High burden of malaria infection in pregnant women in a rural district of Zambia: a cross-sectional study

Malaria Journal

Research

Sungano Mharakurwa¹  Enesia Banda Chaponda²  Daniel Chandramohan³  R. Matthew Chico³  James Chipeta⁴  Charles Michelo⁵ 

[1] Africa University, Mutare, Zimbabwe;Johns Hopkins Bloomberg School of Public Health, Baltimore, USA;Department of Biological Sciences, University of Zambia, Lusaka, Zambia;Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK;Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK;Department of Paediatrics and Child Health, University of Zambia School of Medicine, P.O. Box 50110, Lusaka, Zambia;Department of Public Health, School of Medicine, University of Zambia, Lusaka, Zambia;

关键词: Malaria;    Pregnancy;    Zambia;   

DOI  :  10.1186/s12936-015-0866-1

 received in 2015-03-17, accepted in 2015-08-22,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundMalaria continues to be a major health problem in low-income countries. Consequently, malaria control remains a public health priority in endemic countries such as Zambia. Pregnant women and children under 5 years of age are among groups at high risk of malaria infection. Malaria infection is associated with adverse birth outcomes that affect the mother, foetus, and infant. Infection with HIV has been shown to increase the risk of malaria infection in pregnancy. The prevalence and the predictors of malaria infection among pregnant women resident in the Nchelenge District of northern Zambia were investigated.MethodsBetween November 2013 and April 2014, pregnant women in the catchment areas of two health centres were recruited during their first antenatal care visit. HIV testing was conducted as part of routine care. In addition, blood samples were collected from 1086 participants and tested for malaria infection using standard microscopy and polymerase chain reaction (PCR) techniques specific for Plasmodium falciparum. Multivariate logistic regression were conducted to examine the predictors of malaria infection.ResultsThe prevalence of malaria identified by microscopy was 31.8 % (95 % confidence intervals [CI], 29.0–34.5; N = 1079) and by PCR was 57.8 % (95 % CI, 54.9–60.8; N = 1074). HIV infection was 13.2 % among women on their first antenatal visit; the prevalence of malaria detected by PCR among HIV-uninfected and HIV-infected women was 56.7 % (531/936) and 65.2 % (90/138), respectively. In the final model, the risk of malaria infection was 81 % higher among pregnant women recruited from Nchelenge health centre compared to those attending the Kashikishi health centre (adjusted odds ratio = 1.81; 95 % CI, 1.38–2.37, P < 0.001), and HIV-infected women across health centres had a 46 % greater risk of malaria infection compared to HIV-uninfected women (adjusted odds ratio = 1.46; 95 %, 1.00–2.13, P = 0.045).ConclusionHigh burden of malaria detected by PCR in these pregnant women suggests that past prevention efforts have had limited effect. To reduce this burden of malaria sustainably, there is clear need to strengthen existing interventions and, possibly, to change approaches so as to improve targeting of groups most affected by malaria.

【 授权许可】

CC BY   
© Chaponda et al. 2015