Abstract:
Background: It is well documented that sub-Saharan Africa bears the highest burden of both malaria and HIV. This pathologic effect of malaria on the placental has led to the staging of placental malaria histology. These pathologic features may reflect different levels in the breach of the integrity of the placenta which may predispose to transmission of congenital malaria and possibly HIV. But few if any have examined the association of maternal placental malaria histology stages in HIV positive and negative mothers and the effects of these on their newborns (congenital malaria).
Methods: Subjects were 162 newborns of HIV/malaria co-infected mothers and Controls were 162 newborns of HIV negative malaria infected mothers. Blood film for malaria parasites was done on cord blood and peripheral blood on days 1, 3 and 7 in the newborns. Maternal peripheral blood film for malaria parasite was done at delivery and placental tissue was obtained for confirmation of placental malaria by histology. Diagnosis of malaria in blood films was by light microscopy.
Results: The placental malaria histology in HIV positive mothers were predominantly the chronic type (51.9%) and past type (54.6%) in HIV negative mothers respectively. Congenital malaria was significantly more in chronic types of placental malaria histology irrespective of maternal HIV status (p= 0.017 in subjects and 0.000 in controls respectively)
Conclusion: Babies born to mothers are at increased risk for congenital malaria if their placental malaria histology is of the chronic type compared to the other types (active and past) irrespective of maternal HIV status.
Funding: None
Conflict of interest: None to declare
Keywords: Placental malaria histology; HIV; congenital malaria; HIV/malaria co-infected mothers; Benin-City; Nigeria
Audience Take Away
- Placental malaria histologic pattern in mothers with HIV/malaria co-infection
- Placental malaria histologic pattern in HIV naive mothers with malaria
- The association of placental malaria histologic type and the concomitant risk of congenital malaria in their newborns
This placental malaria histologic pattern has provided an insight as to the risk of newborns having congenital malaria when delivered to HIV positive mothers who are co-infected with malaria. The knowledge gap is having a high index of suspicion when handling such babies and including malaria in both the screening and treatment for congenital malaria that has the potential of mortality if not properly evaluated.
