Heterogeneity in the prevalence of subclinical malaria, other co-infections and anemia among pregnant women in rural areas of Myanmar: a community-based longitudinal study
Abstract Background Due to the low prevalence of clinically suspected malaria among pregnant women in Myanmar, little is known about its impact on mothers and newborns. Helminth and Human Immuno-deficiency Virus (HIV) co-infections cause anemia in pregnant women. This study assessed the prevalence o...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | Tropical Medicine and Health |
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| Online Access: | https://doi.org/10.1186/s41182-024-00577-5 |
| _version_ | 1797266581868249088 |
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| author | Poe Poe Aung Kay Thwe Han Wim Groot Regien Biesma Zaw Win Thein Thura Htay Zaw Lin Kyin Hla Aye Matthew Adams Milena Pavlova |
| author_facet | Poe Poe Aung Kay Thwe Han Wim Groot Regien Biesma Zaw Win Thein Thura Htay Zaw Lin Kyin Hla Aye Matthew Adams Milena Pavlova |
| author_sort | Poe Poe Aung |
| collection | DOAJ |
| description | Abstract Background Due to the low prevalence of clinically suspected malaria among pregnant women in Myanmar, little is known about its impact on mothers and newborns. Helminth and Human Immuno-deficiency Virus (HIV) co-infections cause anemia in pregnant women. This study assessed the prevalence of subclinical malaria and co-infections among pregnant women, and its association with adverse outcomes of pregnancy in the presence of infection. Methods A prospective longitudinal study was conducted in 12 villages in two townships in Myanmar between 2013 to 2015. A total of 752 pregnant women, with a mean age of 27 years, were enrolled and followed up once a month until six weeks after childbirth. Prevalence ratio was calculated in the multivariable analysis. Results The prevalence of subclinical malaria as measured by nested PCR was 5.7% for either P. falciparum or P. vivax, 2.7% prevalence of P. falciparum and 2.8% prevalence of P. vivax. Helminth infections were prevalent in 17% of women, and one woman with an HIV infection was found in our study. The burden of anemia was high, with an overall prevalence of 37% with or without helminth infection, 42% of the women were malaria positive and 43% had dual infections (both malaria and helminth). Only 11 abnormal pregnancy outcomes (7 stillbirths, 2 premature, 2 twins) were identified. Poisson regression showed that women in their first trimester had a 2.9 times higher rate of subclinical malaria compared to women in the third trimester (PR:2.9, 95%CI 1.19, 7.31, p = 0.019), women who were enrolled during the wet season were 2.5 times more likely to be malaria positive than the women enrolled in the dry season (PR: 2.5, 95%CI 1.27, 4.88, p = 0.008), and the malaria positivity rate decreased by 5% when increased in one year of woman’s age (PR:0.95, 95%CI 0.91, 0.99, p = 0.02). In the multivariable regression, the age of respondents was the only significant factor associated with subclinical malaria in pregnancy. Conclusions A comprehensive approach of integrating interventions for malaria, anemia, and helminths should be delivered during antenatal care services for pregnant women in rural areas of Myanmar. |
| first_indexed | 2024-04-25T01:02:58Z |
| format | Article |
| id | doaj.art-a5ab6f2b3d834e18aadc0e8491a7f3bd |
| institution | Directory Open Access Journal |
| issn | 1349-4147 |
| language | English |
| last_indexed | 2024-04-25T01:02:58Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Tropical Medicine and Health |
| spelling | doaj.art-a5ab6f2b3d834e18aadc0e8491a7f3bd2024-03-10T12:22:33ZengBMCTropical Medicine and Health1349-41472024-03-0152111310.1186/s41182-024-00577-5Heterogeneity in the prevalence of subclinical malaria, other co-infections and anemia among pregnant women in rural areas of Myanmar: a community-based longitudinal studyPoe Poe Aung0Kay Thwe Han1Wim Groot2Regien Biesma3Zaw Win Thein4Thura Htay5Zaw Lin6Kyin Hla Aye7Matthew Adams8Milena Pavlova9Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht UniversityDepartment of Medical Research, Ministry of HealthDepartment of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht UniversityGlobal Health Unit, Department of Health Sciences, University Medical Center GroningenMalaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of MedicineMalaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of MedicineNational Malaria Control Program, Ministry of HealthDepartment of Medical Research, Ministry of HealthMalaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of MedicineDepartment of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht UniversityAbstract Background Due to the low prevalence of clinically suspected malaria among pregnant women in Myanmar, little is known about its impact on mothers and newborns. Helminth and Human Immuno-deficiency Virus (HIV) co-infections cause anemia in pregnant women. This study assessed the prevalence of subclinical malaria and co-infections among pregnant women, and its association with adverse outcomes of pregnancy in the presence of infection. Methods A prospective longitudinal study was conducted in 12 villages in two townships in Myanmar between 2013 to 2015. A total of 752 pregnant women, with a mean age of 27 years, were enrolled and followed up once a month until six weeks after childbirth. Prevalence ratio was calculated in the multivariable analysis. Results The prevalence of subclinical malaria as measured by nested PCR was 5.7% for either P. falciparum or P. vivax, 2.7% prevalence of P. falciparum and 2.8% prevalence of P. vivax. Helminth infections were prevalent in 17% of women, and one woman with an HIV infection was found in our study. The burden of anemia was high, with an overall prevalence of 37% with or without helminth infection, 42% of the women were malaria positive and 43% had dual infections (both malaria and helminth). Only 11 abnormal pregnancy outcomes (7 stillbirths, 2 premature, 2 twins) were identified. Poisson regression showed that women in their first trimester had a 2.9 times higher rate of subclinical malaria compared to women in the third trimester (PR:2.9, 95%CI 1.19, 7.31, p = 0.019), women who were enrolled during the wet season were 2.5 times more likely to be malaria positive than the women enrolled in the dry season (PR: 2.5, 95%CI 1.27, 4.88, p = 0.008), and the malaria positivity rate decreased by 5% when increased in one year of woman’s age (PR:0.95, 95%CI 0.91, 0.99, p = 0.02). In the multivariable regression, the age of respondents was the only significant factor associated with subclinical malaria in pregnancy. Conclusions A comprehensive approach of integrating interventions for malaria, anemia, and helminths should be delivered during antenatal care services for pregnant women in rural areas of Myanmar.https://doi.org/10.1186/s41182-024-00577-5Anemia and co-infectionsLongitudinal studyMyanmarPregnant womenSubclinical malaria |
| spellingShingle | Poe Poe Aung Kay Thwe Han Wim Groot Regien Biesma Zaw Win Thein Thura Htay Zaw Lin Kyin Hla Aye Matthew Adams Milena Pavlova Heterogeneity in the prevalence of subclinical malaria, other co-infections and anemia among pregnant women in rural areas of Myanmar: a community-based longitudinal study Tropical Medicine and Health Anemia and co-infections Longitudinal study Myanmar Pregnant women Subclinical malaria |
| title | Heterogeneity in the prevalence of subclinical malaria, other co-infections and anemia among pregnant women in rural areas of Myanmar: a community-based longitudinal study |
| title_full | Heterogeneity in the prevalence of subclinical malaria, other co-infections and anemia among pregnant women in rural areas of Myanmar: a community-based longitudinal study |
| title_fullStr | Heterogeneity in the prevalence of subclinical malaria, other co-infections and anemia among pregnant women in rural areas of Myanmar: a community-based longitudinal study |
| title_full_unstemmed | Heterogeneity in the prevalence of subclinical malaria, other co-infections and anemia among pregnant women in rural areas of Myanmar: a community-based longitudinal study |
| title_short | Heterogeneity in the prevalence of subclinical malaria, other co-infections and anemia among pregnant women in rural areas of Myanmar: a community-based longitudinal study |
| title_sort | heterogeneity in the prevalence of subclinical malaria other co infections and anemia among pregnant women in rural areas of myanmar a community based longitudinal study |
| topic | Anemia and co-infections Longitudinal study Myanmar Pregnant women Subclinical malaria |
| url | https://doi.org/10.1186/s41182-024-00577-5 |
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