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Minimal impact by antenatal subpatent P. falciparum infections on delivery outcomes in Malawian women: a cohort study.

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Taylor, Steve M, Madanitsa, Mwayiwawo, Thwai, Kyaw-Lay, Khairallah, Carole, Kalilani-Phiri, Linda, vanEijk, Anna, Mwapasa, Victor, terKuile, Feiko ORCID: https://orcid.org/0000-0003-3663-5617 and Meshnick, Steven R (2017) 'Minimal impact by antenatal subpatent P. falciparum infections on delivery outcomes in Malawian women: a cohort study.'. Journal of Infectious Disease, Vol 216, Issue 3, pp. 296-304.

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Abstract

Antenatal malaria screening with a rapid diagnostic test (RDT) and treatment only of RDT-positive women may potentially prevent low birthweight resulting from malaria. The consequences of subpatent antenatal infections below the detection limit of RDTs are incompletely understood. In Malawi, pregnant women of any gravidity were tested at each antenatal visit for P. falciparum using RDT and PCR and followed until delivery. Associations between antenatal infections and delivery outcomes were assessed with Poisson regression or ANOVA. Compared to women with no detected antenatal P. falciparum infections, women with RDT-positive infections delivered babies with lower mean birthweights: 2960 vs 2867 grams[g] (mean difference[MD]: -93g; 95% confidence interval[CI]: -27,-159; p=0.006); this was not observed among women with only subpatent infections (mean: 3013g; MD: +54; 95% CI: -33,+140; p=0.2268). These differences were apparent early in pregnancy: At second trimester enrollment, compared to uninfected women, RDT-positive women delivered babies with lower mean birthweight (MD: -94g; 95% CI: -31,-156; p=0.003), but women with subpatent infections did not (MD: +36g; 95% CI: -49,+122; p=0.409). Subpatent antenatal P. falciparum infections were not associated with adverse delivery outcomes. The association of patent infections at enrollment with low birthweight suggests the importance of early-pregnancy P. falciparum prevention.

Item Type: Article
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in 'The Journal of Infectious Diseases' following peer review. The version of record 'Minimal impact by antenatal subpatent P. falciparum infections on delivery outcomes in Malawian women: a cohort study.' J Infect Dis 2017 jix304.' is available online at: https://doi.org/10.1093/infdis/jix304
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
WQ Obstetrics > Pregnancy Complications > WQ 256 Infectious diseases
WS Pediatrics > By Age Groups > WS 420 Newborn infants. Neonatology
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1093/infdis/jix304
SWORD Depositor: JISC Pubrouter
Depositing User: JISC Pubrouter
Date Deposited: 20 Jul 2017 10:26
Last Modified: 07 Dec 2018 10:37
URI: http://archive.lstmed.ac.uk/id/eprint/7360

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