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Malaria prevalence in symptomatic and asymptomatic pregnant women in a high malaria-burden state in India

INTRODUCTION: Malaria in pregnancy (‘MiP’) poses risks to mother, foetus and newborn. Studies from Africa and Asia have reported high prevalence of ‘MiP’ and recommended further research to address ‘MiP’. India has a significant burden of ‘MiP’ but most of the studies are a decade old. Hardly any st...

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Autores principales: Garg, Samir, Dewangan, Mukesh, Barman, Omprakash
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7436977/
https://www.ncbi.nlm.nih.gov/pubmed/32831578
http://dx.doi.org/10.1186/s41182-020-00259-y
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author Garg, Samir
Dewangan, Mukesh
Barman, Omprakash
author_facet Garg, Samir
Dewangan, Mukesh
Barman, Omprakash
author_sort Garg, Samir
collection PubMed
description INTRODUCTION: Malaria in pregnancy (‘MiP’) poses risks to mother, foetus and newborn. Studies from Africa and Asia have reported high prevalence of ‘MiP’ and recommended further research to address ‘MiP’. India has a significant burden of ‘MiP’ but most of the studies are a decade old. Hardly any studies exist in India that report on asymptomatic malaria in pregnant women. The current Indian policies for malaria control are silent on ‘MiP’. A campaign was carried out by community health workers (CHWs) in 2019 to screen pregnant women across rural Chhattisgarh. METHODS: This is a cross-sectional study. Malaria was tested in pregnant women by CHWs using bivalent rapid tests. Multi-stage sampling was used to cover 21,572 pregnant women screened across different geographical areas of rural Chhattisgarh. Cross-tabulation and multivariate regression were used to find out the relationship of ‘MiP’ with different symptoms and geographical areas. GIS maps were used to compare malaria in pregnant women against overall febrile population. RESULTS: In rural Chhattisgarh, malaria was present in 0.81% of the pregnant women at the time of testing. ‘MiP’ prevalence varied across geographies, reaching 4.48% in the geographical division with highest burden. Febrile pregnant women had three times greater malaria-positivity than overall febrile population and both showed a similar geographical pattern. DISCUSSION: Prevalence of ‘MiP’ was found to be less than earlier studies in the state. Though overall malaria in India has shown some decline, a policy response is needed for ‘MiP’ in high-burden areas. Fever, diarrhoea and jaundice remain relevant symptoms in ‘MiP’, but around one fourth of malaria-positive pregnant-women were afebrile, suggesting the need for strategies to address it. CONCLUSION: The current study based on a large sample provides fresh evidence on ‘MiP’ in India. It used CHWs as skilled providers for large-scale screening for malaria. In high-burden areas, intermittent screening and treatment (IST) of all pregnant women can be a useful strategy in order to address ‘MiP’. Pregnant women can be considered as a pertinent sentinel population for malaria. The global and national policies need to evolve concrete strategies for addressing malaria in pregnancy.
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spelling pubmed-74369772020-08-20 Malaria prevalence in symptomatic and asymptomatic pregnant women in a high malaria-burden state in India Garg, Samir Dewangan, Mukesh Barman, Omprakash Trop Med Health Research INTRODUCTION: Malaria in pregnancy (‘MiP’) poses risks to mother, foetus and newborn. Studies from Africa and Asia have reported high prevalence of ‘MiP’ and recommended further research to address ‘MiP’. India has a significant burden of ‘MiP’ but most of the studies are a decade old. Hardly any studies exist in India that report on asymptomatic malaria in pregnant women. The current Indian policies for malaria control are silent on ‘MiP’. A campaign was carried out by community health workers (CHWs) in 2019 to screen pregnant women across rural Chhattisgarh. METHODS: This is a cross-sectional study. Malaria was tested in pregnant women by CHWs using bivalent rapid tests. Multi-stage sampling was used to cover 21,572 pregnant women screened across different geographical areas of rural Chhattisgarh. Cross-tabulation and multivariate regression were used to find out the relationship of ‘MiP’ with different symptoms and geographical areas. GIS maps were used to compare malaria in pregnant women against overall febrile population. RESULTS: In rural Chhattisgarh, malaria was present in 0.81% of the pregnant women at the time of testing. ‘MiP’ prevalence varied across geographies, reaching 4.48% in the geographical division with highest burden. Febrile pregnant women had three times greater malaria-positivity than overall febrile population and both showed a similar geographical pattern. DISCUSSION: Prevalence of ‘MiP’ was found to be less than earlier studies in the state. Though overall malaria in India has shown some decline, a policy response is needed for ‘MiP’ in high-burden areas. Fever, diarrhoea and jaundice remain relevant symptoms in ‘MiP’, but around one fourth of malaria-positive pregnant-women were afebrile, suggesting the need for strategies to address it. CONCLUSION: The current study based on a large sample provides fresh evidence on ‘MiP’ in India. It used CHWs as skilled providers for large-scale screening for malaria. In high-burden areas, intermittent screening and treatment (IST) of all pregnant women can be a useful strategy in order to address ‘MiP’. Pregnant women can be considered as a pertinent sentinel population for malaria. The global and national policies need to evolve concrete strategies for addressing malaria in pregnancy. BioMed Central 2020-08-19 /pmc/articles/PMC7436977/ /pubmed/32831578 http://dx.doi.org/10.1186/s41182-020-00259-y Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Research
Garg, Samir
Dewangan, Mukesh
Barman, Omprakash
Malaria prevalence in symptomatic and asymptomatic pregnant women in a high malaria-burden state in India
title Malaria prevalence in symptomatic and asymptomatic pregnant women in a high malaria-burden state in India
title_full Malaria prevalence in symptomatic and asymptomatic pregnant women in a high malaria-burden state in India
title_fullStr Malaria prevalence in symptomatic and asymptomatic pregnant women in a high malaria-burden state in India
title_full_unstemmed Malaria prevalence in symptomatic and asymptomatic pregnant women in a high malaria-burden state in India
title_short Malaria prevalence in symptomatic and asymptomatic pregnant women in a high malaria-burden state in India
title_sort malaria prevalence in symptomatic and asymptomatic pregnant women in a high malaria-burden state in india
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7436977/
https://www.ncbi.nlm.nih.gov/pubmed/32831578
http://dx.doi.org/10.1186/s41182-020-00259-y
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