Quantification of the burden and consequences of pregnancy-associated malaria in the Democratic Republic of the Congo.

Journal Article (Journal Article)

BACKGROUND: Pregnancy-associated malaria (PAM) produces poor birth outcomes, but its prevalence is commonly estimated in convenience samples. METHODS: We assessed the prevalence of malaria using real-time polymerase chain reaction (PCR) and estimated the consequences of infection on birth outcomes, using specimens from a nationally representative sample of 4570 women of childbearing age (WOCBA) responding to the 2007 Demographic and Health Survey in Democratic Republic of the Congo (DRC). RESULTS: Overall, 31.2% (95% confidence interval [CI], 29.2-33.1) of WOCBA were parasitemic, which was significantly more common in pregnant (37.2% [31.0-43.5]) than nonpregnant women (30.4% [CI, 28.4-32.5], prevalence ratio [PR] 1.22 [1.02-1.47]). Plasmodium falciparum was highest among pregnant women (36.6% vs 28.8%, PR 1.27 [1.05-1.53]). By contrast, P malariae was less common in pregnant (0.6%) compared with nonpregnant women (2.7%, PR 0.23 [0.09-0.56]). Extrapolation of the prevalence estimate to the population at risk of malaria in DRC suggests 1.015 million births are affected by P falciparum infection annually, and that adherence to preventive measures could prevent up to 549 000 episodes of pregnancy-associated malaria and 47 000 low-birth-weight births. CONCLUSIONS: Pregnancy-associated malaria and its consequences are highly prevalent in the DRC. Increasing the uptake of malaria preventive measures represents a significant opportunity to improve birth outcomes and neonatal health.

Full Text

Duke Authors

Cited Authors

  • Taylor, SM; van Eijk, AM; Hand, CC; Mwandagalirwa, K; Messina, JP; Tshefu, AK; Atua, B; Emch, M; Muwonga, J; Meshnick, SR; Ter Kuile, FO

Published Date

  • December 1, 2011

Published In

Volume / Issue

  • 204 / 11

Start / End Page

  • 1762 - 1771

PubMed ID

  • 21990422

Pubmed Central ID

  • PMC3635529

Electronic International Standard Serial Number (EISSN)

  • 1537-6613

Digital Object Identifier (DOI)

  • 10.1093/infdis/jir625


  • eng

Conference Location

  • United States