Quantification of the Burden and Consequences of Pregnancy-Associated Malaria in the Democratic Republic of the Congo

Taylor, S. M., van Eijk, Anna ORCID: https://orcid.org/0000-0003-1635-1289, Hand, C. C., Mwandagalirwa, K., Messina, J. P., Tshefu, A. K., Atua, B., Emch, M., Muwonga, J., Meshnick, S. R. and terKuile, Feiko ORCID: https://orcid.org/0000-0003-3663-5617 (2011) 'Quantification of the Burden and Consequences of Pregnancy-Associated Malaria in the Democratic Republic of the Congo'. Journal of Infectious Disease, Vol 204, Issue 11, pp. 1762-1771.

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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.

Item Type:	Article
Subjects:	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
Digital Object Identifer (DOI):	https://doi.org/10.1093/infdis/jir625
Depositing User:	Martin Chapman
Date Deposited:	07 Apr 2014 11:57
Last Modified:	16 Aug 2019 13:40
URI:	https://archive.lstmed.ac.uk/id/eprint/3646

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