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Volume 25, Number 10—October 2019
Research

VAR2CSA Serology to Detect Plasmodium falciparum Transmission Patterns in Pregnancy

Ana Maria Fonseca, Raquel González, Azucena Bardají, Chenjerai Jairoce, Maria Rupérez, Alfons Jiménez, Llorenç Quintó, Pau Cisteró, Anifa Vala, Charfudin Sacoor, Himanshu Gupta, Jennifer Hegewisch-Taylor, Joe Brew, Nicaise Tuikue Ndam, Simon Kariuki, Marta López, Carlota Dobaño, Chetan E. Chitnis, Peter Ouma, Michael Ramharter, Salim Abdulla, John J. Aponte, Achille Massougbodji, Valerie Briand, Ghyslain Mombo-Ngoma, Meghna Desai, Michel Cot, Arsenio Nhacolo, Esperança Sevene, Eusebio Macete, Clara Menéndez, and Alfredo MayorComments to Author 
Author affiliations: ISGlobal, Hospital Clinic–Universitat de Barcelona, Barcelona, Spain (A.M. Fonseca, R. González, A. Bardají, M. Rupérez, A. Jiménez, L. Quintó, P. Cisteró, H. Gupta, J. Hegewisch-Taylor, J. Brew, C. Dobaño, J.J. Aponte, C. Menéndez, A. Mayor); ICBAS–Universidade do Porto, Porto, Portugal (A.M. Fonseca); Centro de Investigação em Saúde da Manhiça, Maputo, Mozambique (R. González, A. Bardají, C. Jairoce, M. Rupérez, A. Vala, C. Sacoor, C. Dobaño, J.J. Aponte, A. Nhacolo, E. Sevene, E. Macete, C. Menéndez, A. Mayor); Universidade Eduardo Mondlane, Maputo (E. Sevene); CIBER Epidemiología y Salud Pública, Madrid, Spain (R. González, A. Jiménez, A. Mayor, A. Bardají); Université d’Aboméy Calavi, Cotonou, Benin (N.T. Ndam, A. Massougbodji); Kenya Medical Research Institute, Kisumu, Kenya (S. Kariuki, P. Ouma); BCNatal–Barcelona Center for Maternal-Fetal and Neonatal Medicine–Hospital Clínic and Hospital Sant Joan de Deu, Barcelona (M. López); Vrije Universiteit Amsterdam, Amsterdam, the Netherlands (J. Brew); MERIT, Institut de Recherche pour le Développement, Paris, France (N.T. Ndam, V. Briand, M. Cot); Institut Pasteur, Paris (C.E. Chitnis); Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany (G. Mombo-Ngoma); Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (M. Ramharter, G. Mombo-Ngoma); University Medical Center Hamburg-Eppendorf, Hamburg (M. Ramharter); Ifakara Health Institute, Dar es Salaam, Tanzania (S. Abdulla); Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon (G. Mombo-Ngoma); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (M. Desai)

Main Article

Table

Participants in study of VAR2CSA serologic testing to detect Plasmodium falciparum transmission patterns, by country and HIV status*

Variable HIV-uninfected, no. (%)
HIV-infected, no. (%)
2004–2005
  2010–2012
2004–2005
  2010–2012
Mozambique, n = 65 Mozambique,† n = 485 Benin, n = 854 Gabon, n = 131 Tanzania, n = 31 Mozambique, n = 81 Mozambique,† n = 362 Kenya, n = 296
Parity
Primigravid 17 (26) 181 (37) 188 (22) 38 (29) 16 (52) 28 (35) 46 (13) 22 (7)
Multigravid
48 (74)

304 (63)
666 (78)
93 (71)
15 (48)

53 (65)

316 (87)
274 (93)
Age, y
<20 19 (29) 181 (37) 86 (10) 42 (32) 5 (16) 27 (33) 41 (11) 15 (5)
20–24 17 (26) 123 (25) 281 (33) 45 (34) 14 (45) 26 (32) 84 (23) 96 (32)
>25
29 (45)

181 (37)
487 (57)
44 (34)
12 (39)

28 (35)

237 (65)
185 (62)
IPTp
Sulfadoxine/pyrimethamine 65 (100) 151 (31) 288 (34) 55 (42) 11 (35) 81 (100) 0 0
Mefloquine 0 334 (69) 566 (66) 76 (58) 20 (65) 0 178 (49) 139 (47)
Placebo‡
0

0
0
0
0

0

184 (51)
157 (53)
Microscopy§¶
Positive 9 (14) 13 (3) 110 (15) 3 (2) 1 (3) 8 (10) 8 (2) 15 (5)
Negative
56 (86)

468 (97)
616 (85)
125 (98)
30 (97)

73 (90)

323 (98)
268 (95)
qPCR¶#
Positive 16 (25) 28 (6) 332 (46) 9 (10) 0 21 (26) 13 (4) 22 (8)
Negative 49 (75) 424 (94) 393 (54) 80 (90) 31 (100) 60 (74) 314 (96) 251 (92)

*IPTp, intermittent preventive treatment during pregnancy; qPCR, quantitative PCR.
†40% (196/485) of HIV-uninfected and 12% (43/362) of HIV-infected participants were pregnant women with samples collected also at recruitment and second IPTp administration.
‡All HIV-infected women who received placebo were also receiving cotrimoxazol prophylaxis.
§Maternal microscopic infection defined by the presence of P. falciparum parasites in peripheral blood or in placenta on microscopic or histologic examination, respectively.
¶Not determined: 179 microscopy and 196 qPCR.
#Maternal qPCR-positive infection was defined by a positive result on qPCR testing in peripheral or placental blood.

Main Article

Page created: September 17, 2019
Page updated: September 17, 2019
Page reviewed: September 17, 2019
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