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. 2009 Sep 3:8:210.
doi: 10.1186/1475-2875-8-210.

Burden of malaria in pregnancy in Jharkhand State, India

Davidson H Hamer  1 , Mrigendra P Singh, Blair J Wylie, Kojo Yeboah-Antwi, Jordan Tuchman, Meghna Desai, Venkatachalam Udhayakumar, Priti Gupta, Mohamad I Brooks, Manmohan M Shukla, Kiran Awasthy, Lora Sabin, William B MacLeod, Aditya P Dash, Neeru Singh
Affiliations

Burden of malaria in pregnancy in Jharkhand State, India

Davidson H Hamer et al. Malar J. .

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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Figures

Figure 1
Figure 1
Map of Jharkhand with study sites.
See this image and copyright information in PMC

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