Background
Due to the low prevalence of clinically suspected malaria among pregnant women in Myanmar, little is known about its impact on mothers and newborns. Helminth and human immunodeficiency virus (HIV) co-infections cause anaemia in pregnant women. This study assessed the prevalence of subclinical malaria and co-infections among pregnant women, and its association with adverse outcomes of pregnancy in the presence of infection.
Methods
A prospective longitudinal study was conducted in 12 villages in two townships in Myanmar between 2013 and 2015. A total of 752 pregnant women, with a mean age of 27 years, were enrolled and followed up once a month until six weeks after childbirth. Prevalence ratio was calculated in the multivariable analysis.
Results
The prevalence of subclinical malaria as measured by nested PCR was 5.7 percent for either Plasmodium falciparum or Plasmodium vivax, 2.7 percent prevalence of P. falciparum and 2.8 percent prevalence of P. vivax. Helminth infections were prevalent in 17 percent of women, and one woman with an HIV infection was found in our study. The burden of anaemia was high, with an overall prevalence of 37 percent with or without helminth infection, 42 percent of the women were malaria positive and 43 percent had dual infections (both malaria and helminth). Only 11 abnormal pregnancy outcomes (seven stillbirths, two premature, two twins) were identified. Poisson regression showed that women in their first trimester had a 2.9 times higher rate of subclinical malaria compared to women in the third trimester (PR: 2.9, 95% CI 1.19, 7.31, p = 0.019), women who were enrolled during the wet season were 2.5 times more likely to be malaria positive than women enrolled in the dry season (PR: 2.5, 95% CI 1.27, 4.88, p = 0.008), and the malaria positivity rate decreased by 5 percent when increased in one year of woman’s age (PR: 0.95, 95% CI 0.91, 0.99, p = 0.02). In the multivariable regression, the age of respondents was the only significant factor associated with subclinical malaria in pregnancy.
Conclusions
A comprehensive approach of integrating interventions for malaria, anaemia and helminths should be delivered during antenatal care services for pregnant women in rural areas of Myanmar.
Published in Tropical Medicine and Health.
Citation: Tropical Medicine and Health, 2024; 52: 22.
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