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- Title
Quantification of the Burden and Consequences of Pregnancy-Associated Malaria in the Democratic Republic of the Congo.
- Authors
Taylor, Steve M.; van Eijk, Anna Maria; Hand, Carla C.; Mwandagalirwa, Kashamuka; Messina, Jane P.; Tshefu, Antoinette K.; Atua, Benjamin; Emch, Michael; Muwonga, Jérémie; Meshnick, Steven R.; Ter Kuile, Feiko O.
- 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-birthweight 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.
- Subjects
CONGO (Democratic Republic); QUANTITATIVE research; MALARIA in pregnancy; DISEASE prevalence; POLYMERASE chain reaction; PLASMODIUM falciparum; COMMUNICABLE diseases
- Publication
Journal of Infectious Diseases, 2011, Vol 204, Issue 11, p1762
- ISSN
0022-1899
- Publication type
Article
- DOI
10.1093/infdis/jir625