Prevalence of Malaria Infection and Risk Factors Associated with Anaemia among Pregnant Women in Semiurban Community of Hazaribag, Jharkhand, India.

Mohammad Sohail,Mazahirul Islam,Ajay Kumar Sharma,Aakanksha Bharti,Mohammad Raziuddin,Sneh Lata,Tridibes Adak,Faisal Zahid,Vahab Ali,Krishn Pratap Singh,Shweta Kumari,Pradeep Das,Shadab Anwar,Shayan Shakeel

doi:10.1155/2015/740512

Abstract

The escalating burden, pathogenesis, and clinical sequel of malaria during pregnancy have combinatorial adverse impact on both mother and foetus that further perplexed the situation of diagnosis, treatment, and prevention. This prompted us to evaluate the status of population at risk of MIP in Hazaribag, Jharkhand, India. Cross-sectional study was conducted over a year at Sadar Hospital, Hazaribag. Malaria was screened using blood smear and/or RDT. Anaemia was defined as haemoglobin concentration. Pretested questionnaires were used to gather sociodemographic, clinical, and obstetrical data. The prevalence of MIP was 5.4% and 4.3% at ANC and DU, and 13.2% malaria was in women without pregnancy. Interestingly, majority were asymptomatically infected with P. vivax (over 85%) at ANC and DU. Peripheral parasitemia was significantly associated with fever within past week, rural origin of subjects, and first/second pregnancies in multivariate analysis, with the highest risk factor associated with fever followed by rural residence. Strikingly in cohort, anaemia was prevalent in 86% at ANC as compared to 72% at DU, whereas severe anaemia was 13.6% and 7.8% at ANC and DU. Even more anaemia prevalence was observed in MIP group (88% and 89% at ANC and DU), whereas severe anaemia was 23% and 21%, respectively. In view of observed impact of anaemia, parasitemia and asymptomatic infection of P. vivax during pregnancy and delivery suggest prompt diagnosis regardless of symptoms and comprehensive drug regime should be offered to pregnant women in association with existing measures in clinical spectrum of MIP, delivery, and its outcome.

Highlights

Malaria in tropical regions, which is caused by the protozoan parasites Plasmodium falciparum and Plasmodium vivax, is responsible for 515 million clinical cases [1] and 1 to 3 million deaths annually [2]
The investigation is conducted in the Jharkhand state emphasizing tribal dominant area, and the state of Jharkhand is selected to represent an endemic with stable transmission of malaria, with a total of 230 686 malaria cases reported in 2009, of which 39.53%, 52.64%, and 7.83% were due to P. falciparum, P. vivax, and mix infection, respectively [29]
We report that P. vivax is associated with a high burden of anaemia and remarkable severe anaemia during pregnancy and malaria in pregnancy in endemic population of Hazaribag

Summary

Introduction

Malaria in tropical regions, which is caused by the protozoan parasites Plasmodium falciparum and Plasmodium vivax, is responsible for 515 million clinical cases [1] and 1 to 3 million deaths annually [2]. The emergence and spread of drug resistance to commonly used chemotherapeutics are major factors contributing to this increasing burden and most of the mortality and morbidity are borne by children and pregnant women. Pregnant women and their infants are susceptible to common and preventable infectious diseases including malaria but are woefully left unscreened and untreated. Approximately 125 million pregnant women worldwide are exposed to the risks of malaria in pregnancy (MIP) each year, resulting in 200,000 infant deaths [6]. Pregnant women are 3 times more likely to suffer from severe disease as a result of malarial infection compared with their nonpregnant counterparts and have a mortality rate from severe disease that approaches 50% [12, 13]

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