Pregnancy-associated malaria in Sudan: prevalence and possible risk factors

Omer, Samia Ali; Khalil, Eltahir Awad Gasim; Sharief, Abdalla Hassan; Hashim, Anwar H. Abo; Ali, Rahman

doi:10.1016/j.jbiotec.2010.09.592

Cited by 6 publications

(7 citation statements)

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“…Six studies included in this review reported the nature of the association of income status with the occurrence of Plasmodium infection in SSA [32,55,64, 80,100,109]. A high prevalence of P .…”

Section: Resultsmentioning

confidence: 99%

“…The prevalence of malaria in Ghana was also higher among pregnant women with a weekly income< 200,000 Cedis (equivalent to <20 US dollars) compared to those with a weekly income >200,000 Cedis (OR 1.8, 95% CI 1.2–2.9, p = 0.009) [109]. In Sudan, the odds of Plasmodium infection among pregnant women with low income was also found to be two times as likely as the odds of infection in pregnant women with high income (OR 2.3, 95% CI 1.3–4.0, p = 0.004) [80]. A study in Ethiopia also found increased odds of Plasmodium infection among adults with monthly income <31.25 US dollars compared to those with monthly income >62.5 US dollars (OR 3.67, 95% CI 1.05–12.79, p = 0.041) [32].…”

Section: Resultsmentioning

confidence: 99%

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Improving socioeconomic status may reduce the burden of malaria in sub Saharan Africa: A systematic review and meta-analysis

et al. 2019

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BackgroundA clear understanding of the effects of housing structure, education, occupation, income, and wealth on malaria can help to better design socioeconomic interventions to control the disease. This literature review summarizes the relationship of housing structure, educational level, occupation, income, and wealth with the epidemiology of malaria in sub-Saharan Africa (SSA).MethodsA systematic review and meta-analysis was conducted following the preferred reporting items for systematic reviews and meta-analyses guidelines. The protocol for this study is registered in PROSPERO (ID=CRD42017056070), an international database of prospectively registered systematic reviews. On January 16, 2016, available literature was searched in PubMed, Embase, CINAHL, and Cochrane Library. All but case studies, which reported prevalence or incidence of Plasmodium infection stratified by socioeconomic status among individuals living in SSA, were included without any limits. Odds Ratio (OR) and Relative Risk (RR), together with 95% CI and p-values were used as effect measures. Heterogeneity was assessed using chi-square, Moran’s I2, and tau2 tests. Fixed (I2<30%), random (I2≥30%) or log-linear dose-response model was used to estimate the summary OR or RR.ResultsAfter removing duplicates and screening of titles, abstracts, and full text, 84 articles were found eligible for systematic review, and 75 of them were included in the meta-analyses. Fifty-seven studies were cross-sectional, 12 were prospective cohort, 10 were case-control, and five were randomized control trials. The odds of Plasmodium infection increased among individuals who were living in poor quality houses (OR 2.13, 95% CI 1.56–3.23, I2 = 27.7), were uneducated (OR 1.36, 95% CI 1.19–1.54, I2 = 72.4.0%), and were farmers by occupation (OR 1.48, 95% CI 1.11–1.85, I2 = 0.0%) [p<0.01 for all]. The odds of Plasmodium infection also increased with a decrease in the income (OR 1.02, 95% CI 1.01–1.03, tau2<0.001), and wealth index of individuals (OR 1.25, 95% CI 1.18–1.35, tau2 = 0.028) [p<0.001 for both]. Longitudinal studies also showed an increased risk of Plasmodium infection among individuals who were living in poor quality houses (RR 1.86, 95% CI 1.47–2.25, I2 = 0.0%), were uneducated (OR 1.27, 1.03–1.50, I2 = 0.0%), and were farmers (OR 1.36, 1.18–1.58) [p<0.01 for all].ConclusionsLack of education, low income, low wealth, living in poorly constructed houses, and having an occupation in farming may increase risk of Plasmodium infection among people in SSA. Public policy measures that can reduce inequity in health coverage, as well as improve economic and educational opportunities for the poor, will help in reducing the burden of malaria in SSA.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Improving socioeconomic status may reduce the burden of malaria in sub Saharan Africa: A systematic review and meta-analysis

et al. 2019

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“…In Sudan, malaria is one of the deadliest endemic diseases, and the increased susceptibility of pregnant women to malaria is a long-standing public health problem [ 6 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Placental malaria and its effect on pregnancy outcomes in Sudanese women from Blue Nile State

Omer

Idress

Adam

et al. 2017

Malar J

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BackgroundMalaria infection during pregnancy can result in placental malaria and is associated with adverse pregnancy outcomes particularly among primigravidae. The aim of this study was to assess the prevalence and risk factors for placental malaria and its effect on pregnancy outcomes in Blue Nile state, Sudan.MethodsA cross-sectional hospital-based study was conducted consecutively during January 2012–December 2015 in three main hospitals in Blue Nile State, Sudan. At delivery, peripheral and placental blood samples were collected from consenting women. Finger prick blood was used for preparation of peripheral smears and for haemoglobin measurement. Smears were stained with Giemsa and examined microscopically for malaria parasites. Pregnancy outcomes in association to placental malaria were investigated.ResultsA total of 1149 mothers and their newborns were recruited. The mean (SD) of the age was 23.3 (5.2) years. Detection of malaria parasites was confirmed in 37.8% of the peripheral blood films and 59.3% of the placental films with Plasmodium falciparum as the only species detected. In multivariate analysis, younger age ≤23.2 years old (AOR = 3.2, 95% CI 1.9–5.5; P < 0.001), primiparae (AOR = 3.9, CI 2.1–7.6; P < 0.001), secundiparae (AOR = 2.8, 95% CI 1.5–5.1; P < 0.001, no antenatal care (ANC) visits (AOR = 11.9, 95% CI 7.8–18.1; P < 0.001) and not using bed nets (AOR = 3.5, 95% CI 1.7–6.8; P < 0.001) were risk factors for placental malaria. Education and residence were not associated with placental malaria infection. Placental malaria was significantly associated with maternal anaemia (AOR = 41.6, 95% CI 23.3–74.4; P < 0.001) and low birth weight (LBW) (AOR = 25.2, 95% CI 15.1–41.3; P < 0.001).ConclusionDuring the study, there was a high prevalence of placental malaria in Blue Nile State-Sudan, as the enhanced control activities were not practiced, leading to adverse pregnancy outcomes, such as maternal anaemia and LBW.

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“…It has been well documented that pregnant women are more susceptible to Plasmodium falciparum ( P. falciparum ) infection as opposed to their non-pregnant counterparts[ 1 – 4 ]. In malaria endemic areas, the prevalence of clinical and asymptomatic malaria is highest in young women and those in their first and second pregnancies.…”

Section: Introductionmentioning

confidence: 99%

“…High proportions of submicroscopic P. falciparum infections have been demonstrated by polymerase chain reaction (PCR) assays in children and non-pregnant adults in Sub-Saharan Africa[ 9 10 ]; however, there is little information with respect to pregnant women. DNA methods for the detection of parasite showed that at least twice as many pregnant women are infected with malaria as indicated by microscopy[ 4 8 11 12 ].…”

Section: Introductionmentioning

confidence: 99%

Submicroscopic and multiple plasmodium falciparum infections in pregnant Sudanese women

et al. 2011

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Background:Control of malaria during pregnancy remains a major public health challenge in developing countries. Microscopic parasite detection represents a pivotal step in malaria control, while modern molecular techniques are deemed to improve detection rates markedly.Aims:This study aimed to investigate the frequency of submicroscopic and multiple Plasmodium falciparum (P. falciparum) infections during pregnancy, using the P. falciparum merozoite surface protein1 (MSP-1) gene as a polymorphic marker.Materials and Methods:The study was a cross-sectional, analytical study that was conducted at Omdurman Maternity Hospital, Sudan, between July 2003 and December 2004. Following informed consent, 836 pregnant women between the ages of 16-47 years with different gestational ages were enrolled in the study. Thin and thick blood films were stained with Giemsa and examined by experienced microscopists. Parasite DNA was extracted using Chelex method. Nested polymerase chain reaction (PCR) assays specific for P. falciparum were carried out to detect infections below the threshold of microscopy and to genotype different strains in the samples using merozoite surface protein-1.Results:More than a quarter of the study participants (219/836; 26.2%) were smear-positive for malaria infection. The results of the PCR-based assays showed that 41.8 % (257/617) of the smear-negative women were PCR positive and therefore had submicroscopic infections. The mean number of genetically different P. falciparum parasites detected was 2.7 (range 1–9). The multiplicity of infection identified by at least two alleles of MSP-1 was significantly higher among paucigravidae (45.6%) compared to multigravidae (28.9%), with mean number of alleles of 2.4 and 1.9, respectively (p=0.009). This likely indicates the gradual acquisition of immunity.Conclusion:Conventional microscopy underestimates the actual extent of malaria infections during pregnancy in endemic regions. Multiplicity of infection may be an important factor in the gradual acquisition of strain-specific immunity.

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Pregnancy-associated malaria in Sudan: prevalence and possible risk factors

Cited by 6 publications

References 1 publication

Improving socioeconomic status may reduce the burden of malaria in sub Saharan Africa: A systematic review and meta-analysis

Improving socioeconomic status may reduce the burden of malaria in sub Saharan Africa: A systematic review and meta-analysis

Placental malaria and its effect on pregnancy outcomes in Sudanese women from Blue Nile State

Submicroscopic and multiple plasmodium falciparum infections in pregnant Sudanese women

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