Cited by 130Malaria Research and ControlHemoglobinopathies and Related DisordersBird parasitology and diseases

Prevalence of malaria infection in pregnant women compared with children for tracking malaria transmission in sub-Saharan Africa: a systematic review and meta-analysis

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van Eijk, Anna M, Hill, Jenny, Noor, Abdisalan M, Snow, Robert W, ter Kuile, Feiko O·2015·The Lancet Global Health

Abstract

BACKGROUND: In malarious areas, pregnant women are more likely to have detectable malaria than are their non-pregnant peers, and the excess risk of infection varies with gravidity. Pregnant women attending antenatal clinic for their first visit are a potential pragmatic sentinel group to track the intensity of malaria transmission; however, the relation between malaria prevalence in children, a standard measure to estimate malaria endemicity, and pregnant women has never been compared. METHODS: We obtained data on malaria prevalence in pregnancy from the Malaria in Pregnancy Library (January, 2015) and data for children (0-59 months) were obtained from recently published work on parasite prevalence in Africa and the Malaria in Pregnancy Library. We used random effects meta-analysis to obtain a pooled prevalence ratio (PPR) of malaria in children versus pregnant women (during pregnancy, not at delivery) and by gravidity, and we used meta-regression to assess factors affecting the prevalence ratio. FINDINGS: We used data from 18 sources that included 57 data points. There was a strong linear relation between the prevalence of malaria infection in pregnant women and children (r=0·87, p<0·0001). Prevalence was higher in children when compared with all gravidae (PPR=1·44, 95% CI 1·29-1·62; I(2)=80%, 57 studies), and against multigravidae (1·94, 1·68-2·24; I(2)=80%, 7 studies), and marginally higher against primigravidae (1·16, 1·05-1·29; I(2)=48%, 8 studies). PPR was higher in areas of higher transmission. INTERPRETATION: Malaria prevalence in pregnant women is strongly correlated with prevalence data in children obtained from household surveys, and could provide a pragmatic adjunct to survey strategies to track trends in malaria transmission in Africa. FUNDING: The Malaria in Pregnancy Consortium, which is funded through a grant from the Bill & Melinda Gates Foundation to the Liverpool School of Tropical Medicine, UK; US Centers for Disease Control and Prevention; and Wellcome Trust, UK.

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Authors
van Eijk, A. M., Hill, J., Noor, A. M., Snow, R. W., & ter Kuile, F. O.
Affiliations
  • Liverpool School of Tropical Medicine (GB)
  • Kenya Medical Research Institute (KE)
Venue
The Lancet Global Health
Publisher
Elsevier BV
Published
2015-10
Volume
3
Issue
10
Pages
e617-e628
ISSN
2214-109X (ISSN-L)
OpenAlex
W2125571993
Cited by
130
References
50
Citations by year
2026: 9 · 2025: 12 · 2024: 13 · 2023: 14 · 2022: 16 · 2021: 16 · 2020: 15 · 2019: 11 · 2018: 6 · 2017: 13 · 2016: 4 · 2015: 1
FWCI
1.16
Type
journal article
Language
en
Open access
Locations
  • The Lancet Global Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion, other-oa)
  • LSTM Online Archive (Liverpool School of Tropical Medicine) (acceptedVersion)
  • Bushehr University of Medical Sciences Repository (Bushehr University of Medical Sciences) (acceptedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Greater South Information System
Funders
  • US Centers for Disease Control and Prevention (CDC)
  • Division of Parasitic Diseases and Malaria, CDC
  • Liverpool School of Tropical Medicine
  • Bill & Melinda Gates Foundation
  • Wellcome Trust (079080, 103602, 095127)
  • UK's Department for International Development
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
  • Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
  • Life Sciences › Immunology and Microbiology › Parasitology › Bird parasitology and diseases
Keywords
malaria in pregnancy, malaria prevalence, children under five, malaria transmission intensity, gravidity, primigravida, multigravidae, antenatal care attendance, sentinel surveillance, sub-Saharan Africa, parasite prevalence
MeSH terms
Adolescent, Adult, Antimalarials, Child, Child, Preschool, Female, Humans, Malaria, Male, Middle Aged, Pregnancy, Regression Analysis, Pregnancy Complications, Parasitic, Prevalence, Africa South of the Sahara, Young Adult

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