Pregnancy-associated malaria and malaria in infants: an old problem with present consequences

Moya-Alvarez, Violeta; Abellana, Rosa; Cot, Michel

doi:10.1186/1475-2875-13-271

Table 1 Influence of maternal parasitemia on malaria in infants

From: Pregnancy-associated malaria and malaria in infants: an old problem with present consequences

Cohort	Study design and simple size	Time period	Transmission setting	Malaria prevention strategy during pregnancy	Treatment drug regime	Proportion of maternal peripheral parasitemia at delivery	Proportion of placental parasitemia	Proportion of neonatal parasitemia	Infant follow-up period	Median time to first parasitemia (days, min, max)	Association of infant malaria with PAM	Early infant parasitemia <3 months
Mangochi [21] (Malawi)	Clinical trial on comparative efficacy of CQ or MQ; infant cohort follow-up (1766 women at delivery and 1289 infants)	1988-1990	Perennial with seasonal peaks	CQ and MQ	CQ	CQ: 20.3% MQ: 4.1%	CQ: 25.1% MQ: 6.2%	CQ: 8.6% MQ: 3.1%	12 months	199 (192-207)	at 3 months: 1.1 (0.7-1.9)	18.5%
Ebolowa [13] (Cameroon)	Infant cohort follow-up (197)	1993-1995	Perennial with seasonal peaks	CQ	CQ		22.84% (Primigravid: 69%; Multigravid: 31%)		24 months	PM+: 217; PM-:350	at 6 months: PM+: 36%; PM-: 14%, p<0.05 at 2 years: PM+: 46.5%; PM-: 38.5%, p=0.6	≈12%
Muheza [14] (Tanzania)	Infant cohort follow-up (453)	2002-2004	Perennial with seasonal peaks (400 infective mosquito bites each year)	SP (area with 68% resistance 14-day treatment failure rate)			15.2% (Primigravid≤2: 24%; Multigravid>2: 5.6%)		12 months	266 (238–294) PM-:273 (245-322) PM+: 244 (147-266);	Primigravidae: PM+:AOR= 0.21, (0.09–0.47) PM-: Reference*** Multigravidae: PM+: AOR =1.59, (1.16–2.17) PM-:AOR=0.67, (0.50–0.91)	PM+ ≈20%; PM-≈10%
Lambarené [15] (Gabon)	Infant cohort follow-up (527)	2002-2004	Perennial	No		10.5%*	9.48%		30 months	Primigravidae: PM+:107 (83-139) PM-:102 (29-205) Multigravidae: PM+:111 (13-189) PM-:92 (27-208)	PM+:AOR= 2.1, (1.2–3) PM-: Reference**	PM+ ≈2%; PM-≈0%
Manhiça [22] (Mozambique)	Clinical trial on the efficacy of SP compared to placebo; infant cohort follow-up (1030 women at delivery and 997 infants)	2003-2005	Perennial with seasonal peaks	ITNs vs ITNs+SP	SP-AQ	ITNs+ placebo:15.15% ITNs+SP: 7.1%	ITNs+ placebo:52.27% ITNs+SP: 52.11%	ITNs+ placebo:1.15% ITNs+SP: 0.92%	12 months		Clinical PAM: AOR=1.96 (1.13–3.41) Acute PM: AOR= 4.63 (2.1-10.24) Chronic PM: AOR=3.95 (2.07-7.55) PM-: Reference
Tori Bossito [17, 23] (Benin)	Infant cohort follow-up (550)	2007-2008	Perennial with seasonal peaks (400 infective mosquito bites each year)	SP	AL		11%	0.83%	12 months	PM+: 34 (4-83); PM-: 43 (4-85)	ITN:AOR=2.13 (1.24–3.67) No ITN: AOR=1.18 (0.60–2.33)	20.3%
Mono [24] (Benin)	Mother and infant cohort follow-up (218)	2008-2010	Mesoendemic (1-35 bites/person/year)	SP	Quinine or SP		3.67%		12 months	PAM+: 362 (18-390) PAM-: 365 (64-449)	PAM during the 3rd trimester of pregnancy: AOR= 4.6 (1.7; 12.5) PAM during the 1st and 2nd trimesters non significant

PM: Placental malaria, PAM: Pregnancy associated malaria and AOR: Adjusted Odds Ratio.
*data from a reference article.
**the association between placental malaria and malaria in the child was only statistically significant for children who were randomized to receive the sulphadoxine-pyrimethamine intervention (AHR=3 (1.5-6)).
***Analysis of the effect of IPTp on parasitemia of the offspring was performed for 882 women of this cohort. Among them, 21.6% received no IPTp, 42% one dose, and 36.4% two or more doses.

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