Assessing the Relationship Between Gravidity and Placental Malaria Among Pregnant Women in a High Transmission Area in Ghana

2021 ◽  
Author(s):  
Ayodele Akinnawo ◽  
Kaali Seyram ◽  
Ellen Boamah Kaali ◽  
Samuel Harrison ◽  
David Dosoo ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Placental Malaria ◽  
Related Factors ◽  
High Transmission ◽  
Llin Distribution ◽  
Transmission Area ◽  
Itn Use ◽  
High Transmission Area

Abstract Background Malaria infection during pregnancy can cause significant morbidity and mortality to a pregnant woman, her foetus and newborn. In areas of high endemic transmission, gravidity is an important risk factor for infection, but there is a complex relationship with other exposure-related factors, and use of protective measures. This study investigated the association between gravidity and placental malaria (PM), among pregnant women aged 14-49 in Kintampo, a high transmission area of Ghana. Methods Between 2008-2011, as part of a study investigating the association between PM and malaria in infancy, pregnant women attending antenatal care (ANC) clinics in the study area were enrolled and followed up until delivery. The outcome of PM was assessed at delivery by placental histopathology. Multivariable logistic regression analyses were used to investigate the association between gravidity and PM, identify other key risk factors, and control for potential confounders. Pre-specified effect modifiers including area of residence, socio-economic score (SES), ITN use and IPTp-SP use were explored. Results The prevalence of PM was 65.9% in primigravidae, and 26.5% in multigravidae. After adjusting for age, SES and relationship status, primigravidae were shown to have over three times the odds of PM compared to multigravidae, defined as women with 2 or more previous pregnancies (adjusted OR=3.36 (95% CI 2.39-4.71), N=1808, P<0.001). The association appeared stronger in rural areas (OR for PG vs. MG was 3.79 (95% CI: 3.61-5.51) in rural areas; 2.09 (95% CI: 1.17- 3.71) in urban areas; P for interaction =0.07), and among women with lower socio-economic scores (OR for PG vs. MG was 4.73 (95% CI 3.08-7.25) amongst women with lower SES; OR=2.14 (95% CI 1.38-3.35) among women with higher SES; P for interaction =0.008. There was also evidence of lower risk among primigravidae with better use of the current preventive measures IPTp and LLIN. Conclusions The burden of PM is most heavily focused on primigravidae of low SES living in rural areas of high transmission. Programmes should prioritize primigravidae and young women of child-bearing age for interventions such as LLIN distribution, educational initiatives and treatment to reduce the burden of malaria in first pregnancy.

scholarly journals Placental malaria among HIV-infected and uninfected women receiving anti-folates in a high transmission area of Uganda

2009 ◽  
Vol 8 (1) ◽  
pp. 254 ◽  
Author(s):  
Patrick M Newman ◽  
Humphrey Wanzira ◽  
Gabriel Tumwine ◽  
Emmanuel Arinaitwe ◽  
Sarah Waldman ◽  
...  
Keyword(s):  
Placental Malaria ◽  
High Transmission ◽  
Transmission Area ◽  
High Transmission Area

scholarly journals Knowledge and intake of folic acid to prevent neural tube defects among pregnant women in urban China: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mingming Cui ◽  
Xiao-Lin Lu ◽  
Yan-Yu Lyu ◽  
Fang Wang ◽  
Xiao-Lu Xie ◽  
...  
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Rural Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Unplanned Pregnancy ◽  
Urban China ◽  
Cross Sectional

Abstract Background The prevalence of neural tube defects (NTDs) in China declined during 2000–2017 with periconceptional folic acid (FA) supplementation, which is effective in reducing the risk of birth defects. We aimed to assess the knowledge and actual use of FA among Chinese pregnant women and to explore factors associated with FA use before pregnancy. Methods All data were collected in face-to-face interviews during health visits among pregnant women. We collected information about knowledge and use of FA supplements and demographic, socioeconomic, and health status. One maternity and childcare hospital was chosen in each of four cities: Beijing, Huaibei, Kunming, and Haikou. In total, 435 pregnant women were randomly recruited for interviews conducted from June to December 2016. Results A total of 428 pregnant women were included in this survey. Of these, 82.0% (351/428) knew that FA can prevent NTDs, and 75.9% (325/428) knew the correct time to take FA. Overall, 65.9% (282/428) of women knew both that FA can prevent NTDs and the recommended time to take FA before pregnancy. Approximately 95.1% (407/428) of women reported having ever taken FA, only 46.3% (198/428) had begun to take FA supplementation before conception, and 64.5% (109/169) of women from rural areas failed to take FA before pregnancy. Women living in northern China (odds ratio [OR] = 1.81, 95% confidence interval [CI], 1.18–2.77), those with unplanned pregnancy (OR = 1.99, 95% CI 1.30–3.04), and highly educated women (OR = 2.37, 95% CI 1.45–3.88) were more likely to know about FA. Women who were homemakers (OR = 1.94, 95% CI 1.21–3.11) and had unplanned pregnancy (OR = 6.18, 95% CI 4.01–9.53) were less likely to begin taking FA before pregnancy. Conclusions Our survey showed that most pregnant women knew about FA. Although preconception intake of FA can help to reduce NTDs, improving the rate of FA intake before pregnancy is needed in urban areas of China, especially among homemakers and women from rural areas or with unplanned pregnancy. Campaigns are needed to increase awareness about FA and FA use before pregnancy among rural women, homemakers, and those with unplanned pregnancy and lower education levels.

scholarly journals Country compliance with WHO-recommended antenatal care guidelines: equity analysis of the 2015–2016 Demography and Health Survey in Myanmar

2020 ◽  
Vol 5 (12) ◽  
pp. e002169
Author(s):  
Ngatho Samuel Mugo ◽  
Kyaw Swa Mya ◽  
Camille Raynes-Greenow
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Adolescent Mothers ◽  
Health Survey ◽  
Rural Areas ◽  
Urban Areas ◽  
Multinomial Logistic Regression ◽  
Wealth Quintile ◽  
Adjusted Risk ◽  
Factors Associated

IntroductionEarly access to adequate antenatal care (ANC) from skilled providers is crucial for detecting and preventing obstetric complications of pregnancy. We aimed to assess factors associated with the utilisation of the new WHO ANC guidelines including the recommended number, on time initiation and adequate components of ANC contacts in Myanmar.MethodsWe examined data from 2943 mothers aged 15–49 years whose most recent birth occurred in the last 5 years prior to the 2015–2016 Myanmar Demographic and Health Survey. Factors associated with utilisation of the new WHO recommended ANC were explored using multinomial logistic regression and multivariate models. We used marginal standardisation methods to estimate the predicted probabilities of the factors significantly associated with the three measures of ANC.ResultsApproximately 18% of mothers met the new WHO recommended number of eight ANC contacts. About 58% of the mothers received adequate ANC components, and 47% initiated ANC within the first trimester of pregnancy. The predicted model shows that Myanmar could achieve 70% coverage of adequate components of ANC if all women were living in urban areas. Similarly, if ANC was through private health facilities, 63% would achieve adequate components of ANC. Pregnant women from urban areas (adjusted risk ratio (aRR): 4.86, 95% CI 2.44 to 9.68) were more than four times more likely to have adequate ANC components compared with women from rural areas. Pregnant women in the highest wealth quintile were three times more likely to receive eight or more ANC contacts (aRR: 3.20, 95% CI 1.61 to 6.36) relative to mothers from the lowest wealth quintile. On time initiation of the first ANC contact was fourfold for mothers aged 30–39 years relative to adolescent mothers (aRR: 4.07, 95% CI 1.53 to 10.84).ConclusionThe 2016 WHO ANC target is not yet being met by the majority of women in Myanmar. Our results highlight the need to address health access inequity for women who are from lower socioeconomic groups, or are younger, and those living in rural areas.

scholarly journals Increase in Percentage of Seronegative Toxoplasma gondii and Cytomegalovirus in Pregnant Women: An Improvement in Hygienic Conditions in Certain Areas?

2020 ◽  
Vol 2020 (1) ◽  
pp. 1 ◽  
Author(s):  
Dan-Bogdan Navolan ◽  
Florin Gorun ◽  
Cristian Oancea ◽  
Ioana-Mihaela Ciohat ◽  
Daniel Malița ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
Pregnant Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Primary Infection ◽  
Food Quality Control ◽  
Fetal Infection ◽  
Increasing Trend ◽  
Urban And Rural Areas ◽  
Pathogenic Agents

(1) Background: Toxoplasma gondii and cytomegalovirus belong to a group of pathogens entities called TORCH agents. TORCH represents an acronym which derives from the name of a series of certain pathogenic agents (Toxoplasma gondii, Other agents, Rubella virus, Cytomegalovirus, Herpes virus). They could cross the placenta barrier and cause serious damage to the fetus if a primary infection occurs in a pregnant woman. Immunized women are relatively protected against a reinfection and the risk of a materno-fetal infection in these categories of pregnant women is considered low. (2) Aim of the study: To analyze changes in the percentage of pregnant women seronegative to Toxoplasma gondii and cytomegalovirus along a period of ten years, from 2008 to 2018. (3) Material and Methods: We studied the changes in percentage of seronegative Toxoplasma gondii and Cytomegalovirus pregnant women along two periods: 2008–2010 and 2015–2018. Only pregnant women with declared medium of provenience and unequivocal results were enrolled in the study. (4) Results: In urban areas, we found an increase in the percentage of pregnant women seronegative to Toxoplasma gondii (RR = 1.488, p < 0.0001), respectively to cytomegalovirus (RR = 1.985, p < 0.0001), from 2008–2010 to 2015–2018. A similar increasing trend was found also in rural areas: Toxoplasma gondii (RR = 1.136, p < 0.0322), respectively cytomegalovirus (RR = 1.088, p < 0.8265) but it did not reach a significant threshold for cytomegalovirus. (5) Conclusion: Our study showed that the percentage of women seronegative to Toxoplasma gondii and cytomegalovirus antibodies increases along a period of ten years, from 2008–2010 to 2015–2018, in both urban and rural areas. Probably, the main cause of this trend is represented by the improvement in hygienic condition and food quality control. These results present an argument for continuing the TORCH screening of pregnant women.

Rapid Turnover of Plasmodium falciparum Populations in Asymptomatic Individuals Living in a High Transmission Area

1996 ◽  
Vol 54 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Pierre Daubersies ◽  
Sebastien Magne ◽  
Thierry Fandeur ◽  
Odile Mercereau-Puijalon ◽  
Selma Sallenave-Sales ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Rapid Turnover ◽  
High Transmission ◽  
Transmission Area ◽  
Asymptomatic Individuals ◽  
High Transmission Area

Rapid diagnostic tests for the home-based management of malaria, in a high-transmission area

2009 ◽  
Vol 103 (1) ◽  
pp. 3-16 ◽  
Author(s):  
M. L. Willcox ◽  
F. Sanogo ◽  
B. Graz ◽  
M. Forster ◽  
F. Dakouo ◽  
...  
Keyword(s):  
Diagnostic Tests ◽  
Rapid Diagnostic Tests ◽  
High Transmission ◽  
Home Based ◽  
Transmission Area ◽  
High Transmission Area

scholarly journals The Effect of Indoor Residual Spraying on Malaria and Anemia in a High-Transmission Area of Northern Uganda

2013 ◽  
Vol 88 (5) ◽  
pp. 855-861 ◽  
Author(s):  
Laura C. Steinhardt ◽  
Adoke Yeka ◽  
Geoff Lavoy ◽  
Grant Dorsey ◽  
Sussann Nasr ◽  
...  
Keyword(s):  
Indoor Residual Spraying ◽  
Northern Uganda ◽  
High Transmission ◽  
Transmission Area ◽  
High Transmission Area

scholarly journals Challenges in estimating HIV prevalence trends and geographical variation in HIV prevalence using antenatal data: Insights from mathematical modelling

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242595
Author(s):  
Leigh F. Johnson ◽  
Mmamapudi Kubjane ◽  
Jeffrey W. Eaton
Keyword(s):  
South Africa ◽  
Pregnant Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Geographical Variation ◽  
Sexual Experience ◽  
Hiv Prevalence ◽  
Hiv Incidence ◽  
African Countries ◽  
Prevalence Data

Background HIV prevalence data among pregnant women have been critical to estimating HIV trends and geographical patterns of HIV in many African countries. Although antenatal HIV prevalence data are known to be biased representations of HIV prevalence in the general population, mathematical models have made various adjustments to control for known sources of bias, including the effect of HIV on fertility, the age profile of pregnant women and sexual experience. Methods and findings We assessed whether assumptions about antenatal bias affect conclusions about trends and geographical variation in HIV prevalence, using simulated datasets generated by an agent-based model of HIV and fertility in South Africa. Results suggest that even when controlling for age and other previously-considered sources of bias, antenatal bias in South Africa has not been constant over time, and trends in bias differ substantially by age. Differences in the average duration of infection explain much of this variation. We propose an HIV duration-adjusted measure of antenatal bias that is more stable, which yields higher estimates of HIV incidence in recent years and at older ages. Simpler measures of antenatal bias, which are not age-adjusted, yield estimates of HIV prevalence and incidence that are too high in the early stages of the HIV epidemic, and that are less precise. Antenatal bias in South Africa is substantially greater in urban areas than in rural areas. Conclusions Age-standardized approaches to defining antenatal bias are likely to improve precision in model-based estimates, and further recency adjustments increase estimates of HIV incidence in recent years and at older ages. Incompletely adjusting for changing antenatal bias may explain why previous model estimates overstated the early HIV burden in South Africa. New assays to estimate the fraction of HIV-positive pregnant women who are recently infected could play an important role in better estimating antenatal bias.

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