Malaria prevalence among pregnant women in two districts with differing endemicity in Chhattisgarh, India

Malaria Journal

Research

Yeboah A Kojo¹  Lora Sabin¹  Davidson H Hamer²  Chander Shekhar³  Blair J Wylie⁴  Meghna Desai⁵  V Udhayakumar⁵  Mobassir Hussain⁶  Mrigendra P Singh⁶  Neeru Singh⁷ 

[1] Center for Global Health and Development, Boston University, Boston, MA, USA;Department of International Health, Boston University School of Public Health, Boston, MA, USA;Center for Global Health and Development, Boston University, Boston, MA, USA;Department of International Health, Boston University School of Public Health, Boston, MA, USA;Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA;Zambia Centre for Applied Health Research and Development, Lusaka, Zambia;Department of Reproductive Health and Nutrition, Indian Council of Medical Research, New Delhi, India;Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA;Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA;National Institute of Malaria Research Field Station, Jabalpur, Madhya Pradesh, India;Regional Medical Research Centre for Tribals, Jabalpur, Madhya Pradesh, India;National Institute of Malaria Research Field Station, Jabalpur, Madhya Pradesh, India;

关键词: Pregnancy;    Malaria;    India;    Plasmodium falciparum;    Plasmodium vivax;    Anaemia;    Low birth weight;   

DOI  :  10.1186/1475-2875-11-274

 received in 2012-05-31, accepted in 2012-08-01,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundIn India, malaria is not uniformly distributed. Chhattisgarh is a highly malarious state where both Plasmodium falciparum and Plasmodium vivax are prevalent with a preponderance of P. falciparum. Malaria in pregnancy (MIP), especially when caused by P. falciparum, poses substantial risk to the mother and foetus by increasing the risk of foetal death, prematurity, low birth weight (LBW), and maternal anaemia. These risks vary between areas with stable and unstable transmission. The specific objectives of this study were to determine the prevalence of malaria, its association with maternal and birth outcomes, and use of anti-malarial preventive measures for development of evidence based interventions to reduce the burden of MIP.MethodsA cross-sectional study of pregnant women presenting to antenatal clinics (ANC) or delivery units (DU), or hospitalized for non-obstetric illness was conducted over 12 months in high (Bastar) and low (Rajnandgaon) transmission districts in Chhattisgarh state. Intensity of transmission was defined on the basis of slide positivity rates with a high proportion due to P. falciparum. In each district, a rural and an urban health facility was selected.ResultsPrevalence of peripheral parasitaemia was low: 1.3% (35/2696) among women at ANCs and 1.9% at DUs (19/1025). Peripheral parasitaemia was significantly more common in Bastar (2.8%) than in Rajnandgaon (0.1%) (p < 0.0001). On multivariate analysis of ANC participants, residence in Bastar district (stable malaria transmission) was strongly associated with peripheral parasitaemia (adjusted OR [aOR] 43.4; 95% CI, 5.6-335.2). Additional covariates associated with parasitaemia were moderate anaemia (aOR 3.7; 95% CI 1.8-7.7), fever within the past week (aOR 3.2; 95% CI 1.2-8.6), and lack of formal education (aOR 4.6; 95% CI 2.0-10.7). Similarly, analysis of DU participants revealed that moderate anaemia (aOR 2.5; 95% CI 1.1-5.4) and fever within the past week (aOR 5.8; 95% CI 2.4-13.9) were strongly associated with peripheral and/or placental parasitaemia. Malaria-related admissions were more frequent among pregnant women in Bastar, the district with greater malaria prevalence (51% vs. 11%, p < 0.0001).ConclusionsGiven the overall low prevalence of malaria, a strategy of enhanced anti-vector measures coupled with intermittent screening and targeted treatment during pregnancy should be considered for preventing malaria-associated morbidity in central India.

【 授权许可】

CC BY   
© Singh et al.; licensee BioMed Central Ltd. 2012