Project Details

The effect of maternal iron status during pregnancy on the potential for malaria transmission

Sarah Boudova, MD, PhD

Summary

BACKGROUND: Malaria is a major cause of global morbidity and mortality, and disproportionately impacts pregnant women and children. Pregnant women can carry subclinical malaria infections for extended periods of time and have high rates of carriage of gametocytes- the malaria life stage that is transmitted to mosquitos—and thus serve as a reservoir for malaria transmission. GAP: Iron deficiency anemia has been associated with protection from clinical malaria. It is unknown what effect iron deficiency during pregnancy has on subclinical malaria and gametocytemia, and thus the potential for malaria transmission HYPOTHESIS: We hypothesize that iron deficiency (inflammation corrected ferritin <15 ug/L) is associated with decreased risk of subclinical malaria (parasitemia detected by RT-PCR in the absence of clinical symptoms) and decreased risk of gametocytemia (detected by RT-PCR) at delivery METHODS: This is a sub-study of a large observational trial of birth outcomes in resource-limited settings. Blood specimens from 650 women without hemoglobinopathies who delivered at Korle-Bu teaching hospital in Ghana will be tested for iron deficiency, malaria and the presence of gametocytes. RESULTS: Pending. IMPACT: If iron deficiency prevents malaria transmission it will be important to examine interventions that couple malaria prevention with iron supplementation during pregnancy. It would also be valuable to examine the impact of intermittent preventive therapy during pregnancy using drugs with gametocidal activity on risk of malaria transmission.