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Cited by 67Malaria Research and ControlGlobal Maternal and Child HealthHemoglobinopathies and Related Disorders

Burden of malaria in pregnancy in Jharkhand State, India

Open access
Hamer, Davidson H, Singh, Mrigendra P, Wylie, Blair J, Yeboah-Antwi, Kojo, Tuchman, Jordan, Desai, Meghna, Udhayakumar, Venkatachalam, Gupta, Priti +7 more·2009·Malaria Journal
DOI 10.1186/1475-2875-8-210PMC PMC2744702
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Abstract

BACKGROUND: Past studies in India included only symptomatic pregnant women and thus may have overestimated the proportion of women with malaria. Given the large population at risk, a cross sectional study was conducted in order to better define the burden of malaria in pregnancy in Jharkhand, a malaria-endemic state in central-east India. METHODS: Cross-sectional surveys at antenatal clinics and delivery units were performed over a 12-month period at two district hospitals in urban and semi-urban areas, and a rural mission hospital. Malaria was diagnosed by Giemsa-stained blood smear and/or rapid diagnostic test using peripheral or placental blood. RESULTS: 2,386 pregnant women were enrolled at the antenatal clinics and 718 at the delivery units. 1.8% (43/2382) of the antenatal clinic cohort had a positive diagnostic test for malaria (53.5% Plasmodium falciparum, 37.2% Plasmodium vivax, and 9.3% mixed infections). Peripheral parasitaemia was more common in pregnant women attending antenatal clinics in rural sites (adjusted relative risk [aRR] 4.31, 95%CI 1.84-10.11) and in those who were younger than 20 years (aRR 2.68, 95%CI 1.03-6.98). Among delivery unit participants, 1.7% (12/717) had peripheral parasitaemia and 2.4% (17/712) had placental parasitaemia. Women attending delivery units were more likely to be parasitaemic if they were in their first or second pregnancy (aRR 3.17, 95%CI 1.32-7.61), had fever in the last week (aRR 5.34, 95%CI 2.89-9.90), or had rural residence (aRR 3.10, 95%CI 1.66-5.79). Malaria control measures including indoor residual spraying (IRS) and untreated bed nets were common, whereas insecticide-treated bed nets (ITN) and malaria chemoprophylaxis were rarely used. CONCLUSION: The prevalence of malaria among pregnant women was relatively low. However, given the large at-risk population in this malaria-endemic region of India, there is a need to enhance ITN availability and use for prevention of malaria in pregnancy, and to improve case management of symptomatic pregnant women.

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  • Younger women, particularly adolescents, are at higher risk of malaria infection than older women, independent of parity.

    “It is well established that younger women (primigravidae and multigravidae), particularly adolescents, are at higher risk of malaria infection than older women,18–20 and this is independent of parity.20–22”

    From Malaria in pregnancy. (2013) · cites this paper as [20]

    In Results > Delivery units (Table 5; page unavailable), women under 20 had higher parasitaemia than older women, including after adjustment for recent fever. The analysis did not adjust age for parity, so it does not establish that the age association is independent of parity. Results > Antenatal clinics (Table 4; page unavailable) found no significant age association. (LLM, conf=0.86)

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  • Primigravidae are at higher risk of malaria than multigravidae, though less in low transmission settings, while in epidemic areas the risk is not affected by parity.

    “Parity also affects the risk of malaria as primigravidae are at higher risk than multigravidae,18–20, 23–24 though less in low transmission settings,15 while in epidemic areas, the risk is not affected by parity.25”

    From Malaria in pregnancy. (2013) · cites this paper as [20]

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Authors
Hamer, D. H., Singh, M. P., Wylie, B. J., Yeboah-Antwi, K., Tuchman, J., Desai, M., Udhayakumar, V., Gupta, P., Brooks, M. I., Shukla, M. M., Awasthy, K., Sabin, L., MacLeod, W. B., Dash, A. P., & Singh, N.
Affiliations
  • Boston University (US)
  • National Institute of Malaria Research (IN)
  • Management Sciences for Health (US)
  • Centers for Disease Control and Prevention (US)
  • National Institute for Research in Tribal Health (IN)
Corresponding author
Hamer, Davidson H
ORCID
Venue
Malaria Journal
Publisher
Springer Science and Business Media LLC
Published
2009-09-03
Volume
8
Issue
1
Pages
210-210
ISSN
1475-2875 (ISSN-L)
DOI
10.1186/1475-2875-8-210
PMC
PMC2744702
OpenAlex
W2140830432
Cited by
67
References
33
Citations by year
2026: 1 · 2025: 1 · 2024: 5 · 2023: 11 · 2022: 5 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 5 · 2017: 5 · 2016: 3 · 2015: 3 · 2014: 2 · 2013: 3 · 2012: 10
FWCI
6.39
Type
journal article
Language
en
Open access
Licence
Locations
  • Malaria Journal (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • OpenBU (Boston University) (submittedVersion, cc-by)
Funders
Indian Council of Medical Research
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
Keywords
malaria in pregnancy, malaria prevalence, Plasmodium falciparum, Plasmodium vivax, prenatal screening, insecticide-treated nets, malaria chemoprophylaxis, indoor residual spraying, malaria control, Jharkhand, urban-rural differences, parity, fever in pregnancy, rapid diagnostic tests
MeSH terms
Adult, Animals, Blood, Cross-Sectional Studies, Female, Humans, India, Plasmodium falciparum, Plasmodium vivax, Pregnancy, Pregnancy Complications, Infectious, Prevalence, Malaria, Falciparum, Malaria, Vivax, Young Adult

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