Global estimates of the number of pregnancies at risk of malaria from 2007 to 2020: a demographic study

Reddy, Valentina, Weiss, Daniel J., Rozier, Jennifer, terKuile, Feiko ORCID: https://orcid.org/0000-0003-3663-5617 and Dellicour, Stephanie (2023) 'Global estimates of the number of pregnancies at risk of malaria from 2007 to 2020: a demographic study'. Lancet Global Health, Vol 11, Issue 1, e40-e47.

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Abstract

Background: This study estimates the global distribution of pregnancies at risk of malaria for 2020 and shows trends since 2007.

Rationale: This study aims to provide data on the global distribution of pregnancies at risk to inform global malaria prevention and control efforts.

Methods: We used estimates from the Malaria-Atlas-Project on the total population living within areas of Plasmodium falciparum and P. vivax transmission, combined with country-specific demographic data on women of reproductive age, fertility rates, induced abortions, and stillbirths to derive the annual number of pregnancies overall and by parasite species and endemicity strata from 2007-to-2020.

Results: In 2020, 122 million pregnancies occurred in malaria transmission areas, resulting in an estimated 71m live-births, including 53, 5, 46, 11, and 7 million pregnancies in the countries falling
under the World Health Organization regional offices for South-East-Asia (SEARO), Western-Pacific (WPRO), Africa (AFRO), Eastern-Mediterranean (EMRO), and Americas (AMRO). Between 2007 and
2020, pregnancies in P. falciparum transmission areas fell by 11.4% globally despite an overall 7.0% increase in pregnancies by 2020, representing a decrease of 100%, 52.6%, 51.5%, 23.9% and 17.2% in
EURO, WPRO, AMRO, EMRO and SEARO, but a 25.4% increase in AFRO. Those in P. vivax transmission areas fell by 42.8%, representing a decrease of 100.0%, 89.8%, 48.4%, 32.4% and 10% in EURO, WPRO,
AMRO, EMRO and SEARO, but a 25.8% increase in AFRO. Our sensitivity analysis suggests that the number of pregnancies at risk of P.vivax could be 7-fold higher for AFRO if the whole of sub-Saharan
Africa is considered endemic, which could be confirmed once more sensitive diagnostics and data are available.

Conclusion: Between 2007 and 2020, substantial declines in the number of pregnancies at risk of malaria were seen globally. In AFRO, 25% more pregnancies are at risk of P. falciparum and P.vivax malaria than in 2007. This increase in the numbers at risk comes despite the decline in malaria rates due to the rapidly rising population and the number of pregnancies in endemic areas. These estimates should guide priority setting for resource allocation to control malaria in pregnancy.

Funding: Gates Foundation and Telethon Trust

Item Type:	Article
Subjects:	WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria WQ Obstetrics > Pregnancy Complications > WQ 240 Pregnancy complications (General)
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1016/S2214-109X(22)00431-4
Depositing User:	Lynn Roberts-Maloney
Date Deposited:	20 Dec 2022 14:43
Last Modified:	02 Feb 2023 10:24
URI:	https://archive.lstmed.ac.uk/id/eprint/21506

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