Abstracts

533B
Malaria in pregnancy; Promoting andscaling up
the implementation of the strategy in Southern
Africa [MIM-WD-81120]
N. Chisaka, S. Murugasampillay, A. Ba-nguz, N. Sipilanyambe,
A. Ali, P. Uusiku, F. Filomeno, F. Saute, A.
Mwita, V. Teveredzi
(1) World Health Organisation, Southern Africa Inter-
CountryMalaria Control Programme; (2) World
Health Organisation, Regional Office for Africa;
(3) National Malaria Control Centre, Zambia; (4)
National Malaria Control Programme, Zanzibar; (5)
National Malaria Control Programme, Namibia; (6)
National Malaria Control Programme, Angola; (7)
National Malaria Control Programme, Mozambique;
(8) National Malaria Control Programme, Tanzania;
(9) National Malaria Control Programme, Zimbabwe
Introduction: Malaria in pregnancy remains a major
cause of morbidity and mortality in southern Africa.
Interventions directed towards malaria in pregnancy
vary depending on the intensity of malaria transmission.
Those countries with stable malaria transmission
embrace all the three components of MIP, viz; good
case management, use of IPT and ITNs. However, in
those countries with unstable transmission case management
and personal protection remain the main intervention
areas.
Methods: Aim of paper is to highlight the adoption,
implementation and scaling up of malaria in pregnancy
in countries of Southern Africa. Eight of the countries
in southern Africa are implementing MIP strategy.
The other countries are only looking at effective case
management and personal protection. The process of
adoption of MIP in most of the countries involved partnership
participation in the development of the policy
strategy and followed by consensus meeting to agree
on the way forward for MIP. Sensitization of MIP strategy
to the health workers and involvement of RH for
the implementation of MIP was a crucial process as
delivery of MIP is done by ANC workers.
Results: As data collection for MIP in most countries is
rather lacking a deliberate process of developing indicators
that can be collected via the HMIS was initiated.
In addition, the antenatal card was modified to reflect
the delivery of IPT as DOT, nutritional supplements
and ITN use. For the early adopter countries, Tanzania,
Abstracts / Acta Tropica 95S (2005) S1–S506 S445
Malawi and Zambia, coverage of both IPT and ITNs is
at scale and coverage indicators are constantly improving.
The involvement of RH in the implementation of
MIP has strengthened integration between malaria and
RH units. It has also supported the first line health
worker in managing pregnant women in a holistic manner.
Major challenges of MIP include inadequate personnel
and commodities at ANC units. The concept
of integrated information gathering is also a big challenge.
Scaled up implementation for MIP is possible
as shown by early adopter countries. Impact on country
wide implementation on maternal and peri-natal
morbidity and mortality remains. Other challenges
include SP stock-outs, the unavailability of nets at ANC
and the capturing of MIP data correctly within the
HMIS.
Interpretation: Finally the increased resistance of P.
falciparum to SP implies the intervention may be shortlived
and urgent need for alternative drugs is critical.
534C
The human choriocarcinoma cell line BeWo as an
in vitro model for adhesion of Plasmodium falciparum
infectedredbloodcells to syncytiotrophoblast
[MIM-TS-19588]
R. Haase, R. Megnekou, M. Ofori, M. Lundquist, L.
Hviid, T. Staalsoe
(1) Center for Medical Parasitology(CMP), Copenhagen
UniversityHospital, Universityof Copenhagen,
Copenhagen, Denmark; (2) ImmunologyUnit, Noguchi
Memorial Institute for Medical Research, Legon,
Ghana
Introduction: Pregnancy-associated malaria is characterised
by sequestration of infected erythrocytes (IE)
in the placenta. These parasites express variant surface
antigens (VSAPAM) that are recognised in a sexand
parity-dependent manner and mediate binding to
chondroitin sulphate A (CSA). Selection for VSAPAM
expression in vitro and adhesion assays with such
parasites are central for molecular characterisation of
VSAPAM. We have used the human choriocarcinoma
cell line BeWo for these purposes.
Methods: Three P. falciparum lines, 3D7, FCR3 and
Hb3 were panned × 3 on BeWo cells. The selected
and unselected lines were tested for expression of
VSAPAM by labelling purified IE with plasma from