Neonatal malaria: Probable immune system modulation by Plasmodium falciparum infection

Abstract

Malaria is a global health problem, with high prevalence rates especially among children and pregnant women. This hospital-based, prospective & longitudinal study aimed to determine the modulation of the neonatal immune system due to plasmodium falciparum (P. falciparum) infection, collective antimalarial immunity in cord blood and to measure soluble transferrin receptors in neonates as a measure of iron status. Following informed consent, one hundred and five women were enrolled, 44.3% were primigravidae. Seronegativity was seen in 56.2% of primigravidae. Multigravidae had an increased IgG anti- MSP119 seropositivity, while secondigravidae and grandmultigravidae were comparable to primigravidae. Women living in rural areas had increased anti- MSP119 densities, compared to those living in urban and semi-urban areas. The densities of anti- MSP119 were significantly higher in women with ≥ 1-malaria attacks, compared to those with one malaria attack (p< 0.009). The cytokines pattern in cord blood mononuclear cells was predominantly Th2 type of immune response with predominance of interleukine-10 (IL-10) virtual absence of interferon gamma (IFN-γ). Women with repeated attacks of malaria during pregnancy had a 1L-10: IgG of 1:30 compared 1:80 in those with one or no malaria attack. Soluble transferrin receptors (s-Tf-Rs) levels in cord blood were significantly correlated to the Haemoglobin concentration of the mothers and gravidity (p<0.000). There was no significant correlation between s-Tf-Rs and babies’ birth weights (p<0.8). Babies whose mothers had malaria during pregnancy had significantly low birth weight compared to those whose mothers experienced no pregnancy-associated malaria (p<0.000).