, urldate = {2021-04-01}, journal = {Matern. Child Nutr.}, volume = {17}, number = {2}, pages = {e13106}, publisher = {Wiley}, abstract = {This study in Burkina Faso investigated whether offspring of young mothers who had received weekly periconceptional iron supplementation in a randomised controlled trial were at increased risk of malaria. A child safety survey was undertaken in the peak month of malaria transmission towards the end of the trial to assess child iron biomarkers, nutritional status, anaemia and malaria outcomes. Antenatal iron biomarkers, preterm birth, fetal growth restriction and placental pathology for malaria and chorioamnionitis were assessed. Data were available for 180 babies surviving to the time of the survey when their median age was 9 months. Prevalence of maternal iron deficiency in the last trimester based on low body iron stores was 16%. Prevalence of active placental malaria infection was 24.8%, past infection 59% and chorioamnionitis 55.6%. Babies of iron supplemented women had lower median gestational age. Four out of five children ≥ 6 months were iron deficient, and 98% were anaemic. At 4 months malaria prevalence was 45%. Child iron biomarkers, anaemia and malaria outcomes did not differ by trial arm. Factors associated with childhood parasitaemia were third trimester C-reactive protein level (OR 2.1; 95% CI 1.1-3.9), active placental malaria (OR 5.8; 1.0-32.5, P = 0.042) and child body iron stores (OR 1.13; 1.04-1.23, P = 0.002). Chorioamnionitis was associated with reduced risk of child parasitaemia (OR 0.4; 0.1-1.0, P = 0.038). Periconceptional iron supplementation of young women did not alter body iron stores of their children. Higher child body iron stores and placental malaria increased risk of childhood parasitaemia.}, note = {© 2020 The Authors. Maternal \& Child Nutrition published by John Wiley \& Sons Ltd. PMID: 33236840 PMCID: PMC7988873}, keywords = {Burkina Faso, child iron, Dietary Supplements/analysis, Female, Folic Acid, Humans, Infant, Malaria, Newborn, periconceptional, placenta, Pregnancy, Premature Birth, Preschool}, pubstate = {published}, tppubtype = {article} } Close This study in Burkina Faso investigated whether offspring of young mothers who had received weekly periconceptional iron supplementation in a randomised controlled trial were at increased risk of malaria. A child safety survey was undertaken in the peak month of malaria transmission towards the end of the trial to assess child iron biomarkers, nutritional status, anaemia and malaria outcomes. Antenatal iron biomarkers, preterm birth, fetal growth restriction and placental pathology for malaria and chorioamnionitis were assessed. Data were available for 180 babies surviving to the time of the survey when their median age was 9 months. Prevalence of maternal iron deficiency in the last trimester based on low body iron stores was 16%. Prevalence of active placental malaria infection was 24.8%, past infection 59% and chorioamnionitis 55.6%. Babies of iron supplemented women had lower median gestational age. Four out of five children ≥ 6 months were iron deficient, and 98% were anaemic. At 4 months malaria prevalence was 45%. Child iron biomarkers, anaemia and malaria outcomes did not differ by trial arm. Factors associated with childhood parasitaemia were third trimester C-reactive protein level (OR 2.1; 95% CI 1.1-3.9), active placental malaria (OR 5.8; 1.0-32.5, P = 0.042) and child body iron stores (OR 1.13; 1.04-1.23, P = 0.002). Chorioamnionitis was associated with reduced risk of child parasitaemia (OR 0.4; 0.1-1.0, P = 0.038). Periconceptional iron supplementation of young women did not alter body iron stores of their children. Higher child body iron stores and placental malaria increased risk of childhood parasitaemia. Close
2015
Journal Articles
	Halidou Tinto, Esperança Sevene, Stephanie Dellicour, Gregory S. Calip, Umberto D'Alessandro, Eusébio Macete, Seydou Nakanabo-Diallo, Adama Kazienga, Innocent Valea, Hermann Sorgho, Anifa Valá, Orvalho Augusto, Maria Ruperez, Clara Menendez, Peter Ouma, Meghna Desai, Feiko Ter Kuile, Andy Stergachis Assessment of the safety of antimalarial drug use during early pregnancy (ASAP): Protocol for a multicenter prospective cohort study in Burkina Faso, Kenya and Mozambique Journal Article In: Reproductive Health, vol. 12, iss. 1, pp. 161-165, 2015, ISSN: 17424755. Abstract \| BibTeX \| Tags: ACTs, Malaria, Pregnancy \| Links: Close Close @article{Tinto2015, title = {Assessment of the safety of antimalarial drug use during early pregnancy (ASAP): Protocol for a multicenter prospective cohort study in Burkina Faso, Kenya and Mozambique}, author = {Halidou Tinto and Esperan\c{c}a Sevene and Stephanie Dellicour and Gregory S. Calip and Umberto D'Alessandro and Eus\'{e}bio Macete and Seydou Nakanabo-Diallo and Adama Kazienga and Innocent Valea and Hermann Sorgho and Anifa Val\'{a} and Orvalho Augusto and Maria Ruperez and Clara Menendez and Peter Ouma and Meghna Desai and Feiko Ter Kuile and Andy Stergachis}, url = {https://www.internationalscholarsjournals.com/abstract/field-evaluation-of-sd-bioline-malaria-antigen-pf-forrnplasmodium-falciparum-malaria-diagnosis-in-nanorornburkina-faso-62349.html}, doi = {10.1186/s12978-015-0101-0}, issn = {17424755}, year = {2015}, date = {2015-01-01}, journal = {Reproductive Health}, volume = {12}, issue = {1}, pages = {161-165}, publisher = {BioMed Central Ltd.}, abstract = {Background: A major unresolved safety concern for malaria case management is the use of artemisinin combination therapies (ACTs) in the first trimester of pregnancy. There is a need for human data to inform policy makers and treatment guidelines on the safety of artemisinin combination therapies (ACT) when used during early pregnancy. Methods: The overall goal of this paper is to describe the methods and implementation of a study aimed at developing surveillance systems for identifying exposures to antimalarials during early pregnancy and for monitoring pregnancy outcomes using health and demographic surveillance platforms. This was a multi-center prospective observational cohort study involving women at health and demographic surveillance sites in three countries in Africa: Burkina Faso, Kenya and Mozambique [(ClinicalTrials.gov Identifier: NCT01232530)]. The study was designed to identify pregnant women with artemisinin exposure in the first trimester and compare them to: 1) pregnant women without malaria, 2) pregnant women treated for malaria, but exposed to other antimalarials, and 3) pregnant women with malaria and treated with artemisinins in the 2nd or 3rd trimesters from the same settings. Pregnant women were recruited through community-based surveys and attendance at health facilities, including antenatal care clinics and followed until delivery. Data from the three sites will be pooled for analysis at the end of the study. Results are forthcoming. Discussion: Despite few limitations, the methods described here are relevant to the development of sustainable pharmacovigilance systems for drugs used by pregnant women in the tropics using health and demographic surveillance sites to prospectively ascertain drug safety in early pregnancy.}, keywords = {ACTs, Malaria, Pregnancy}, pubstate = {published}, tppubtype = {article} } Close Background: A major unresolved safety concern for malaria case management is the use of artemisinin combination therapies (ACTs) in the first trimester of pregnancy. There is a need for human data to inform policy makers and treatment guidelines on the safety of artemisinin combination therapies (ACT) when used during early pregnancy. Methods: The overall goal of this paper is to describe the methods and implementation of a study aimed at developing surveillance systems for identifying exposures to antimalarials during early pregnancy and for monitoring pregnancy outcomes using health and demographic surveillance platforms. This was a multi-center prospective observational cohort study involving women at health and demographic surveillance sites in three countries in Africa: Burkina Faso, Kenya and Mozambique [(ClinicalTrials.gov Identifier: NCT01232530)]. The study was designed to identify pregnant women with artemisinin exposure in the first trimester and compare them to: 1) pregnant women without malaria, 2) pregnant women treated for malaria, but exposed to other antimalarials, and 3) pregnant women with malaria and treated with artemisinins in the 2nd or 3rd trimesters from the same settings. Pregnant women were recruited through community-based surveys and attendance at health facilities, including antenatal care clinics and followed until delivery. Data from the three sites will be pooled for analysis at the end of the study. Results are forthcoming. Discussion: Despite few limitations, the methods described here are relevant to the development of sustainable pharmacovigilance systems for drugs used by pregnant women in the tropics using health and demographic surveillance sites to prospectively ascertain drug safety in early pregnancy. Close

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" Our main objective is to develop and maintain over time a good expertise and infrastructure ensuring high quality training and clinical research."
Prof Halidou TINTO, PharmD, Msc, PhD Head of the CRUN