Biomedical subjects

J A Muchi

Publications and source records attributed to J A Muchi.

3 recordsLinked to original sources

PubMed1996

Malaric placentas. A quantitative study and clinico-pathological correlations.

A histological and morphometric study was conducted on 372 placentae out of a total 440 delivered in Zanzibar. Fibrin (F), intervillous space (IVS) and Villi (V) relative volumes were determined by the point-counting system and the ratio of syncytium to blood capillaries by the linear intercept method. Parasitemia load and inflammatory reaction were graded semiquantitatively by the use of a 1 mm square grid. Parasitised red cells identified active malaria (AM), the presence of malarial pigment only identified past malaria (PM), and the absence of both characterized non-malarial placentae (NM). AM(17.87%), PM(21.61%) and NM(60.52%) placentae did not vary significantly in weight. Newborns from AM had a significantly lower weight than those from PM and NM. Peripheral and placental parasitemia were not coincident. Placental parasitemia load increased parallel with birthweight. The latter decreased with the increasing severity of the inflammation, particularly with the prevalence of lymphocytes in the IVS. Significantly increased volume of F was found in AM and PM placentae, while no significant variation was noticed in IVS and V volumes. The syncytium/capillaries ratio was significantly increased in AM. We conclude that low birthweight in malaria is linked to IVS inflammation but not to F deposits or parasitemia load. Non-leukotactic lymphokines might play some role. Morphologic aspects bespeak for a less mature placenta than expected and this might represent an adaptive change.

Birth Weight↗

PubMed1996

Malarial infection and birthweight in urban Zanzibar, Tanzania.

In urban Zanzibar, Tanzania, 389 women with full-term pregnancies were studied to see what effect their infection with malaria (at delivery) had on the birthweight (BW) of their infants. The overall prevalence of low birthweight (LBW) (i.e. < 2500 g) was 3.9% (15 out of 389). Overall, 21.3% (82/384) of the women only had peripheral parasitaemias at delivery, 17.6% (58/329) only had active placental infections and 47.9% (157/328) had both. The youngest women (< 20 years), the primiparae and those with Plasmodium infection gave birth to neonates with relatively low mean BW. The lowest mean BW (2967 g) was found among the offspring of women with active placental infection (N = 58). The women with past/chronic infection (N = 73) or no infection (N = 201) generally produced heavier infants, with mean BW of 3242 and 3338 g, respectively. The women with active placental infection were also far more likely to have babies of LBW (15.5%) than those with past/chronic infection (1.4%) or no infection (1.5%). Multivariate analysis indicated that the highest relative risk of LBW (10.1, with a 95% confidence interval of 2.9-35.4) was associated with active placental infection, with no significant difference between primiparae and multiparae. In the study population, therefore, with its low prevalence of LBW, malaria infection increased the risk of LBW in full-term neonates by about 10-fold, with a population-attributable proportion of 55.4%.

Adult↗

PubMed1994

Malaria and anaemia in pregnant women in urban Zanzibar, Tanzania.

Severe anaemia in pregnancy is a major obstetric problem in malaria-endemic areas. This study reports a cross-sectional investigation of malaria infection and haematological values at delivery in 440 women from urban Zanzibar. Severe anaemia [with haemoglobin (Hb) < or = 7 g/dl] was identified in 36 women (9.3%) and mild anaemia (7 < Hb < 10 g/dl) in 269 (69.7%) while 81 women (21.0%) had normal Hb values. Malaria infection was diagnosed in 187/385 women (48.6%) on the basis of either peripheral blood examination or placental histology. Univariate analysis indicated that the proportion of women with anaemia was similar in those with (85%) and without (80%) malaria infection. However, when primigravidae were considered alone, malaria infection was significantly more frequent among anaemic women (65.2%) than in those with normal Hb values (40.0%). In the logistic regression analysis, including age, parity, education level, malaria and free serum iron as independent variables and anaemia (Hb < or = 10 g/dl) as response variable, the odds ratio (OR) for malaria infection was 1.2 (P > 0.1). However, a similar analysis indicated that malaria was significantly associated with anaemia in the primigravidae, with an OR of 3.2 (95% confidence interval: 1.1-9.6; P < 0.05). In conclusion, this cross-sectional investigation indicated that malaria plays a significant role in the determination of anaemia in primigravidae, but not in multiparae, in the urban study area.

Adult↗