Maternal anaemia as an indicator for monitoring malaria control in pregnancy in sub-Saharan Africa

Savage, E.J., Msyamboza, K., Gies, S., D'Alessandro, U. and Brabin, Bernard (2007) 'Maternal anaemia as an indicator for monitoring malaria control in pregnancy in sub-Saharan Africa'. BJOG: An International Journal of Obstetrics & Gynaecology, Vol 114, Issue 10, pp. 1222-1231.

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Abstract

Design Malarial anaemia is a major problem in many developing countries and often occurs more frequently in first pregnancies, as primigravidae are more susceptible to Plasmodium falciparum malaria and are at excess risk of malarial anaemia.
Objective and methods To analyse the excess risk of anaemia in primigravidae as a potential indicator of malaria control and exposure in pregnant women living in sub-Saharan Africa. The sensitivity, specificity and predictive values for anaemia in first compared with later pregnancies are calculated for 27 studies from malarious and 7 studies from nonmalarious areas.
Setting Surveys of pregnancy anaemia reported for highly malarious and nonmalarious areas.
Results In malarious areas, the weighted odds ratio for excess anaemia (haemoglobin [Hb] < 11 g/dl) in primigravidae compared with multigravidae for all studies was 1.34 (95% CI 1.14-1.58). At an Hb cutoff below 8 g/dl, the weighted odds ratio was 1.79 (95% CI 1.52-2.10). In nonmalarious areas, there was no increased risk of anaemia in primigravidae with Hb below 11 g/dl (OR 0.80; 95% CI 0.63-1.90) or below 8 g/dl (OR 0.82, 95% CI 0.51-1.28).
Conclusions In view of the consistency of results across highly malarious areas compared with nonmalarious areas, maternal anaemia has the potential to be used for surveillance of malaria control in pregnancy. Based on the analysis, an anaemia nomogram is developed for use as a surveillance indicator in malarious areas in sub-Saharan Africa.

Item Type:	Article
Uncontrolled Keywords:	anaemia indicators malaria nomogram pregnancy iron-deficiency anemia birth-weight risk-factors women prevalence area prophylaxis malawi primigravidae determinants
Subjects:	WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare WC Communicable Diseases > Tropical and Parasitic Diseases > WC 765 Prevention and control WH Hemic and Lymphatic Systems > Hematologic Diseases. Immunologic Factors. Blood Banks > WH 155 Anemia WQ Obstetrics > Pregnancy Complications > WQ 256 Infectious diseases
Faculty: Department:	Groups (2002 - 2012) > Child & Reproductive Health Group
Digital Object Identifer (DOI):	https://doi.org/10.1111/j.1471-0528.2007.01420.x
Depositing User:	Ms Julia Martin
Date Deposited:	16 Sep 2010 10:21
Last Modified:	06 Feb 2018 13:01
URI:	https://archive.lstmed.ac.uk/id/eprint/1274

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