Guemouri Sayeh auteur aut IRD Dégbègni R. auteur aut IRD Courtois L. auteur aut IRD Accrombessi M. auteur aut IRD Massougbodji A. auteur aut IRD Ding X. C. auteur aut IRD Tuikue Ndam Nicaise auteur aut IRD Mama A. auteur aut IRD Fievet Nadine auteur aut IRD Sarrasin-Hubert V. auteur aut IRD Cotrell G. auteur aut IRD Briand Valérie auteur aut IRD text journalArticle eng text/pdf reformatted digital access Background Malaria infections in pregnancy are a major cause of maternal morbidity and neonatal mortality in sub-Saharan Africa. A high proportion of these infections are submicroscopic, which are usually asymptomatic and therefore untreated during pregnancy. Intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) aims to prevent and treat all potential infections whether submicroscopic or not. However, the resistance of parasites to SP is steadily increasing. The dynamic of microscopic and submicroscopic infections in a cohort of Beninese women throughout their pregnancy and its relation to IPTp-SP has been assessed.Methods As a subsample of the RECIPAL project, 130 women with at least 2 infections detected by polymerase chain reaction during their pregnancy were included. Infections were categorized as new (isolated) or persistent based on msp-2 genotyping, where persistent infections had identical genotypes in all studied time points. Submicroscopic infections were defined as polymerase chain reaction-positive and thick blood smear-negative. The persistence of infections according to IPTp-SP uptake was assessed.Results A total of 73.1% of women (95 women of 130) had exclusively persistent infections throughout their pregnancy, whereas only 7.7% (10 of 130) had exclusively new infections. During pregnancy, the median time spent with 1 persistent infection was 7.2 weeks. A considerable proportion of these persistent infections 64.3% (72 of 113) was only submicroscopic. Approximately 20% of these persistent infections occurred despite the use of IPTp-SP.Conclusions Using new antimalarial combinations could contribute to limit the persistence of submicroscopic infections and their probable negative effects on the mother and the fetus. Intermittent preventive treatment with sulfadoxine-pyrimethamine prevents malaria in pregnant women in Africa. A sensitive genotyping method shows that a considerable number of women have persistent infections throughout pregnancy despite this treatment. Using new antimalarial combinations could contribute to limit this persistence. specialized intermittent preventive treatment msp-2 fragment analysis method plasmodium falciparum pregnancy submicroscopic BENIN AFRIQUE SUBSAHARIENNE 050 052 12 1 ofae762 [9 p.] 2025 2328-8957 https://www.documentation.ird.fr/hor/fdi:010092616 10.1093/ofid/ofae762 2328-8957 [F B010092616] https://www.documentation.ird.fr/hor/fdi:010092616 https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2025-02/010092616.pdf IRD - Base Horizon / Pleins textes 2025-02-07 2025-02-07 fdi:010092616 fre