International Conference on Parasitology August 24-26, 2015 Philadelphia, Pennsylvania, USA

Objectives: Occurrence of heat-tolerant free-living amoebae in the Nile, tap and swimming-pool waters in the Nile Delta region, Egypt. Morpho-physiological, biochemical and molecular characterization of the isolated strains of free-living amoebae.

Materials & Methods: Cultivation of free-living amoebae on non-nutrient agar.Identification of the isolated strains based on the morphology of cyst and trophozoite forms as well as temperature and osmo-tolerance assays. Biochemical characterization of the isolated amoeba strains using quantitative and qualitative (SDS-PAGE) assays as well as qualitative determination of proteolytic activity in zymograph analysis.

Results: Potentially pathogenic free-living amoebae were isolated from all of the examined water sources. Colorimetric assays showed protease activity in heat-tolerant isolates of Acanthamoeba and Naegleria. All pathogenic isolates exhibited higher protease activity than non-pathogenic ones did. The zymographic protease assays showed various banding patterns for different strains of Acanthamoeba and Naegleria.

Conclusion: The incidence and prevalence of the pathogenic free-living amoebae in different populations using parasitological and biochemical diagnostic tools will provide baseline data against which the risk factors associated with waterborne transmission can be identified.

Bekir OGUZ has completed his PhD at the age of 29 years from Yuzuncu Yıl University. He is thernAssisstant Prof, in Parasitology, Veterinary Faculty. He has published more than 6 papers inrnreputed journals.

Cockroaches are claimed to be mechanical transmitters of disease causing microorganismsrnsuch as intestinal parasites, bacteria, fungi, and viruses. A study was conducted to determine thernrole of cockroaches as potential carriers of parasites of medical importance in Van, Turkey. Onernhundred and thirty-eight cockroaches were collected from different parts of apartments and housesrnaround the town from March to April 2014. All of the collected cockroaches were identified tornspecies as Blatella germanica. They were examinated for isolation and identification of humanrnintestinal parasites from external surface of cockroaches. The results show that 66 (48 %) of therncockroaches harbored parasitic organisms. Of these, 96.6 % were protozoa and the remaining 3.4 %rnwere helminthes. Of the isolated helminthes, the species included Toxocara sp. (3 %), Ascarisrnlumbricoides (3 %), Trichostrongylus sp. (1.5 %), Trichuris trichiura (1.5 %), unidentifiedrnnematode egg samples (3 %). The protozoa types that were identified included Endolimax nana (7.6rn%), Blastocystis hominis (41 %), Entamoeba histolytica/E. dispar (16.7 %), Eimeria spp. (7.6 %),rnChilomastix mesnilli ( 4.5 %), Entamoeba coli (35 %), Giardia sp. ( 13.6 %), Iodamoeba butschliirn(7.6 %). In conclusion, Blattella germenica was found to harbor intestinal parasites of public healthrnimportance. Hence, awareness on the potential role of cockroaches in the mechanical transmissionrnof human intestinal parasites needs to be created. Therefore, control of cockroaches willrnsubstantially minimize the spread of infectious diseases in our environment.

Manana Lordkipanidze has completed his PhD at the age of 50 years from Ilia State University, Institute of Zoology. She is the main investigator of entomopathogens. Her field usage biological pesticides: entomopathogenic nematodes, entomopathogenic fungi and bacteria for biological control of the major pest insects in Georgia. She has more than 70 papers in reputed journals.

Ecological changes connected with global warming produce an essential effect on the thermal conditions of the biotopes of blood-feeding arthropods, which play a highly important role in the transmission of various pathogenic microorganisms. In recent years much attention has been given to the study of carriers of pathogenic microorganisms which cause various infections in man and animals. rnAmong blood-feeding arthropods as carriers of causative agents of dangerous infectious diseases, mosquitoes have major importance. Mosquitoes (Diptera: Culicidae) are the most important groups of arthropods in medical and veterinary. They act as vectors of several diseases such as malaria, yellow fever, dengue etc. rnThe objective of this study was to evaluate the susceptibility of entomopathogenic menatode (EPN) species Steinernema feltiae and biological pesticide Bacilus thiringiensis (Bt) against mosquitoes-Anopheles maculipennis and Culex pipiens molestus in the laboratory. These biological agents are regarded as environmentally friendly, and successfully used for biological control of insect pests.rn Both species of mosquitoes (50 specimens of larval stage) were treated with suspension of 5000 nematodes/ml water (i.e. dose 100 nem/per insect) and Bt with concentration 0.1, 0.2, 0.5%. Mortality was assessed 3, 4, 5 and 6 days after treated. Effectiveness of EPNs and Bt ware checked as indicator of infection. It can be concluded that EPNs infection slight insecticide activity towards the larvae of the indicated mosquito’s species. More effective is the action of Bt, the insect mortality (100%) growing with the increase of concentration 0.5%. The mosquito’s larvae are most sensitive to the Bt toxins.

Lela Arabuli has completed Tbilisi State University Faculty of Biology the Master´s programme in 2005. Now she is the student of Tbilisi Ilia State University School of Natural Sciences and Engineering at Doctoral Program of Life sciences. Also she works as an assistant-researcher in Ilia State Universiry Institute of Zoology´s Parasitological research group. She has published 10 scientific articles and she is a participant of 7 International scientific conferences. Her research object is molluscs´ as helminths intermediate hosts investigation of spreading invasion diseases. She is a member of Georgian Parasitological Association.

For the first time Limnaea stagnalis is investigated in the ecologically important and parasitological uninvestigated region. Lake Madatapa is located on the Javakheti plateau and is one of the richest areas in Caucasus in terms of its waters and marshy lands. In September 2014, 192 individuals of L. stagnalis were investigated. 97.3% of mollusks were invaded by larval forms of trematodes on different stage of development( sporocists, rediae, cercariae, metacercariae). Immature forms of three trematoda species were found:Moliniella anceps(Echinostomatidae Dietz, 1909); Diplostomum spathaceum (Strigeidae Railliet, 1919); Notocotilus sp. (Notocotylidae Lühe, 1909). As for dominant parasites larval forms of M. anceps are regarded that were frequently found together with D. spathaceum. On the Madatapa Lake 36 species of water birds and numerous migratory birds are found which represent definitive hosts for trematodes. The lake`s fish population consided only of Carassius gibelio which serves as additional host for D. spathaceum. Parasitological investigation of C. gibelio showed high percent of invasion by D. spathaceum. High percent of invasion of the population of L. stagnalis is provided by high number of mollusks and monopopulation, also by high number of definitive and additional hosts. It was found that L. stagnalis plays a significant role as an intermediate host in the life cycles of trematodes in the region Javakheti.

Andrea Martin completed her Bachelors of Science degree in Bionegineering with a minor in Mechanical Engineering from the University of Pittsburgh in 2012. She is currently a PhD candidate in Biomedical Engineering at Carnegie Mellon University.

The Plasmodium falciparum malaria parasite causes nearly one million deaths per year across over 100 countries. The parasite invades the host’s red blood cells (RBC), feeding off of the RBC’s hemoglobin and creates a magnetic byproduct within the infected RBCs (iRBC). A low concentration of iRBCs often leads to death in less than 24 hours. Therapies include parental quinine or artesunate treatments. However, parasites have become resistant to these often pricey drugs thus limiting their effectiveness. Exchange transfusion (ET) has been used as an adjunct treatment yet its efficacy remains the subject of clinical debate. mPharesis, a magnetic dialysis-like device, is in development to remove a patient’s iRBCs without removing the healthy RBCs while minimizing plasma loss. The device, used in adjunct with drugs, provides a useful alternative to ET while being more accessible to low-resource settings where blood supply is limited. Here, preliminary data on a device prototype is reported. The device is made in-lab with inexpensive rapid manufacturing techniques. The magnetophoretic force is generated with an external permanent magnet array. Experiments were conducted in vitro using iRBCs and a non-pathogenic blood analog composed of a mixture of healthy and methemoglobin RBCs (metRBC) which has similar paramagnetic properties as iRBCs. Tests were conducted with multiple hematocrits and flow rates. The concentration of metRBC was reduced by as much as 24.7% for 15% Hct and 14.6% for 30% Hct in a single pass at a flow rate of 0.077 mL/min. Ongoing progress includes design modifications to allow for automation and increased throughput. In addition to malaria treatment applications, the mPharesis device could potentially be used as an alternative to ET with other disease management, such as Sickle-cell disease.

Jesca Nakayima is a PhD graduate from Hokkaido University, Sapporo, Japan (2014). She specialized in Molecular epidemiology; Dissertation: Molecular epidemiological study of protozoan and other zoonotic diseases from two countries in Africa. Jesca holds a Master of Wildlife Health & Management (MWHM) from Makerere University and a Bachelor of Veterinary Medicine (BVM) from Makerere University, in 2006 and 2002 respectively. She joined National Agricultural Research Organization (NARO)/National Livestock Resources Research Institute (NaLIRRI) in June 2006, where she has worked to-date. Jesca has worked under the Biotechnology section then later Livestock health Programme. She has participated in the surveillance and control of Trypanosomiasis. But also worked on the Molecular epidemiology of Zoonoses, Protozoan parasites, Helminths, Wildlife diseases, Tick-borne diseases, Viruses, among others.

Wildlife may harbor infectious pathogens that are of zoonotic concern acting as a reservoir of diseases transmissible to humans and domestic animals. This is due to human-wildlife conflicts that have become more frequent and severe over recent decades, competition for the available natural habitats and resources leading to increased human encroachment on previously wild and uninhabited areas. A total of 88 spleen DNA samples from baboons and vervet monkeys from Zambia were tested for zoonotic haemo-pathogens using genus or species-specific PCR. The amplified products were subjected to sequencing. We detected three different pathogenic agents, including Anaplasma phagocytophilum in 12 samples (13.6%), Rickettsia spp. in 35 samples (39.8%) and Babesia microti in 2 samples (2.3%). \r\nThe continuously increasing contacts between humans and primate populations raise concerns about transmission of pathogens between these groups. Therefore, increased physician awareness and public health surveillance support will be required to detect and control infections caused by these agents at the interface between human and wildlife.\r\n

The trematode Fasciola hepatica is spread worldwide causing important losses in livestock and is also an expanding zoonotic disease. Chemotherapy is fundamental for its control, yet triclabenzadol resistance is appearing, thus closantel can be a valid alternative. It is effective against mature and immature stages yet it does not exhibit ovicidal activity in vitro and the ovicidal effects in vivo at present are undetermined. rn The Egg Hatch Assay is a valid test to evaluate ovicidal activity and was implemented to evaluate the effect of closantel; morphometrical study was included as part of the characterization of the treated eggs. Sheep were inoculated with Cullompton strain of F. hepatica; eggs were recovered from the gall bladder of control and closantel treated (subcutaneously and orally) at 12, 24, and 36 hours post treatment. Measures were taken on 50 eggs from each were found in length; size; width and shape. No statistically significant differences were found in length and size between control and experimental groups, for another hand significant differences were detected in width and shape. Eggs exposed to Closantel tend to be more elliptical. It is worth highlighting that al the length, width and size of the control eggs are considerably greater than previous descriptions for normal F. hepatica eggs in sheep and other domestic and wild species. This could be a characteristic of the Cullompton strain, yet studies should be done to assess if these large eggs are isolated strains or there is greater variability in egg morphology than previously supposed.rn

Doaa Sultan took up education in Mansoura Faculty of Medicine, Mansoura University, Egypt. She was graduated in 1991 with MBBCh and she completed her Master’s degree in Parasitology in 1997 and her PhD in 2004. She is working as an Associate Professor of medical Parasitology, Dubai Medical College, Dubai, UAE. She has published more than 25 papers in conferences and reputed journals.

Serologic evidence indicates that human infections by toxoplasmosis are common in many parts of the world. Hormones could induce anti-parasitic functions of the host immune system and there is a wealth of evidence that illustrates the ability of sex-associated hormones, to influence directly, a variety of diverse immunological function. This study aimed to investigate the correlation between the prevalence of toxoplasmosis and certain levels of sex-associated hormones (progesterone, estradiol & testosterone). The study was carried out in the city of Sharjah, UAE at the blood transfusion and research center with 85 participants included in the study consisting of 49 female and 36 males, mean age (SD±) 31.88±6.156 and 35.69±9.591 for females and males, respectively. ELISA test kits for detection of anti-Toxoplasma IgM was used to screen the samples. The level of serum progesterone, estradiol, and testosterone in Toxoplasma positive samples was measured using ELISA test kits. From the 85 studied subjects, a total of 24 were found to be positive for anti-Toxoplasma IgM using ELISA test, corresponding to an overall prevalence of 28.2%, 9/49 females (18.4%) and 15/36 males (41.6%).The negative samples were used as a control. There was a significant positive correlation between the level of testosterone and anti-Toxoplasma IgM in men and a significant negative correlation between the levels of testosterone, progesterone and anti-Toxoplasma IgM in women p<0.05. However, estradiol showed insignificant correlation with anti-Toxoplasma IgM p>0.05.

Shehla Khalil is working as a PhD student in the Parasitology Division of Department of Microbiology at All India Institute of Medical Sciences, India with title “development of rapid method for screening of Cryptosporidium spp. in clinical samples”. She published 10 research papers in reputed journals.

Background: Intestinal parasitic infections in Human immunodeficiency (HIV) seropositive patients vary with geographical topology and are associated with socioeconomic variables. Present hospital based study was conducted to determine the spectrum of intestinal parasitosis in adult HIV/AIDS (Acquired Immunodeficiency Syndrome) patients in our tertiary care setting.
\r\n \r\n Materials and methods: A total of three hundred and forty two (n=342) individuals were enrolled and were screened for intestinal parasitosis. Of these study population one hundred and forty two (n=142) were adult HIV seropositives and were further subdivided into ART naive (n=80) without diarrhea (CD4+T-cell count >350 cells/µl) and sixty two (n=62) on-ART with diarrhea. The rest two hundred (n=200) were non-HIV individuals comprising of hundred each with diarrhea (n=100) and without diarrhea. Intestinal parasites were identified by using microscopic techniques and Polymerase Chain Reaction (PCR) assay.
\r\n Results: A total of one hundred and thirty one (n=131) intestinal parasites could be identified from the study population [HIV seropositive (n=142) and non-HIV (n=200) individuals]. Amongst the intestinal parasites, 64% (84/131) were identified in HIV seropositives and 36% (47/131) in non-HIV individuals (OR=4.7; 95% CI 2.95 to 7.52; p<0.0001. Of these eighty four parasites identified in HIV seropositives (74%, 62/84) were found in patients with diarrhea and (26%, 22/84) without diarrhea (p<0.001). Out of the total parasites identified (n=131), 25% (33/131) were coccidia and microsporidia, that includes Crystosporidium spp. (13/131, 9.9%), Cystoisospora belli (13/131, 9.9%), Cyclospora cayetanensis (3/131, 2.2%), Enterocytozoon bieneusi (4/131, 3%), 42% (55/131) were non-coccidian pathogenic and helminthic parasites that includes Giardia intestinalis (27/131, 20.6%), Entamoeba histolytica/Entamoeba dispar (14/131, 10.6%), Ascaris lumbricoides (1/131, 0.7%), Strongyloides stercoralis (4/131, 3%), Hymenolepis nana (9/131, 6.8%).33% (46/131) other parasites were identified including Blastocystis hominis (26/131, 19.8%), Entamoeba coli (9/131, 6.8%) and Endolimax nana (8/131, 6.1%).The higher frequency of infection as well as multiple parasitic infections were observed at CD4+ T-cell counts of less than 200 cells/μL and was two-fold higher compared to individuals having counts more than 350 cells/μL (p<0.0001).
\r\n Conclusion: Cryptosporidium spp. was significantly higher in HIV/AIDS patients with diarrhea (on-ART) compared to patients without diarrhea (ART naive) (P<0.05). Higher rate of infection with Cryptosporidium spp. and Cystoisospora belli (p<0.001) was detected among individuals with CD4+ T-cell counts less than 200 cells/μL, besides significant association (p < 0.001) of Cryptosporidium spp., Cystoisospora belli and Giardia intestinalis in HIV patients with diarrhea.
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Iman F Abou-El-Naga has done her MBChB in 1981, Master Degree in Medical Parasitology in 1986 and PhD in Medical Parasitology all from Alexandria University in 1992. Currently, he is working as a Professor in Medical Parasitology Department, Alexandria University. He has published more than 22 papers in reputed journals and is serving as an Editorial Board Member of Alexandria Journal of Medicine.

Biomphalaria snails display different compatibility patterns to Schistosoma mansoni infection. The current study was performed to elucidate the impact of Biomphalaria alexandrina snails’ age on their genetic variability and internal defense against Schistosoma mansoni infection, using parasitological parameters and cytosolic superoxide dismutase enzyme assay. Susceptible and resistant snails were reared singly for self-reproduction. Of their progeny, four experimental subgroups underwent the present study being; young susceptible, adult susceptible, young resistant and adult resistant. Young susceptible subgroup showed the highest susceptibility with shortest pre-patent period, highest infection rate, highest total cercarial production and least superoxide dismutase activity. Moreover, 8%, 26% resistant members were obtained among young and adult susceptible subgroups respectively, indicating inheritance of resistance alleles from their parents. Adult resistant subgroup contained only resistant members and showed the highest superoxide dismutase activity, compared to young resistant subgroup which contained 37% susceptible members, with less enzyme activity. The significant differences in parasitological and biochemical parameters between young and adult snails in the same group were attributed to age effect that made the resistance alleles more functioning with higher cytosolic superoxide dismutase enzyme activity in adult snails. Moreover, the complex interaction between age, genetic background and internal defense system between susceptible and resistant subgroups has resulted in great variability in their compatibility patterns. Herein, the presented results could provide potential epidemiological implications in Biomphalaria control. Identification of the most susceptible snail’s age determines the best timing for applying molluscicides. Moreover, adult resistant snails could be benefited of in biological snail control.

Ait-Oudhia Khatima has completed his PhD from high National Veterinary School of Algiers, Algeria and Postdoctoral studies from University of Medicine of Montpellier in France. She has published more than 10 papers in reputed journals and has been serving as an Editorial Board Member of repute.

Described for the first time in Tunisia, toxoplasmosis is a cosmopolitan parasitic zoonosis caused by a protozoan. It occurs in most warm-blooded animals and causes abortions in pregnant females, a high rate of mortality among infants and young. By its medical importance, health and economic toxoplasmosis is not only a hindrance to the intensification of our meat production but also a real danger to man and his environment. Prevalence of toxoplasmosis in Toxoplasma gondii in 150 cattles, 700 sheeps and 350 goats was carried out using serological methods (MAT and ELISA) in the East of Algeria. In the sample studied, the overall serological prevalence was 24.83% for sheep, 14.17% in cattle and 7.2% in goats. Seroprevalence found in females was 29.7% for sheep, cattle 14.7% and 7.1% in goats. Among males, the prevalence found was 20.3% for sheep, 13% in cattle and 7% in goats. In conclusion, animal toxoplasmosis is strongly present in the East of Algeria, area known for its large herds of sheep, cattle and goats for human consumption; highlighting the importance of the implementation of preventive measures in order to reduce zoonotic infection by T. gondii.

Cuiqin Huang has completed her PhD at the age of 29 years from South China Agricultural University in China. She is a associated professor in Longyan Univerity in China.She has published more than 25 papers in reputed journals and has been serving as an editorial board member of repute.

Isospora suis is an intestinal protozoan parasite in pigs. The 2-3 weeks old piglets are most often infected by I. suis because their immune system is not fully developed. The infection exhibits clinical features such as diarrhea and dehydration and seriously affects the economic interests of farmers. The traditional method of identifying I. suis relies on the detection of fecal oocysts, which depends heavily on the accumulation of experience. Thus, missed detection, and false alarms often occur during detection. With the development of molecular-based detection methods, development of a simple, convenient and more sensitive method for the detection of I. suis is an urgent need. In this study, based on the 18S rRNA gene sequence, a real-time fluorescence loop-mediated isothermal amplification (LAMP) assay was established for the detection of I. suis. The results showed that the assay is highly specific and sensitive, with a detection limit of 2.74×102 copies/µL recombinant plasmid of I. suis, corresponding to 1 fg/µL plasmid when converted to DNA concentration. The sensitivity is about 100 times higher than conventional PCR. Additionally, DNA extracted from a certain number of oocysts was used for detection, and it showed that the LAMP assay had a detection limit of 5 oocysts, lower than that of 13 oocysts of conventional PCR. The established LAMP assay overcomes the shortage of the traditional microscopy-based method, and provides a valuable way for molecular detection of I. suis.

Simon-Oke I A completed her PhD at the age of 38 years from the University of Ado Ekiti, Nigeria. She is currently a Lecturer I at the Federal University of Technology Akure, Ondo State, Nigeria. She has published 10 papers in reputed journal and serving as a reviewer for journal articles.

This research work was carried out between May and September, 2014 in Ikole Ekiti, Ekiti State, Nigeria. Prior to the commencement of the research, ethical clearance was received from the Ekiti State Ministry of Health and informed consent of the respondents was received from the respondents after focus group discussion in local language. A total of 380 blood samples were collected from the pregnant women and children under five years respectively. Malaria parasites were examined microscopically on thick and thin blood smear stained with Giemsa stain, personal data were collected orally using structured questionnaire and from file records. Data obtained were subjected to Chi-square analysis at 95% level of significance. The results showed that of 380 pregnant women sampled, 153 (40.3%) were positive for malaria parasites while out of 100 children sampled, 63 (63%) were also positive. The highest prevalence of malaria parasites (51.8%) and (71.1%) were observed in ages 36-39years and 3-4years for pregnant women and children respectively. Prevalence of infection was significantly different among the trimesters (P<0.05). Pregnant women with genotype SS had the highest prevalence (66.7%) of malaria parasites while the least prevalence of (29.4%) was recorded in pregnant women with genotype AS. Similarly, children with genotype SS recorded the highest prevalence (87.5%) while the least prevalence of (48.3%) was found in genotype AS. Prevalence of malaria infection among the blood groups of the pregnant woman revealed that blood group O had the highest prevalence (76.1%) while the least prevalence was found in blood group AB (53.6%). In children, females were more positive (66.7%) with malaria parasites than males (58.1%). Malaria infection showed a high level of endemicity in the study area, hence, there is need to incorporate the laboratory components into the RBM strategy by enhancing parasite diagnosis at all levels of health care.

Amira Bakr Mokhtar has completed his PhD at the age of 34 years from Suez Canal University, Faculty of medicine. She is an assistant professor of Medical Parasitology, Faculty of medicine, Suez Canal University.

Pathogenicity due to different Blastocystis species is controversial due to its heterogeneous antigenic and genetic characters within different geographic regions. The role of B. hominis in irritable bowel syndrome was demonstrated by its frequent significant detection in IBS patients, which required more investigations in view of its pathogenic and non-pathogenic strains. The main objective of this study is to identify Blastocystis subtypes of clinical isolates obtained from 3 different groups of patients; IBS, non-IBS with and without GIT symptoms. Secondary objective is to evaluate the infectivity and pathogenicity of detected subtypes from each group in experimental rats. This study was designed as a case control study. Stool samples were collected from patients attending Suez Canal University Hospitals. Only positive samples for Blastocystis were included in the study and three groups were identified (No. = 19). Blastocystis subtypes were identified using seven pairs of primers (SB83, SB155, SB227, SB332, SB340, SB336 and SB337) to explore the relation of different subtypes with different clinical presentations of each group. Detected subtypes, from each group, were then used to evaluate the infectivity and pathogenicity in experimentally infected rats monitored by parasitological and histopathological parameters. Subtyping using 7 different sequence-tagged site primers revealed 54 isolates with single infection and 3 isolates with mixed infection. Subtype 3 (ST3) was the most common one in the present Egyptian population (56.1%) followed by ST1 (35.1%), then ST2 (3.5%), while 5.3% were mixed infection (subtypes 1 and 3). Our results showed that blastocystosis is not likely associated with specific ST even if some STs are predominant in the epidemiologic studies.

Background and Objectives- The escalating burden of malaria during pregnancy (MIP) is of public health concern across the globe, in view of the pathogenesis, epidemiology, clinical sequel, prevention and treatment; all have unique features during pregnancy. The combinatorial adverse impact on maternal health during MIP further perplexed the situation of prompt diagnosis, treatment and preventive strategies. This prompted us to evaluate the status of population at risk of MIP in Hazaribag, Jharkhand, a malaria-endemic state in central-eastern India.
\r\n Methods- Cross-sectional evaluation between September 2012 and December 2013 at antenatal clinics (ANC) and delivery units (DU) were performed at Sadar hospital, Hazaribag. Malaria was screened by Giemsa-stained blood smear and/or rapid diagnostic test. Serum levels of iron and ferritin were quantified by a colorimetric method and complete blood counts were carried out for evaluating RBC indices in stratified groups during MIP and control groups from ANC and DU attendee. Anaemia was defined as haemoglobin concentration. Pre-tested questionnaires were used to gather socio-demographic, clinical and obstetrical data.
\r\n Results- The prevalence of MIP was 5.4% and 4.3% at ANC and DU, and there were 13.2% malaria in women without pregnancy. Interestingly, majority were infected with P.vivax (over 85%) and asymptomatic (extremely lower positive predictive value and non significant association of sign and symptoms in multivariate analysis) cases at ANC and DU. Peripheral parasitemia were significantly associated with fever within past week, rural origin of subjects and first/second pregnancies in multivariate analysis, with a highest risk factor associated with fever followed by rural residence in pregnant women. Strikingly, anaemia was prevalent in 86% at ANC cohort (N=1270) compared to 72% at DU cohort (N=870); whereas severe anaemia was 13.6% and 7.8%, respectively. Even more anaemic situations were observed in MIP (88% and 89% at ANC and DU); whereas severe anaemia was 23% and 21% at ANC and DU, respectively. Importantly, anaemia were significantly associated with incidence of malaria, content of iron and ferritin, level of haemoglobin and with formal education in cohort and MIP in univariate and multivariate analysis, with a highest risk factor associated with haemoglobin followed by incidence of malaria in all stratified groups. Further, significantly lower RBC content, RBC indices, iron, ferritin and haemoglobin levels were observed in P.vivax infection compared to healthy subjects and other infection during MIP.
\r\n Conclusion- In view of significant association of anaemia and parasitemia during asymptomatic infection of P.vivax in MIP suggests prompt diagnosis regardless of symptoms and comprehensive drug regime should be offered to pregnant women in association with existing measures in clinical spectrum of MIP, delivery and its outcome.
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