Quantification of the Burden and Consequences of Pregnancy-Associated Malaria in the Democratic Republic of the Congo
Open Access
- 11 October 2011
- journal article
- research article
- Published by Oxford University Press (OUP) in The Journal of Infectious Diseases
- Vol. 204 (11), 1762-1771
- https://doi.org/10.1093/infdis/jir625
Abstract
Background. Pregnancy-associated malaria (PAM) produces poor birth outcomes, but its prevalence is commonly estimated in convenience samples. Methods. We assessed the prevalence of malaria using real-time polymerase chain reaction (PCR) and estimated the consequences of infection on birth outcomes, using specimens from a nationally representative sample of 4570 women of childbearing age (WOCBA) responding to the 2007 Demographic and Health Survey in Democratic Republic of the Congo (DRC). Results. Overall, 31.2% (95% confidence interval [CI], 29.2–33.1) of WOCBA were parasitemic, which was significantly more common in pregnant (37.2% [31.0–43.5]) than nonpregnant women (30.4% [CI, 28.4–32.5], prevalence ratio [PR] 1.22 [1.02–1.47]). Plasmodium falciparum was highest among pregnant women (36.6% vs 28.8%, PR 1.27 [1.05–1.53]). By contrast, P malariae was less common in pregnant (0.6%) compared with nonpregnant women (2.7%, PR 0.23 [0.09–0.56]). Extrapolation of the prevalence estimate to the population at risk of malaria in DRC suggests 1.015 million births are affected by P falciparum infection annually, and that adherence to preventive measures could prevent up to 549 000 episodes of pregnancy-associated malaria and 47 000 low-birth-weight births. Conclusions. Pregnancy-associated malaria and its consequences are highly prevalent in the DRC. Increasing the uptake of malaria preventive measures represents a significant opportunity to improve birth outcomes and neonatal health.Keywords
This publication has 33 references indexed in Scilit:
- Coverage of malaria protection in pregnant women in sub-Saharan Africa: a synthesis and analysis of national survey dataThe Lancet Infectious Diseases, 2011
- Marked Reduction in Prevalence of Malaria Parasitemia and Anemia in HIV-Infected Pregnant Women Taking Cotrimoxazole With Or Without Sulfadoxine-Pyrimethamine Intermittent Preventive Therapy during Pregnancy in MalawiThe Journal of Infectious Diseases, 2011
- Comparison of real-time PCR and microscopy for malaria parasite detection in Malawian pregnant womenMalaria Journal, 2010
- Global, regional, and national causes of child mortality in 2008: a systematic analysisThe Lancet, 2010
- Quantifying Aggregated Uncertainty in Plasmodium falciparum Malaria Prevalence and Populations at Risk via Efficient Space-Time Geostatistical Joint SimulationPLoS Computational Biology, 2010
- High-Throughput Pooling and Real-Time PCR-Based Strategy for Malaria DetectionJournal of Clinical Microbiology, 2010
- Quantifying the Number of Pregnancies at Risk of Malaria in 2007: A Demographic StudyPLoS Medicine, 2009
- Fetal Responses during Placental Malaria Modify the Risk of Low Birth WeightInfection and Immunity, 2008
- Effect of Sulfadoxine-Pyrimethamine Resistance on the Efficacy of Intermittent Preventive Therapy for Malaria Control During PregnancyJama-Journal Of The American Medical Association, 2007
- Insecticide-treated nets for preventing malaria in pregnancyEmergencias, 2006