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.
journal_name
Lancet Glob Healthjournal_title
The Lancet. Global healthauthors
van Eijk AM,Hill J,Noor AM,Snow RW,ter Kuile FOdoi
10.1016/S2214-109X(15)00049-2subject
Has Abstractpub_date
2015-10-01 00:00:00pages
e617-28issue
10issn
2214-109Xpii
S2214-109X(15)00049-2journal_volume
3pub_type
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