The clinical burden of microscopically patent and sub-microscopic P. falciparum and P. vivax malaria in pregnancy in Indonesia

Abstract

anaemia (Hb ≤9 g/dL); [RR 2.2 (95% CI 1.7-2.9) P. vivax RR 0.5 (0.3-0.9)] whereas with sub-microscopic infections both species were associated with increased risk of moderate to severe anaemia [P. falciparum: RR 2.1 (95% CI 1.6-2.8) and P. vivax: RR 1.9 (95% CI 1.3-2.7)]. The prevalence of placental malaria was 4.8% (72/1632) by PCR and 3.3% sub-microscopically; this was 2.4% in primigravidae, 3.1% in secundi and 1.7% in multigravidae (≥3 pregnancies). The mean difference in birth weight in women with patent placental P. falciparum infection compared with uninfected women was 101 g (95% CI 70-273 g) with RR 2.1 (95% CI 1.2-3.0) for low birth weight. The reduction in birth weight with sub-microscopic infection was 70 g (63-204 g) with low birth weight RR 1.7 (95% CI 1.0-2.5). Corresponding figures for P. vivax were: patent placental infections: 252 g (57560 g), low birth weight RR 4.7 (95% CI 2.2-67); and for sub-microscopic infections the mean difference in birth weight was 146 (70-364 g); low birth weight RR 2.9 (95% CI 1.6-3.4). Conclusions