Neonatal malaria Probable immune system modulation by Plasmodium falciparum infection

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Date
2006
Authors
Abd Algaleil, Kawthar
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Publisher
University of Khartoum
Abstract
Malaria is a global health problem, with high prevalence rates especially among children andpregnant 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). In conclusion; neonatal Th2 immune responses with measurable levels of IL-10, anti-MSP119 IgG predominate to fight neonatal malaria and maintain normal pregnancy. Levels of maternal/cord anti-MSP119 IgG do not correlate to residence of pregnant women. Levels of sTf- Rs in the cord blood closely correlate to the expectant mothers haemoglobin levels. Mean birth weights were significantly lower in babies of mothers with pregnancy-associated malaria.
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Keywords
Malaria endemicity,Merozoite Surface Protein-2 (MSP-2)
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