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Cited by 30Malaria Research and ControlGlobal Maternal and Child HealthTravel-related health issues

Global estimates of pregnancies at risk of Plasmodium falciparum and Plasmodium vivax infection in 2020 and changes in risk patterns since 2000

Open access
Gore-Langton, Georgia R., Cano, Jorge, Simpson, Hope, Tatem, Andrew, Tejedor-Garavito, Natalia, Wigley, Adelle, Carioli, Alessandra, Gething, Peter +5 more·2022·PLOS Global Public Health
DOI 10.1371/journal.pgph.0001061PMC PMC10022219
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Abstract

Background: Women are at risk of severe adverse pregnancy outcomes attributable to Plasmodium spp . infection in malaria-endemic areas. Malaria control efforts since 2000 have aimed to reduce this burden of disease. Methods: We used data from the Malaria Atlas Project and WorldPop to calculate global pregnancies at-risk of Plasmodium spp . infection. We categorised pregnancies as occurring in areas of stable and unstable P . falciparum and P . vivax transmission. We further stratified stable endemicity as hypo-endemic, meso-endemic, hyper-endemic, or holo-endemic, and estimated pregnancies at risk in 2000, 2005, 2010, 2015, 2017, and 2020. Findings: In 2020, globally 120.4M pregnancies were at risk of P . falciparum , two-thirds (81.0M, 67.3%) were in areas of stable transmission; 85 2M pregnancies were at risk of P . vivax , 93.9% (80.0M) were in areas of stable transmission. An estimated 64.6M pregnancies were in areas with both P . falciparum and P . vivax transmission. The number of pregnancies at risk of each of P . falciparum and P . vivax worldwide decreased between 2000 and 2020, with the exception of sub-Saharan Africa, where the total number of pregnancies at risk of P . falciparum increased from 37 3M in 2000 to 52 4M in 2020. Interpretation: Historic investments in malaria control have reduced the number of women at risk of malaria in pregnancy in all endemic regions except sub-Saharan Africa. Population growth in Africa has outpaced reductions in malaria prevalence. Interventions that reduce the risk of malaria in pregnancy are needed as much today as ever.

AI snapshot

Written from the paper’s full text.

TL;DR

In 2020, an estimated 120.4 million pregnancies were at risk of *P. falciparum* and 85.2 million at risk of *P. vivax* worldwide, with most at-risk pregnancies in areas of stable transmission. Global numbers fell between 2000 and 2020, but sub-Saharan Africa saw *P. falciparum*-at-risk pregnancies rise from 37.3 million to 52.4 million.

Key findings

  • In 2020, 120.4M pregnancies were at risk of *P. falciparum*; 81.0M (67.3%) were in areas of stable transmission. For *P. vivax*, 85.2M pregnancies were at risk, and 80.0M (93.9%) were in stable-transmission areas.
  • 64.6M pregnancies were in areas with both *P. falciparum* and *P. vivax* transmission, mostly in Central and Southern Asia (41.5M, 64.2%).
  • In sub-Saharan Africa, pregnancies at risk of *P. falciparum* increased from 37.3M in 2000 to 52.4M in 2020, driven by increases in lower-transmission hypo-endemic and meso-endemic areas; pregnancies eligible for IPTp in sub-Saharan Africa rose from 30.0M in 2000 to 34.8M in 2020.
  • Counterfactual estimates suggested 2.4M fewer pregnancies in holo-endemic and 13.4M fewer in hyper-endemic *P. falciparum* areas in sub-Saharan Africa in 2020 than if 2000 prevalence had persisted, with 16.1M more in hypo-endemic and meso-endemic areas.

Methods

  • Used Malaria Atlas Project (MAP) prevalence estimates at 5 km² and WorldPop pregnancy estimates at 1 km², aggregated to 5 km² for malaria-endemic countries.
  • Classified pregnancies as at risk of stable (≥0.01%) or unstable (>0% and <0.01%) transmission; stable endemicity was further categorized as hypo-, meso-, hyper-, or holo-endemic.
  • Estimated pregnancies at risk for 2000, 2005, 2010, 2015, 2017, and 2020; for 2020, used central, lower, and upper prevalence estimates from 100 realizations, and calculated counterfactual risk using 2020 pregnancies with 2000 prevalence.

Limitations

  • The paper states that *P. falciparum* prevalence in children aged 2–10 years was used as a proxy for prevalence in pregnant women, and *P. vivax* estimates represented all ages.
  • Averaging prevalence at the smallest administrative region may classify all pregnancies in a region as at risk even if transmission is only in hot-spots; MAP and WorldPop estimates carry their own uncertainties, including possible ecological fallacies and the Modifiable Areal Unit Problem.
  • The paper also notes that 2020 estimates do not reflect seasonality of transmission and are not stratified by gravidity, so primigravid pregnancies at greatest risk cannot be estimated.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1371/journal.pgph.0001061

Cites

Statistics

Nothing to recompute.

Claims the paper makes

0 of 39 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    In sub-Saharan Africa, the total number of pregnancies at risk of P. falciparum increased from 37.3 million in 2000 to 52.4 million in 2020.

    “with the exception of sub-Saharan Africa, where the total number of pregnancies at risk of P. falciparum increased from 37 3M in 2000 to 52 4M in 2020.”
    • Also stated in: § Changes from 2000 to 2020 · plain
      “the total number of pregnancies at risk of P. falciparum increased year-on-year between 2000 and 2020 in sub-Saharan Africa from 37 3M to 52 4M”
    Quote in the paperSubstantial claim
  • Findingown data

    In 2020, globally 85.2 million pregnancies were at risk of Plasmodium vivax.

    “85 2M pregnancies were at risk of P. vivax”
    • Also stated in: § Plasmodium vivax · plain
      “Worldwide, 85 2M pregnancies were at risk of P. vivax”
    Quote in the paperSubstantial claim
  • Findingown data

    Of the 120.4 million pregnancies at risk of P. falciparum in 2020, 81.0 million (67.3%) were in areas of stable transmission.

    “two-thirds (81.0M, 67.3%) were in areas of stable transmission”
    • Also stated in: § Plasmodium falciparum: Stable versus unstable transmission · plain
      “Over half of these (81.0M, 67.25%) were in areas of stable (≥0 01%) transmission.”
    Quote in the paperNot a substantial claim
  • Findingown data

    In 2020, an estimated 64.6 million pregnancies were in areas with both P. falciparum and P. vivax transmission.

    “An estimated 64.6M pregnancies were in areas with both P. falciparum and P. vivax transmission.”
    • Also stated in: § Mixed infections · plain
      “Worldwide, 64.6M pregnancies in 2020 were resident in areas of both P. falciparum and P. vivax transmission, and therefore at risk of mixed infections.”
    Quote in the paperSubstantial claim
  • Findingown data

    The number of pregnancies at risk of P. vivax worldwide decreased between 2000 and 2020.

    “The number of pregnancies at risk of each of P. falciparum and P. vivax worldwide decreased between 2000 and 2020”
    • Also stated in: § Changes from 2000 to 2020 · plain
      “Global pregnancies at risk of P. vivax decreased between 2000 and 2020, with a slight increase between 2017 and 2020.”
    Quote in the paperSubstantial claim
  • May combine two claims. 30
  • The quote only partly states this claim. 2
  • Classified as probably not a substantial claim. 11

  • May combine two claims.

    Findingown data

    In East Africa, Ethiopia had the most pregnancies at risk of P. falciparum (5.2 million), of which 99.7% were in areas of stable transmission.

    “In East Africa, Ethiopia had the most pregnancies at risk of P. falciparum, 5 2M, of which 99 7% were in areas of stable transmission”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Central and Southern Asia had the largest number of pregnancies at risk of unstable P. falciparum (28.5 million), making up 59.47% of the region's at-risk pregnancies.

    “Central and Southern Asia had the largest number of pregnancies at risk of unstable P. falciparum (28 5M) making up 59.47% of the region’s at risk pregnancies.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Central and Southern Asia had the second largest number of pregnancies at risk of stable P. falciparum (19.4 million), making up 40.53% of total pregnancies at risk in the region.

    “Central and Southern Asia had the second largest number of pregnancies at risk of stable P. falciparum, 19.4M, making up 40 53% of total pregnancies at risk in the region”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Eastern and South-Eastern Asia had the second highest number of pregnancies at risk of unstable P. falciparum transmission (6.1 million), accounting for 60.7% of at-risk pregnancies in the region.

    “Eastern and South-Eastern Asia had the second highest number of pregnancies at risk of unstable P. falciparum transmission, 6.1M, accounting for 60 7% of at risk pregnancies in the region (Table 1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The number of pregnancies at risk of moderate to high P. falciparum transmission in sub-Saharan Africa (i.e. women requiring preventative intervention) has remained relatively unchanged, increasing between 2017 and 2020.

    “the number of pregnancies at risk of moderate to high P. falciparum transmission in sub-Saharan Africa i.e. women requiring preventative intervention, has remained relatively unchanged, increasing between 2017 and 2020.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Indonesia had the third largest number of pregnancies at risk of P. vivax (6.7 million), 96.8% (6.5 million) in areas of stable transmission.

    “Indonesia had the third largest number of pregnancies at risk of P.vivax; in total 6.7M pregnancies were at risk, 96.8% (6.5M) of these were in areas of stable transmission”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In West Africa, Nigeria had the most pregnancies at risk of P. falciparum (10.7 million), all in areas of stable transmission.

    “In West Africa, Nigeria had the most pregnancies at risk, 10 7M, all of which were in areas of stable P. falciparum transmission”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    In sub-Saharan Africa, the total number of pregnancies increased year-on-year between 2000 and 2020.

    “In sub-Saharan Africa, there has been a year-on-year increase in both the total number of pregnancies and the proportion of total pregnancies at risk of each of P. falciparum and P. vivax, applicable to the six African countries for which MAP generate P. vivax transmission (Ethiopia, Eritrea, Djibouti, Somalia, Sudan, and Madagascar) (S9 Fig and S4 Table).”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    In sub-Saharan Africa, the proportion of total pregnancies at risk of P. falciparum increased year-on-year between 2000 and 2020.

    “In sub-Saharan Africa, there has been a year-on-year increase in both the total number of pregnancies and the proportion of total pregnancies at risk of each of P. falciparum and P. vivax, applicable to the six African countries for which MAP generate P. vivax transmission (Ethiopia, Eritrea, Djibouti, Somalia, Sudan, and Madagascar) (S9 Fig and S4 Table).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In Central Africa, the Democratic Republic of Congo had the most pregnancies at risk of P. falciparum infection (5.3 million), all in areas of stable transmission.

    “In Central Africa, the Democratic Republic of Congo (DRC) had the most pregnancies at risk of P. falciparum infection, 5 3M, all in areas of stable transmission”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    A total of 7.0 million pregnancies within sub-Saharan Africa were at risk of P. vivax, 99.9% of which were in areas of stable transmission.

    “A total of 7 0M pregnancies within sub-Saharan Africa were at risk of P. vivax (99.9% of which in areas of stable transmission).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Across Asia, pregnancies at risk of P. falciparum decreased from 2000 to 2020, as did the proportion of at-risk pregnancies in areas of higher transmission levels.

    “Across Asia, pregnancies at risk of P. falciparum decreased from 2000 to 2020, as did the proportion of at risk pregnancies in areas of higher transmission levels”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Sierra Leone had a mean P. falciparum prevalence of 39.2% and 328,800 pregnancies at risk.

    “Sierra Leone, mean prevalence 39 2% (IQR: 22 7 to 46.0) and 328,800 pregnancies at risk.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The majority of pregnancies at risk of stable P. vivax transmission were in Central and Southern Asia (51.7 million), accounting for 94.8% of all pregnancies at risk of P. vivax in the region.

    “The majority of pregnancies at risk of stable P. vivax transmission were in Central and Southern Asia (51 7M), accounting for 94 8% of all pregnancies at risk of P. vivax in the region.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Pakistan had 10.3 million pregnancies at risk of P. vivax, all at risk of stable transmission.

    “followed by Pakistan with 10.3M pregnancies all at risk of stable transmission”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    India had the largest number of pregnancies at risk of P. vivax (38.3 million), 97.2% (37.2 million) in areas of stable transmission.

    “India had the largest number of pregnancies at risk of P.vivax, 38 3M, 97.2% of these (37.2M) were in areas of stable transmission”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Among High burden to high impact countries, India had the most pregnancies at risk of P. falciparum (37.5 million), of which 38.0% were at risk of stable but low transmission.

    “Among these, India had the most pregnancies at risk of P. falciparum (37 5M), of which 38.0% were at risk of stable but low transmission”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Despite malaria prevalence having decreased overall in sub-Saharan Africa since 2000, the number and proportion of pregnancies exposed to hyper- or holo-endemic malaria decreased.

    “Despite malaria prevalence having decreased overall in sub-Saharan Africa since 2000, and the number and proportion of pregnancies exposed to hyper- (51 to75%) or holo-endemic (>75%) malaria decreasing”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Across other regions, pregnancies at risk of hypo-endemic (>0.01 to 10%) transmission have decreased while the numbers in areas of unstable (<0.01%) or no P. falciparum transmission have increased.

    “Across other regions, pregnancies at risk of hypo-endemic (>0.01 to 10%) transmission have decreased while the numbers in areas of unstable (<0.01%) or no P. falciparum transmission have increased.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    The World Malaria Report of 2021 estimated that 33.8 million pregnancies were at risk of moderate to high P. falciparum transmission in sub-Saharan Africa in 2020, one million fewer than our estimate for the same year.

    “The World Malaria Report of 2021 estimated that 33 8M pregnancies were at risk of moderate to high P. falciparum transmission in sub-Saharan Africa in 2020 [11], one million fewer than our estimate for the same year.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11] Geneva: World Health Organization. World malaria report 2021. Licence: CC BY-NC-SA 3.0 IGO.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In areas of high P. falciparum transmission, pregnant women develop partial immunity to placental infection through repeated malaria exposure over successive pregnancies.

    “In areas of high P. falciparum transmission, pregnant women develop partial immunity to placental infection through repeated malaria exposure over successive pregnancies [7–10].”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [7] SJ Rogerson, 2007, Malaria in pregnancy: pathogenesis and immunity, The Lancet Infectious Diseases source

      Not checked in the free run.

    • cites [8] I O’Neil-Dunne, 2001, Gravidity-dependent production of antibodies that inhibit binding of Plasmodium falciparum-infected erythrocytes to placental chondroitin sulfate proteoglycan during pregnancy, Infect Immun source

      Not checked in the free run.

    • cites [9] PG Walker, 2013, A model of parity-dependent immunity to placental malaria, Nature communications source

      Not checked in the free run.

    • cites [10] R Ma, 2021, Structural basis for placental malaria mediated by Plasmodium falciparum VAR2CSA, Nature Microbiology source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    P. falciparum infection during pregnancy increases the risk of spontaneous abortion, stillbirth, preterm delivery, low birthweight, small for gestational age, maternal and newborn anaemia, and maternal death.

    “Plasmodium falciparum infection during pregnancy increases the risk of spontaneous abortion [1], stillbirth [1], preterm delivery [2], low birthweight [3], small for gestational age [4], maternal and newborn anaemia [5], and maternal death [2, 4, 6].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [1] KA Moore, 2017, Quantification of the association between malaria in pregnancy and stillbirth: a systematic review and meta-analysis, The Lancet Global Health source

      Not checked in the free run.

    • cites [2] C Menendez, 2000, The Impact of Placental Malaria on Gestational Age and Birth Weight, The Journal of Infectious Diseases source

      Not checked in the free run.

    • cites [3] HL Guyatt, 2004, Impact of malaria during pregnancy on low birth weight in sub-Saharan Africa, Clin Microbiol Rev source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The vast majority of global P. falciparum cases are in sub-Saharan Africa, whereas lower transmission persists across parts of South America and Asia.

    “The vast majority of global P. falciparum cases are in sub-Saharan African, whereas lower transmission persists across parts of South America and Asia [11, 12].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [11] Geneva: World Health Organization. World malaria report 2021. Licence: CC BY-NC-SA 3.0 IGO.

      Not checked in the free run.

    • cites [12] DJ Weiss, 2019, Mapping the global prevalence, incidence, and mortality of Plasmodium falciparum, 2000–17: a spatial and temporal modelling study, The Lancet source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    P. vivax infection during pregnancy is associated with stillbirth, preterm delivery, low birthweight, and anaemia.

    “Plasmodium vivax is also associated with stillbirth [1], preterm delivery [14], low birthweight [15, 16], and anaemia [16–18]”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [1] KA Moore, 2017, Quantification of the association between malaria in pregnancy and stillbirth: a systematic review and meta-analysis, The Lancet Global Health source

      Not checked in the free run.

    • cites [14] SJ Allen, 1998, Causes of preterm delivery and intrauterine growth retardation in a malaria endemic region of Papua New Guinea., Archives of Disease in Childhood—Fetal and Neonatal Edition source

      Not checked in the free run.

    • cites [15] MJ Rijken, 2012, Malaria in pregnancy in the Asia-Pacific region., The Lancet Infectious diseases source

      Not checked in the free run.

    • cites [16] JR Poespoprodjo, 2008, Adverse pregnancy outcomes in an area where multidrug-resistant plasmodium vivax and Plasmodium falciparum infections are endemic., Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study sponsors had no role in any stage of data analysis or manuscript development.

    “The study sponsors had no role in any stage of data analysis or manuscript development.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The most recent regional estimates of pregnancies at risk of malaria were for 2020 and were specific to P. falciparum in sub-Saharan Africa.

    “The most recent regional estimates were for 2020 and were specific to P. falciparum in sub-Saharan Africa [11].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [11] Geneva: World Health Organization. World malaria report 2021. Licence: CC BY-NC-SA 3.0 IGO.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    All gravidae infected with P. vivax are equally vulnerable to having low birthweight newborns.

    “Moreover, all gravidae infected with P. vivax are equally vulnerable to having low birthweight newborns [18].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] FO ter Kuile, 2008, Plasmodium vivax Infection during Pregnancy: An Important Problem in Need of New Solutions, Clinical Infectious Diseases source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    P. vivax infection during pregnancy is considered less severe than P. falciparum in part because P. vivax infects only reticulocytes which limits parasite densities.

    “but infection during pregnancy is considered less severe than P. falciparum in part because P. vivax infects only reticulocytes which limits parasite densities [18].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] FO ter Kuile, 2008, Plasmodium vivax Infection during Pregnancy: An Important Problem in Need of New Solutions, Clinical Infectious Diseases source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Since 2007 there have been decreases in the prevalence of P. falciparum and P. vivax, as well as global fertility rates, although absolute populations have grown at regional and global levels.

    “Since 2007 there have been decreases in the prevalence of P. falciparum [12] and P. vivax [19], as well as global fertility rates [21, 22], although absolute populations have grown at regional and global levels.”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [12] DJ Weiss, 2019, Mapping the global prevalence, incidence, and mortality of Plasmodium falciparum, 2000–17: a spatial and temporal modelling study, The Lancet source

      Not checked in the free run.

    • cites [19] KE Battle, 2019, Mapping the global endemicity and clinical burden of Plasmodium vivax, 2000–17: a spatial and temporal modelling study, Lancet (London, England). source

      Not checked in the free run.

    • cites [21] C Pezzulo, 2021, Geographical distribution of fertility rates in 70 low-income, lower-middle-income, and upper-middle-income countries, 2010–16: a subnational analysis of cross-sectional surveys, The Lancet Global Health source

      Not checked in the free run.

    • cites [22] United Nations Depratment of Economic and Social Affairs PD. World Fertility and Family Planning 2020: Highlights. 2020.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Most P. vivax cases are in geographic areas of the WHO Regional Offices for South-East Asia and Eastern Mediterranean.

    “Most P. vivax cases are in geographic areas of the WHO Regional Offices for South-East Asia and Eastern Mediterranean [19]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] KE Battle, 2019, Mapping the global endemicity and clinical burden of Plasmodium vivax, 2000–17: a spatial and temporal modelling study, Lancet (London, England). source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Malaria control efforts have led to a reduction in the number of pregnancies at risk of higher levels of P. falciparum transmission within sub-Saharan Africa, and a corresponding increase in the numbers at risk of lower levels of transmission.

    “We have shown that malaria control efforts have led to a reduction in the number of pregnancies at risk of higher levels of P. falciparum transmission within sub-Saharan Africa, and a corresponding increase in the numbers at risk of lower levels of transmission.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Eleven countries are considered "High burden to high impact countries" that account for approximately 70% of global P. falciparum.

    “Eleven countries are considered “High burden to high impact countries” that account for approximately 70% of the global P. falciparum [32].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [32] World Health Organisation, 2018, High burden to high impact: a targeted malaria response

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Matching the reductions in malaria prevalence over the next two decades may be challenging and the total population at risk of malaria is projected to increase over the coming 50 years.

    “matching the reductions in malaria prevalence over the next two decades may be challenging and the total population at risk of malaria is projected to increase over the coming 50 years [42].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [42] FJ Colón-González, 2021, Projecting the risk of mosquito-borne diseases in a warmer and more populated world: a multi-model, multi-scenario intercomparison modelling study, The Lancet Planetary Health source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Premisecitation

    New tools are increasingly available for use in malaria control and elimination, specifically malaria vaccines could increasingly feature in reducing the burden of malaria in pregnancy, potentially in combination with malaria chemoprevention.

    “New tools are increasingly available for use in malaria control and elimination, specifically malaria vaccines could increasingly feature in reducing the burden of malaria in pregnancy, potentially in combination with malaria chemoprevention [43].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [43] B Greenwood, 2021, Combining malaria vaccination with chemoprevention: a promising new approach to malaria control., Malar J. source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    The more recent MAP prevalence estimates allowed stratification of at-risk pregnancies by prevalence in more detail than just stable/unstable, and the use of WorldPop estimates of numbers of pregnancies at 5km resolution enabled estimation of the number of pregnancies and the level of malaria transmission within which they reside at a much finer geographic resolution than was applied to 2007估计.

    “The more recent MAP prevalence estimates allowed us to stratify at risk pregnancies by prevalence in more detail than just stable/unstable, and the use of WorldPop estimates of numbers of pregnancies at 5km resolution enable us to estimate number of pregnancies, and the level of malaria transmission within which they reside, at a much finer geographic resolution than was applied to 2007 estimates”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [20] S Dellicour, 2010, Quantifying the number of pregnancies at risk of malaria in 2007: a demographic study., PLoS Med. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The Covid-19 pandemic has disrupted malaria control programmes and health systems in general and malaria prevalence and cases greatly increased in 2020.

    “The Covid-19 pandemic has disrupted malaria control programmes and health systems in general and malaria prevalence and cases greatly increased in 2020 [40, 41].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [40] E Sherrard-Smith, 2020, The potential public health consequences of COVID-19 on malaria in Africa, Nature Medicine

      Not checked in the free run.

    • cites [41] DJ Weiss, 2021, Indirect effects of the COVID-19 pandemic on malaria intervention coverage, morbidity, and mortality in Africa: a geospatial modelling analysis., The Lancet Infectious Diseases source

      Not checked in the free run.

36 of 36

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Malaria control efforts have significantly reduced the risk to pregnant women in most endemic areas, with the exception of sub-Saharan Africa, where population growth has exceeded the progress made in malaria control.

    “Malaria control efforts have significantly reduced the risk to pregnant women in most endemic areas, with the exception of sub-Saharan Africa, where population growth has exceeded the progress made in malaria control.”

    From Current update on malaria in pregnancy: a systematic review (2025) · cites this paper as [162]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Sub-Saharan stable-transmission count rounds to 52.3M, not 52.4M

    Minor

    The prose describes 52.4M pregnancies at risk of stable transmission in sub-Saharan Africa, but the table gives 52,320,300, which rounds to 52.3M. The table's total at-risk count, 52,395,400, rounds to 52.4M.

  • Hypo-endemic range has conflicting lower bounds

    Minor

    The methods define hypo-endemic transmission as beginning at 0.01%, whereas the results describe the same category as beginning at 0.1%. Those definitions classify pregnancies in areas with prevalence between 0.01% and 0.1% differently.

  • Latin America and Caribbean uncertainty bounds do not partition the total

    Minor

    The upper bound for stable pregnancies and lower bound for unstable pregnancies should sum to the region's fixed total. Instead, they fall short by 182,200 pregnancies.

    Reported 5979000 · recomputed 5796800

  • Central and Southern Asia uncertainty bounds do not partition the total

    Minor

    Stable and unstable transmission are complementary categories, so the lower bound for stable pregnancies and upper bound for unstable pregnancies should sum to the region's fixed total. They sum to 46,836,100, not 47,849,200.

    Reported 47849200 · recomputed 46836100

4 of 4

The citation lists haven’t been fetched yet

References 37 · Cited by 30

Research works printed but not linked: 1

  1. World Health Organisation, 2018, High burden to high impact: a targeted malaria response

Authors
Gore-Langton, G. R., Cano, J., Simpson, H., Tatem, A., Tejedor-Garavito, N., Wigley, A., Carioli, A., Gething, P., Weiss, D. J., Chandramohan, D., Walker, P. G. T., Cairns, M. E., & Chico, R. M.
Affiliations
  • London School of Hygiene & Tropical Medicine (GB)
  • University of Southampton (GB)
  • The Kids Research Institute Australia (AU)
  • Imperial College London (GB)
ORCID
Venue
PLOS Global Public Health
Publisher
Public Library of Science (PLoS)
Published
2022-11-09
Volume
2
Issue
11
Pages
e0001061
ISSN
2767-3375 (ISSN-L)
DOI
10.1371/journal.pgph.0001061
PMC
PMC10022219
OpenAlex
W4308654525
Semantic Scholar
0d32d732ba7592f5469abf63275ecb4eae954599
Cited by
30
References
37
Citations by year
2026: 7 · 2025: 8 · 2024: 6 · 2023: 7 · 2022: 2
FWCI
5.08
Type
journal article
Language
en
Open access
Licence
Locations
  • PLOS Global Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by-nc-sa)
  • PubMed (publishedVersion)
  • ePrints Soton (University of Southampton) (acceptedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
  • Spiral (Imperial College London) (submittedVersion, cc-by)
Funders
  • Medical Research Council (MR/N013638/1)
  • Wellcome Trust (220658/Z/20/Z)
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 › Public Health, Environmental and Occupational Health › Travel-related health issues
Keywords
malaria in pregnancy, Plasmodium falciparum, Plasmodium vivax, malaria transmission, endemicity, sub-Saharan Africa, malaria control, population growth, global burden of disease, temporal trends

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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