scholarly journals Asymptomatic malaria and anaemia among pregnant women during high and low malaria transmission seasons in Burkina Faso: household-based cross-sectional surveys in Burkina Faso, 2013 and 2017

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Toussaint Rouamba ◽  
Sékou Samadoulougou ◽  
Mady Ouédraogo ◽  
Hervé Hien ◽  
Halidou Tinto ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Pregnant Women ◽  
Malaria Transmission ◽  
Asymptomatic Malaria ◽  
Cross Sectional ◽  
Transmission Season ◽  
Low Transmission ◽  
High Transmission ◽  
Asymptomatic Carriage ◽  
Low Malaria Transmission

Abstract Background Malaria in endemic countries is often asymptomatic during pregnancy, but it has substantial consequences for both the mother and her unborn baby. During pregnancy, anaemia is an important consequence of malaria infection. In Burkina Faso, the intensity of malaria varies according to the season, albeit the prevalence of malaria and anaemia as well as their risk factors, during high and low malaria transmission seasons is underexplored at the household level. Methods Data of 1751 pregnant women from October 2013 to March 2014 and 1931 pregnant women from April 2017 to June 2017 were drawn from two cross-sectional household surveys conducted in 24 health districts of Burkina Faso. Pregnant women were tested for malaria in their household after consenting. Asymptomatic carriage was defined as a positive result from malaria rapid diagnostic tests in the absence of clinical symptoms of malaria. Anaemia was defined as haemoglobin level less than 11 g/dL in the first and third trimester and less than 10.5 g/dL in the second trimester of pregnancy. Results Prevalence of asymptomatic malaria in pregnancy was estimated at 23.9% (95% CI 20.2–28.0) during the high transmission season (October–November) in 2013. During the low transmission season, it was 12.7% (95% CI 10.9–14.7) between December and March in 2013–2014 and halved (6.4%; 95% CI 5.3–7.6) between April and June 2017. Anaemia prevalence was estimated at 59.4% (95% CI 54.8–63.8) during the high transmission season in 2013. During the low transmission season, it was 50.6% (95% CI 47.7–53.4) between December and March 2013–2014 and 65.0% (95% CI 62.8–67.2) between April and June, 2017. Conclusion This study revealed that the prevalence of malaria asymptomatic carriage and anaemia among pregnant women at the community level remain high throughout the year. Thus, more efforts are needed to increase prevention measures such as IPTp–SP coverage in order to reduce anaemia and contribute to preventing low birth weight and poor pregnancy outcomes.

Asymptomatic malaria and anemia among pregnant women during high and low malaria transmission seasons in Burkina Faso: household-based cross-sectional surveys in Burkina Faso, 2013–2017

2020 ◽  
Author(s):  
Toussaint Rouamba ◽  
Sékou Samadoulougou ◽  
Mady Ouédraogo ◽  
Hervé Hien ◽  
Halidou Tinto ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Pregnant Women ◽  
Malaria Transmission ◽  
Malaria In Pregnancy ◽  
Asymptomatic Malaria ◽  
Cross Sectional ◽  
Transmission Season ◽  
Asymptomatic Carriage ◽  
Low Malaria Transmission ◽  
In Pregnancy

Abstract Background: Malaria in endemic countries is often asymptomatic during pregnancy, but it has substantial consequences for both the mother and her unborn baby. In Burkina Faso, the prevalence and risk factors of asymptomatic malaria in pregnancy and its main consequence, anemia, during high and low malaria transmission seasons is underexplored at the household level.Methods: Data of 1751 pregnant women from October 2013 to March 2014 and 1931 pregnant women from April 2017 to June 2017 were drawn from two cross-sectional household surveys conducted in 24 health districts of Burkina Faso. Pregnant women were tested for malaria in their household after consenting. Asymptomatic carriage was defined as a positive result from malaria rapid diagnostic tests in the absence of malaria symptoms. Anemia was defined as hemoglobin level less than 11 g/dL.Results: Prevalence of asymptomatic malaria in pregnancy was estimated at 23.9% (95%CI: 20.2–28.0) during the high transmission season (October–November) in 2013. During the low transmission season, it was 12.7% (95%CI: 10.9–14.7) between December and March in 2013–2014 and halved (6.4%; 95%CI: 5.3–7.6) between April and June 2017. Anemia prevalence was estimated at 43.7% (95%CI: 39.3–48.3) during the high transmission season in 2013. During the low transmission season, it was 32.7% (95%CI: 30.1–35.5) between December and March 2013–2014 and 46.6% (95%CI: 44.3–48.9) between April and June, 2017.Conclusion: Prevalence of asymptomatic malaria in pregnancy was significantly higher during the high malaria transmission season while anemia prevalence was lower. Our study provides an opportunity to assess the prevalence of asymptomatic carriage and one of its main consequences, anemia, among pregnant women at the community level throughout the year. In order to mitigate the harmful effects of asymptomatic carriage for both the mother and fetus, health programs aimed at increasing the number of women coming into contact with health workers are necessary.

scholarly journals The epidemiology and detectability of asymptomatic Plasmodium vivax and Plasmodium falciparum infections in low, moderate and high transmission settings in Ethiopia

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Elifaged Hailemeskel ◽  
Surafel K Tebeje ◽  
Sinknesh W. Behaksra ◽  
Girma Shumie ◽  
Getasew Shitaye ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Plasmodium Vivax ◽  
Age Groups ◽  
Diagnostic Tools ◽  
Asymptomatic Malaria ◽  
Rapid Diagnostics ◽  
Cross Sectional ◽  
Low Transmission ◽  
High Transmission ◽  
Study Sites

Abstract Background As countries move to malaria elimination, detecting and targeting asymptomatic malaria infections might be needed. Here, the epidemiology and detectability of asymptomatic Plasmodium falciparum and Plasmodium vivax infections were investigated in different transmission settings in Ethiopia. Method: A total of 1093 dried blood spot (DBS) samples were collected from afebrile and apparently healthy individuals across ten study sites in Ethiopia from 2016 to 2020. Of these, 862 were from community and 231 from school based cross-sectional surveys. Malaria infection status was determined by microscopy or rapid diagnostics tests (RDT) and 18S rRNA-based nested PCR (nPCR). The annual parasite index (API) was used to classify endemicity as low (API > 0 and < 5), moderate (API ≥ 5 and < 100) and high transmission (API ≥ 100) and detectability of infections was assessed in these settings. Results In community surveys, the overall prevalence of asymptomatic Plasmodium infections by microscopy/RDT, nPCR and all methods combined was 12.2% (105/860), 21.6% (183/846) and 24.1% (208/862), respectively. The proportion of nPCR positive infections that was detectable by microscopy/RDT was 48.7% (73/150) for P. falciparum and 4.6% (2/44) for P. vivax. Compared to low transmission settings, the likelihood of detecting infections by microscopy/RDT was increased in moderate (Adjusted odds ratio [AOR]: 3.4; 95% confidence interval [95% CI] 1.6–7.2, P = 0.002) and high endemic settings (AOR = 5.1; 95% CI 2.6–9.9, P < 0.001). After adjustment for site and correlation between observations from the same survey, the likelihood of detecting asymptomatic infections by microscopy/RDT (AOR per year increase = 0.95, 95% CI 0.9–1.0, P = 0.013) declined with age. Conclusions Conventional diagnostics missed nearly half of the asymptomatic Plasmodium reservoir detected by nPCR. The detectability of infections was particularly low in older age groups and low transmission settings. These findings highlight the need for sensitive diagnostic tools to detect the entire parasite reservoir and potential infection transmitters.

scholarly journals Evaluation of a single screen and treat strategy to detect asymptomatic malaria among pregnant women from selected health facilities in Lindi region, Tanzania

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Chonge Kitojo ◽  
Frank Chacky ◽  
Emmanuel S. Kigadye ◽  
Joseph P. Mugasa ◽  
Abdallah Lusasi ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Intermittent Preventive Treatment ◽  
First Trimester ◽  
Asymptomatic Malaria ◽  
Low Transmission ◽  
The Past ◽  
High Transmission ◽  
History Of ◽  
Asymptomatic Infections ◽  
The Impact

Abstract Background In areas of high transmission, malaria in pregnancy (MiP) primarily causes asymptomatic infections; these infections nonetheless increase the risk of adverse maternal and fetal outcomes. In 2014, Tanzania initiated a single screening and treatment (SST) strategy for all pregnant women at their first antenatal care (ANC) visit using malaria rapid diagnostic tests (RDT) for surveillance purposes. However, there is paucity of data on the effectiveness of SST in the prevention of MiP. The objective of this study was to estimate the number of asymptomatic infections among pregnant women detected by SST, which would have been missed in the absence of the policy. Methods Data from pregnant women attending their first ANC visits between October 2017 and June 2018, including gestational age, history of fever, and RDT results, were abstracted from ANC registers in eight health centres in two randomly selected districts, Kilwa and Lindi, in Lindi Region. The proportion of symptomatic (with history of fever in the past 48 h) and asymptomatic pregnant women with positive RDTs were calculated and stratified by trimester (first, second and third). The study areas were categorized as low transmission with prevalence < 10% or moderate/high with ≥ 10%. Results Over the study period, 1,845 women attended their first ANC visits; 22.1% were in the first trimester (< 12 weeks gestation age). Overall 15.0% of the women had positive RDTs, and there was a trend towards higher malaria prevalence in the first (15.9%) and second (15.2%) trimesters, compared to the third (7.1%), although the differences were not statistically significant (p = 0.07). In total, 6.9% of women reported fever within the past 48 h and, of these, 96.1% were RDT positive. For every 100 pregnant women in the moderate/high and low transmission areas, SST identified 60 and 26 pregnant women, respectively, with asymptomatic infections that would have otherwise been missed. Among the 15.9% of women detected in the first trimester, 50.7% were asymptomatic. Conclusion In areas of moderate/high transmission, many infected women were asymptomatic, and would have been missed in the absence of SST. The benefits on maternal and fetal birth outcomes of identifying these infections depend heavily on the protection afforded by treatment, which is likely to be greatest for women presenting in the first trimester when intermittent preventive treatment (IPTp) with sulfadoxine-pyrimethamine (SP) is contraindicated, and in areas with high SP resistance, such as most parts of Tanzania. An evaluation of the impact and cost-effectiveness of SST across different transmission strata is warranted.

scholarly journals The Epidemiology and Detectability of Asymptomatic Plasmodium Vivax and Plasmodium Falciparum Infections in Low, Moderate and High Transmission Settings in Ethiopia 

2020 ◽  
Author(s):  
Elifaged Hailemeskel ◽  
Surafel K Tebeje ◽  
Sinknesh Behaksra ◽  
Girma Shumie ◽  
Getasew Shitaye ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Age Groups ◽  
Diagnostic Tools ◽  
Asymptomatic Malaria ◽  
Rapid Diagnostics ◽  
Cross Sectional ◽  
Low Transmission ◽  
High Transmission ◽  
School Based ◽  
Study Sites

Abstract Background: As countries move to malaria elimination, detecting and targeting asymptomatic malaria infections might be needed. Here, we investigated the epidemiology and detectability of asymptomatic Plasmodium falciparum and P. vivax infections in different transmission settings in Ethiopia.Method: A total of 1093 dried blood spot (DBS) samples were collected from afebrile and apparently healthy individuals across ten study sites in Ethiopia from 2016 to 2020. Of these, 862 were from community and 231 from school based cross-sectional surveys. Malaria infection status was determined by microscopy or rapid diagnostics tests (RDT) and 18S rRNA based nested PCR (nPCR). The annual parasite index (API) was used to classify endemicity as low (API>0 and<5), moderate (API ≥5 and <100) and high transmission (API≥100) and detectability of infections was assessed in these settings. Results: In community surveys, the overall prevalence of asymptomatic Plasmodium infections by microscopy/RDT, nPCR and all methods combined was 12.2% (105/860), 21.6% (183/846) and 24.1% (208/862), respectively. The proportion of nPCR positive infections that was detectable by microscopy/RDT was 48.7% (73/150) for P. falciparum and 4.6% (2/44) for P. vivax. Compared to low transmission settings, the likelihood of detecting infections by microscopy/RDT was increased in moderate (Adjusted odds ratio [AOR]: 3.4; 95% confidence interval [95%CI]:1.6-7.2, P=0.002) and high endemic settings (AOR=5.1; 95%CI=2.6-9.9, P<0.001). After adjustment for site and correlation between observations from the same survey, the likelihood of detecting asymptomatic infections by microscopy/RDT (AOR per year increase = 0.95, 95%CI=0.9-1.0, P=0.013) declined with age.Conclusion: Conventional diagnostics missed nearly half of the asymptomatic Plasmodium reservoir detected by nPCR. The detectability of infections was particularly low in older age groups and low transmission settings. These findings highlight the need for sensitive diagnostic tools to detect the entire parasite reservoir and potential infection transmitters.

scholarly journals Effect of Sulfadoxine-Pyrimethamine doses for prevention of malaria during pregnancy in hypoendemic area in Tanzania

2020 ◽  
Author(s):  
Wigilya Padili Mikomangwa ◽  
Omary Minzi ◽  
Ritah Mutagonda ◽  
Vito Baraka ◽  
Eulambius M. Mlugu ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Malaria Transmission ◽  
Geometric Mean ◽  
Placental Malaria ◽  
Intermittent Preventive Treatment ◽  
Premature Delivery ◽  
Maternal Anaemia ◽  
Malaria During Pregnancy ◽  
Placental Blood ◽  
Low Malaria Transmission

Abstract Background Malaria in pregnancy increases the risk of deleterious maternal and birth outcomes. The use of ≥3 doses of sulfadoxine-pyrimethamine (SP) for intermittent preventive treatment of malaria (IPTp-SP) is recommended for preventing the consequences of malaria during pregnancy. This study assessed the effect of IPTp-SP for prevention of malaria during pregnancy in low transmission settings. Methods A cross-sectional study that involved consecutively selected 1,161 pregnant women was conducted at Mwananyamala regional referral hospital in Dar es Salaam. Assessment of the uptake of IPTp-SP was done by extracting information from antenatal clinic cards. Maternal venous blood, cord blood, placental blood and placental biopsy were collected for assessment of anaemia and malaria. High performance liquid chromatography with ultraviolet detection (HPLC-UV) was used to detect and quantify sulfadoxine (SDX). Dried blood spots (DBS) of placental blood were collected for determination of sub-microscopic malaria using polymerase chain reaction (PCR). Results In total, 397 (34.2%) pregnant women reported to have used sub-optimal doses (≤2) while 764(65.8%) used optimal doses (≥3) of IPTp-SP at the time of delivery. The prevalence of placental malaria as determined by histology was 3.6%. Submicroscopic placental malaria was detected in 1.4% of the study participants. Women with peripheral malaria had six times risk of maternal anaemia than those who were malaria negative (aOR, 5.83; 95% CI, 1.10-30.92; p = 0.04). The geometric mean plasma SDX concentration was 10.76± 2.51μg/mL. Sub-optimal IPTp-SP dose was not associated with placental malaria, premature delivery and fetal anaemia. The use of ≤2 doses of IPTp-SP increased the risk of maternal anaemia by 1.36 fold compared to ≥3 doses (aOR, 1.36; 95%CI, 1.04-1.79; p = 0.02). Conclusion The use of <2 doses of IPTp-SP increased the risk of maternal anaemia. However, sub-optimal doses (≤2 doses) were not associated with increased the risk of malaria parasitaemia, fetal anaemia and preterm delivery among pregnant women in low malaria transmission setting. The use of optimal doses (≥3doses) of IPTp-SP and complementary interventions should continue even in areas with low malaria transmission.

HIV infection among pregnant women in Burkina Faso: a nationwide serosurvey

1997 ◽  
Vol 8 (10) ◽  
pp. 646-651 ◽  
Author(s):  
Lassina Sangare ◽  
Nicolas Meda ◽  
Salif Lankoande ◽  
Eddy Van Dyck ◽  
Michel Cartoux ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Burkina Faso ◽  
Pregnant Women ◽  
Screening Method ◽  
Syphilis Infection ◽  
Cross Sectional ◽  
Hiv Surveillance ◽  
The North ◽  
The Impact ◽  
Syphilis Serology

To determine the prevalence of HIV infection among pregnant women in Burkina Faso and to identify factors associated with HIV infection in this population, we performed in 4 antenatal clinics in 4 urban centres located in the centre, the north, the east and the south-west of the country cross-sectional serological surveys between 7 October 1994 and 7 February 1995 using unlinked anonymous HIV screening method. In the towns included in the study more than 94% of pregnant women attend at least 2 antenatal consultations. In each centre all pregnant women attending an antenatal consultation during a 2-week period were invited to take part in a study to measure the prevalence of syphilis. Women with positive syphilis serology were offered treatment free of charge. A total of 1294 pregnant women were recruited into the study. There were no refusals. Thirty-two women (2.5%) had positive syphilis serology. The overall seroprevalence of HIV infection was 8% (95% confidence interval [CI]: 6.6-9.6). There was no evidence that the prevalence of syphilis or HIV infection varied between the 4 towns ( P =0.12 and 0.52 respectively). In logistic regression analyses only the presence of syphilis infection was associated with risk of HIV (odds ratio=3.4; 95% CI: 1.4-7.9). The prevalence of syphilis among pregnant women in Burkina Faso is relatively low compared with that of HIV infection. These results suggest that HIV epidemic in Burkina Faso is important and that there is an urgent need to intensify HIVprevention activities. The need for HIV surveillance in this sentinel population is urgent to follow the course of the epidemic and to measure the impact of interventions. One of the consequences of the high prevalence of HIV infection among pregnant women which requires greater attention in Burkina Faso is the increasing number of children who will be infected with HIV by vertical transmission.

scholarly journals Reactive Case Detection of Asymptomatic Malaria in Households and Neighbors of Laboratory Confirmed Cases in Raya Kobo District, Northeast Ethiopia

2019 ◽  
Author(s):  
Yimer Melese ◽  
megbaru alemu abate ◽  
Mulat Yimer ◽  
Banchamlak Tegegne
Keyword(s):  
Diagnostic Tests ◽  
Multivariable Analysis ◽  
High Morbidity ◽  
Asymptomatic Malaria ◽  
Case Detection ◽  
Reactive Case Detection ◽  
Cross Sectional ◽  
Asymptomatic Carriage ◽  
Northeast Ethiopia ◽  
Asymptomatic Infections

Abstract Background Malaria is the leading vector borne parasitic disease causing enormously high morbidity and mortality worldwide. There have been huge efforts so far to control and eliminate malaria in the world. However, high prevalence of asymptomatic carriage poses a threat on malaria control and elimination programs. Since asymptomatic infections present no overt sign and symptoms, they do not get clinical attention. Moreover, asymptomatic cases are a potential source of infection in high and low transmission settings. Despite the presence of some pocket data, the prevalence of asymptomatic carriage has not yet been known nationally and the current study area as well. Therefore, we aimed to assess the prevalence of asymptomatic malaria cases and associated factors in households and neighbors of laboratory confirmed cases in Raya Kobo district, Northeast Ethiopia. Methods: A community based cross-sectional study was conducted from February to April, 2019 among 270 study participants selected by convenient sampling technique at the community where laboratory confirmed cases were found. A structured questionnaire was used to collect data on socio-demographic characteristics, individual and household level factors. The data were entered in Epi Data 3.1 version and analyzed by using SPSS version 20. Variables with P<0.25 in the bivariable analysis were taken to the multivariable analysis to control potential confounders, and p< 0.05 was considered statistically significant. Results: The overall prevalence of asymptomatic malaria was 7.0%, with 3.0%, 5.2% and 12.0%, respectively by Rapid diagnostic tests (RDT), Microscopy and Polymerase chain reaction (PCR). Majority of the infections (73.7%) were identified from index households. PCR detected asymptomatic infections about 2.7 and 2.3 folds higher than RDT and microscope, respectively. Previous malaria history (AOR: 4.030, 95% CI: 1.021-15.903), living with index cases (AOR: 3.880, 95% CI: 1.275-11.806) and family size > 6 members (AOR: 4.820, 95% CI: 1.260-18.437) were significant predictors of Plasmodium spp infection.Conclusion: Reactive case detection had identified considerably higher asymptomatic malaria cases at the community. Therefore, active case investigation should be established in the community by tracking the symptomatic cases at the health facilities. Diagnostic tests involving the PCR should be implemented in the surveillance of asymptomatic malaria. Active malaria cases should also be treated.

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