A systematic review and meta-analysis of asymptomatic malaria infection in pregnant women in Sub-Saharan Africa: A challenge for malaria elimination efforts

Yimam, Yonas; Nateghpour, Mehdi; Mohebali, Mehdi; Afshar, Mohammad Javad Abbaszadeh

doi:10.1371/journal.pone.0248245

Cited by 46 publications

(49 citation statements)

References 47 publications

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“…Besides this, prime gravidae had increased odds of malaria infection compared to the multigravid. Similar results were found from studies done in sub-Saharan Africa countries [24][25][26][27], which showed a higher risk of malaria infection among primigravidae than multigravidae. Low risk of malaria among multigravidae mothers may be associated with the development of preimmunity to malaria with increased gravidity and previous exposures.…”

Section: Discussionsupporting

confidence: 89%

Malaria Prevalence and Associated Factors among Pregnant Women Attending their First Antenatal Care in Kole and Kyenjojo Districts in Uganda

Ssekitooleko¹

2021

TIJPH

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Malaria during pregnancy has negative consequences to both the mother and fetus. In 2019, there were an estimated 33million pregnancies globally, of which 35% were exposed to malaria in Africa. To avert the consequences, the Uganda Ministry of Health is implementing approaches for effective prevention with intermittent preventive treatment, use Insecticide-Treated Nets (ITN), prompt diagnosis, and treatment through antenatal care (ANC). This study was conducted to determine the prevalence of malaria and associated factors among pregnant women attending their first ANC visit in Kole and Kyenjojo Districts in Uganda. A cross-sectional study design was conducted among 760 randomly selected pregnant women. Quantitative data was collected using a structured questionnaire to gather participants’ demographic, obstetric, coverage, and use of malaria preventive methods and laboratory results on malaria, anaemia, and HIV. Data was analyzed using STATA 15. Chi-square, odds ratio, and logistic regression were used to test for associations. The overall prevalence of malaria was 11.1%, varying from 6.8% in Kyenjojo to 15.3% in Kole District. Most cases were caused by P. falciparum. Factors associated with malaria were age of mother (aOR: 0.44, 95% CI: 0.21-0.88), residence in Kyenjojo (aOR: 0.48, 95% CI: 0.26-0.88), multiparity (aOR: 0.38, 95% CI: 0.16-0.91), anaemia (aOR: 2.12, 95% CI: 1.12-4.00) and ITN non-use (aOR: 6.17, 95% CI: 2.76-13.86). Malaria prevalence was low and varied between districts. Age, gravidity, gestational age, and ITN use had a significant association with malaria. Therefore, early screening and identification of mothers at most risk of complications during pregnancy is needed, plus improving ANC.

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Section: Discussionsupporting

confidence: 89%

Malaria Prevalence and Associated Factors among Pregnant Women Attending their First Antenatal Care in Kole and Kyenjojo Districts in Uganda

Ssekitooleko¹

2021

TIJPH

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“…Further, P. falciparum is accountable for most of the malaria-related deaths worldwide, estimated at about 409,000 deaths arising from approximately 229 million cases of malaria in 2019, as reported by the World Health Organization (WHO) 5 . Children under five years and pregnant women are among the most vulnerable group affected by malaria 1 , 5 – 7 . An obligatory step of infection by malaria parasites starts with the clinically silent liver-stage infection, wherein Plasmodium sporozoites, delivered by female Anopheles mosquitoes invade hepatocytes and replicate inside a parasitophorous vacuole, inside the hepatic host cell.…”

Section: Introductionmentioning

confidence: 99%

Synthesis and antiplasmodial activity of regioisomers and epimers of second-generation dual acting ivermectin hybrids

Singh

Fontinha

Francisco

et al. 2022

Sci Rep

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With its strong effect on vector-borne diseases, and insecticidal effect on mosquito vectors of malaria, inhibition of sporogonic and blood-stage development of Plasmodium falciparum, as well as in vitro and in vivo impairment of the P. berghei development inside hepatocytes, ivermectin (IVM) continues to represent an antimalarial therapeutic worthy of investigation. The in vitro activity of the first-generation IVM hybrids synthesized by appending the IVM macrolide with heterocyclic and organometallic antimalarial pharmacophores, against the blood-stage and liver-stage infections by Plasmodium parasites prompted us to design second-generation molecular hybrids of IVM. Here, a structural modification of IVM to produce novel molecular hybrids by using sub-structures of 4- and 8-aminoquinolines, the time-tested antiplasmodial agents used for treating the blood and hepatic stage of Plasmodium infections, respectively, is presented. Successful isolation of regioisomers and epimers has been demonstrated, and the evaluation of their in vitro antiplasmodial activity against both the blood stages of P. falciparum and the hepatic stages of P. berghei have been undertaken. These compounds displayed structure-dependent antiplasmodial activity, in the nM range, which was more potent than that of IVM, its aglycon or primaquine, highlighting the superiority of this hybridization strategy in designing new antiplasmodial agents.

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“…We noted that first pregnancy women were at higher risk of malaria and STI/RTI coinfections. The high susceptibility of primigravid women to malaria [ 10 ], combined with the high prevalence of STI/RTI reported in the current study increased the risk of malaria and STI/RTI coinfection. Therefore, it would be more effective to systematically screen and treat this population or explore alternative combination drug that can prevent malaria infection and adequately treat STI/RTI without the need of diagnostic.…”

Section: Discussionmentioning

confidence: 77%

“…Another study estimated that 38% of Zambian pregnant women were coinfected with malaria and at least one STI/RTI [8]. Pregnant women, despite their high susceptibility to infections in SSA are usually asymptomatic, which severely limits clinical detection and appropriate case management [9][10][11].…”

Section: Tropical Medicine and Healthmentioning

confidence: 99%

Malaria and curable sexually transmitted and reproductive tract coinfection among pregnant women in rural Burkina Faso

et al. 2021

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Background Malaria and sexually transmitted/reproductive tract infections (STI/RTI) are leading and preventable causes of low birthweight in sub-Saharan Africa. Reducing their impact on pregnancy outcomes requires efficient interventions that can be easily integrated into the antenatal care package. The paucity of data on malaria and STI/RTI coinfection, however, limits efforts to control these infections. This study aimed to determine the prevalence and associated factors of malaria and STI/RTI coinfection among pregnant women in rural Burkina Faso. Methods A cross-sectional survey was conducted among 402 pregnant women attending antenatal clinics at the Yako health district. Sociodemographic and behavioral data were collected, and pregnant women were tested for peripheral malaria by microscopy. Hemoglobin levels were also measured by spectrophotometry and curable bacterial STI/RTI were tested on cervico-vaginal swabs using rapid diagnostic test for chlamydia and syphilis, and Gram staining for bacterial vaginosis. A multivariate logistic regression model was used to assess the association of malaria and STI/RTI coinfection with the characteristics of included pregnant women. Results The prevalence of malaria and at least one STI/RTI coinfection was 12.9% (95% confidence interval, CI: [9.8–16.7]), malaria and bacterial vaginosis coinfection was 12.2% (95% CI: [9.3–15.9]), malaria and chlamydial coinfection was 1.6% (95% CI: [0.6–3.8]). No coinfection was reported for malaria and syphilis. The individual prevalence was 17.2%, 7.2%, 0.6%, 67.7% and 73.3%, respectively, for malaria infection, chlamydia, syphilis, bacterial vaginosis and STI/RTI combination. Only 10% of coinfections were symptomatic, and thus, 90% of women with coinfection would have been missed by the symptoms-based diagnostic approach. In the multivariate analysis, the first pregnancy (aOR = 2.4 [95% CI: 1.2–4.7]) was the only factor significantly associated with malaria and STI/RTI coinfection. Clinical symptoms were not associated with malaria and STI/RTI coinfection. Conclusion The prevalence of malaria and curable STI/RTI coinfection was high among pregnant women. The poor performance of the clinical symptoms to predict coinfection suggests that alternative interventions are needed.

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A systematic review and meta-analysis of asymptomatic malaria infection in pregnant women in Sub-Saharan Africa: A challenge for malaria elimination efforts

Cited by 46 publications

References 47 publications

Malaria Prevalence and Associated Factors among Pregnant Women Attending their First Antenatal Care in Kole and Kyenjojo Districts in Uganda

Malaria Prevalence and Associated Factors among Pregnant Women Attending their First Antenatal Care in Kole and Kyenjojo Districts in Uganda

Synthesis and antiplasmodial activity of regioisomers and epimers of second-generation dual acting ivermectin hybrids

Malaria and curable sexually transmitted and reproductive tract coinfection among pregnant women in rural Burkina Faso

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