The burden of malaria in pregnancy in malaria-endemic areas

Abstract

Abstract. Pregnant women in malarious areas may experience a variety of adverse consequences from malaria infection including maternal anemia, placental accumulation of parasites, low birth weight (LBW) from prematurity and intrauterine growth retardation (IUGR), fetal parasite exposure and congenital infection, and infant mortality (IM) linked to preterm-LBW and IUGR-LBW. We reviewed studies between 1985 and 2000 and summarized the malaria population attributable risk (PAR) that accounts for both the prevalence of the risk factors in the population and the magnitude of the associated risk for anemia, LBW, and IM. Consequences from anemia and human immunodeficiency virus infection in these studies were also considered. Population attributable risks were substantial: malaria was associated with anemia (PAR range ϭ 3-

Adverse birth outcomes in a malarious area

“…8) for this cohort of mothers [9]. The lack of an association in the present study may relate to the small sample size of women tested for HIV, or confounding as maternal HIV infection has been significantly associated with increased malaria prevalence during pregnancy [27,28].…”

Malaria: current status of control, diagnosis, treatment, and a proposed agenda for research and development

“…10,11 In addition to the more routinely measured costs associated with malaria, such as the cost of prevention activities, lost workdays for both patients and caregivers, and treatment seeking and medication, malaria-related costs in endemic countries also include those associated with suffering, retarded physical and cognitive development in children and consequently poor educational performance, related malnutrition, anaemia, and potential increases in vulnerability to other diseases. [12][13][14][15] Malaria incapacitates the labour force, lowers educational achievement, discourages tourism and business investment, and reduces opportunities for specialisation both within the household and for the economy as a whole.…”

“…[91][92][93] Malariarelated maternal mortality can be very high, 15 particularly in epidemics and in areas of low transmission and therefore low immunity. The economic burden on households resulting from the illness or death of a mother is devastating, and the need for effective diagnosis and treatment is a desperate priority for this high-risk group.…”

Many ways to die, one way to arrive: how selection acts through pregnancy

“…As a result, pregnant women with malaria die 2--3 times more often than the general infected population [78]. In sub--Saharan Africa, malaria causes 20% of the cases of low infant birthweight, along with slow growth, spontaneous abortion, maternal anemia, and infant mortality [9,78,79]. Intriguingly, positive selection on a genetic variant of the gene FLT1, which reduces spontaneous abortions in cases of placental malaria, has been found for a malaria--endemic population in Tanzania [80].…”