Parasitological and Molecular Assesment of Some Antimalarial Drugs Used In Pregnancy in Lagos

ABSTRACT An estimated 25-30 million women become pregnant annually in malaria-endemic areas of Africa; most of them live in areas of stable malaria transmission (WHO, 2004). The immunosuppression associated with pregnancy and the absence of specific immunity to the unique subset of P. falciparum that sequester in the placenta, especially in primigravidae, have been adduced as reasons for the increased susceptibility of pregnant women to malaria infection (Fried and Duffy, 1996; Hviid and Salanti, 2007). The anti-disease immunity acquired prior to pregnancy keeps the infection asymptomatic in presentation. However, the subclinical infection still poses a great danger to both the mother and the foetus. The presence of parasites in the placenta can lead to maternal anaemia (potentially responsible for maternal death when severe), low birth weight (LBW), intrauterine growth retardation, congenital malaria, premature delivery, abortion and stillbirth (Steketee et al., 1996; Newman et al., 2003; Rogerson and Boeuf, 2007).

Reports on the burden of MIP in Nigeria vary widely, ranging from 8.4% to 72% (Okwa, 2003; Adefioye et al., 2007; Falade et al., 2008), thus exposing the obvious challenge in methodology and competency of microscopists used in these assessments. With the increased level of malaria interventions currently sponsored by the managers of the Global Fund (for HIV/AIDS, tuberculosis and malaria), it becomes difficult to assess their impact since the baseline data for such comparisons are questionable and unrealistic. It is therefore necessary to determine acceptable prevalence data on MIP using standard protocol. The paucity of data on MIP in Nigeria was shown in two consecutive World Malaria Reports of 2008 and 2009 (WHO, 2008; 2009).