Burden of malaria in pregnancy among adolescent girls compared to adult women in 5 sub-Saharan African countries: A secondary individual participant data meta-analysis of 2 clinical trials

Malaria in pregnancy: baby steps

PURPOSE OF REVIEW

Malaria threatens pregnant women and their babies, particularly in Africa.

RECENT FINDINGS

This century, the number of women at risk of malaria in pregnancy has decreased globally, apart from in Africa, where it has increased. Low and sub microscopic infections are increasingly documented but remain hard to diagnose with current point-of-care tests, and their contribution to morbidity and transmission are unclear. Artemether-lumefantrine has been endorsed for treatment in first trimester, but many women attend antenatal clinics later in pregnancy, and reaching high-risk young, first-time mothers is particularly difficult. Small-for-gestational-age babies frequently result from malaria, which affects the placenta's development and its functions such as nutrient transport. Resistance to continues to increase to sulphadoxine-pyrimethamine, the mainstay of intermittent preventive treatment in pregnancy. The alternative, dihydroartemisinin-piperaquine controls malaria better, but does not improve pregnancy outcomes, suggesting that sulphadoxine-pyrimethamine may have nonmalarial effects including improving gut function or reducing dangerous inflammation. Understanding of how the malaria parasite uses the VAR2CSA protein to bind to its placental receptor is increasing, informing the search for a vaccine to prevent pregnancy malaria.

SUMMARY

Progress in several areas increases optimism that improved prevention and control of malaria in pregnancy is possible, but obstacles remain.

Prevalence and determinants of anaemia among pregnant women in a high malaria transmission setting: a cross-sectional study in rural Burkina Faso

Introduction

anemia, the commonest nutritional deficiency disorder among pregnant women in sub-Saharan Africa, is associated with severe peripartum complications. Its regular monitoring is necessary to timely inform clinical and preventive decision-making. The aim of this study was to assess the prevalence and determinants of anemia among pregnant women in rural areas of Burkina Faso.

Methods

between August 2019 and March 2020, a cross-sectional study was conducted to collect maternal sociodemographic, gynaeco-obstetric, and medical characteristics by face-to-face interview or by review of antenatal care books. In addition, maternal malaria was diagnosed by standard microscopy and the hemoglobin levels (Hb) measured by spectrophotometry. The proportion of anaemia (Hb<11.0 g/dL), moderate (7.0

Results

of 594 pregnant women assessed, the mean hemoglobin level (± standard deviation) was 10.7 (±0.1) g/dL, and the prevalence of anemia was 54.4% (323/594). The proportion of moderate, and severe anemia among pregnant women was 49.2% (95% CI: 45.1%-53.2%), and 5.2% (95% CI: 3.7%-7.3%) respectively. Multivariate analysis showed that the young maternal age (<20 years old) (adjusted OR (aOR): 1.5, 95% CI: 1.1-2.3) and the presence of malaria (aOR: 2.0, 95% CI: 1.3-3.2) were independently associated with the presence of maternal anemia.

Conclusion

anemia remains common in the study setting and interventions to strengthen malaria prevention in pregnancy, particularly among young adolescent pregnant women, are required to prevent maternal anemia.

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Key Words

• Anaemia
• Burkina Faso
• malaria
• pregnancy
• rural area

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MESH Headings

• Adolescent
• Female
• Pregnancy
• Humans
• Young Adult
• Adult
• Cross-Sectional Studies
• Pregnant Women
• Burkina Faso/epidemiology
• Prevalence
• Risk Factors
• Malaria/complications
• Malaria/epidemiology
• Malaria/prevention & control
• Anemia/epidemiology
• Anemia/etiology
• Pregnancy Complications, Hematologic/epidemiology
• Pregnancy Complications, Hematologic/etiology
• Hemoglobins/analysis

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Affiliation(s)

Moussa Lingani Institut de Recherche en Sciences de la Santé Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso
Serge Henri Zango Institut de Recherche en Sciences de la Santé Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso
Innocent Valéa Institut de Recherche en Sciences de la Santé Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso
Sékou Samadoulougou Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec City, Canada
Moussa Abdel Sanou Institut de Recherche en Sciences de la Santé Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso
Hermann Sorgho Institut de Recherche en Sciences de la Santé Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso
Edmond Sawadogo Institut de Recherche en Sciences de la Santé Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso
Michèle Dramaix École de Santé Publique, Université Libre de Bruxelles, Route de Lennik, Bruxelles, Belgique
Philippe Donnen École de Santé Publique, Université Libre de Bruxelles, Route de Lennik, Bruxelles, Belgique
Robert Annie Epidemiology and Biostatistics Research Division, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Clos Chapelle-aux-Champs, Brussels, Belgique
Halidou Tinto Institut de Recherche en Sciences de la Santé Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso

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