Asymptomatic Plasmodium falciparum infection is associated with anaemia in pregnancy and can be more cost-effectively detected by rapid diagnostic test than by microscopy in Kinshasa, Democratic Republic of the Congo
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BACKGROUND: In areas of high malaria transmission, Plasmodium falciparum infection during pregnancy is characterized by malaria-related anaemia, placental malaria and does not always result in clinical symptoms. This situation is associated with poor pregnancy outcomes. The aim of this study was to determine the extent of asymptomatic P. falciparum infection, its relation with anaemia as well as the most cost-effective technique for its diagnosis in healthy pregnant women living in Kinshasa, Democratic Republic of the Congo. METHODS: In a cross-sectional study design, information on socio-demographic characteristics and cost data were collected in healthy pregnant women attending antenatal care consultations. Plasmodium falciparum infection was diagnosed using rapid diagnostic test (RDT), microscopy and polymerase chain reaction (PCR). Haemoglobin concentration was also determined. RESULTS: In total, 332 pregnant women were enrolled. RDT and microscopy data were available for all the blood samples and 166 samples were analysed by PCR. The prevalence of asymptomatic P. falciparum infection using microscopy, RDTs and PCR, were respectively 21.6%, 27.4% and 29.5%. Taking PCR as a reference, RDTs had a sensitivity of 81.6% and a specificity of 94.9% to diagnose asymptomatic P. falciparum infection. The corresponding values for microscopy were 67.3% and 97.4%. The prevalence of anaemia was 61.1% and asymptomatic malaria increased five times the odds (p < 0.001) of having anaemia. RDTs were more cost-effective compared to microscopy. Incremental cost-effectiveness ratio was US$ 63.47 per microscopy adequately diagnosed case. CONCLUSION: These alarming results emphasize the need to actively diagnose and treat asymptomatic malaria infection during all antenatal care visits. Moreover, in DRC, malaria and anaemia control efforts should be strengthened by promoting the use of insecticide-treated nets, intermittent preventive treatment with sulphadoxine-pyrimethamine and iron and folic acid supplements.
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In asymptomatic pregnant Congolese women, RDT was better at diagnosing peripheral infection detected by nested PCR compared to LM.
“In asymptomatic pregnant Congolese women RDT was better at diagnosing peripheral infection detected by nested PCR compared to LM [43].”
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- Authors
- Matangila, J. R., Lufuluabo, J., Ibalanky, A. L., Inocêncio da Luz, R. A., Lutumba, P., & Van Geertruyden, J.-P.
- Affiliations
- University of Kinshasa (CD)
- Corresponding author
- Matangila, Junior R
- Venue
- Malaria Journal
- Published
- 2014-04-02
- Volume
- 13
- Issue
- 1
- Pages
- 132-132
- ISSN
- 1475-2875 (ISSN-L)
- PMC
- PMC3976674
- OpenAlex
- W2159168017
- Cited by
- 80
- References
- 42
- Citations by year
- 2025: 5 · 2024: 2 · 2023: 2 · 2022: 7 · 2021: 8 · 2020: 14 · 2019: 6 · 2018: 8 · 2017: 12 · 2016: 3 · 2015: 13
- FWCI
- 9.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Malaria Journal (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Vlaamse Interuniversitaire Raad
- 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
- Plasmodium falciparum, asymptomatic malaria, malaria in pregnancy, anemia in pregnancy, rapid diagnostic tests, microscopy, sensitivity and specificity, cost-effectiveness, prenatal care, placental malaria, Kinshasa
- MeSH terms
- Adult, Anemia, Cost-Benefit Analysis, Cross-Sectional Studies, Diagnostic Tests, Routine, Female, Humans, Microscopy, Middle Aged, Pregnancy, Rural Health, Sensitivity and Specificity, Democratic Republic of the Congo, Pregnancy Complications, Parasitic, Prevalence, Polymerase Chain Reaction, Malaria, Falciparum, Young Adult, Asymptomatic Infections
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