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Impact of maternal malaria during pregnancy on Infant Mortality Rate in an highly endemic area

Impact of maternal malaria during pregnancy on Infant Mortality Rate in an highly endemic area. Ali-Akbar Haghdoost , London school of hygiene and tropical medicine Neal Alexander , London school of hygiene and tropical medicine

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Impact of maternal malaria during pregnancy on Infant Mortality Rate in an highly endemic area

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  1. Impact of maternal malaria during pregnancy on Infant Mortality Rate in an highly endemic area Ali-Akbar Haghdoost, London school of hygiene and tropical medicine Neal Alexander, London school of hygiene and tropical medicine Tom Smith, Swiss Tropical Institute Department of Public Health & Epidemiology Royal Society of Tropical Medicine and Hygiene Manson House 12th December 2002

  2. immunity severity Introduction1 Pregnancy malaria and IMR Why malaria during pregnancy is important? Pregnant Women: pregnancy

  3. Anaemia in woman Congenital malaria (rare) LBW and anaemia increase Placental infection mortality Maternal immunity decrease Severe disease and/or infection Introduction2 Pregnancy malaria and IMR Baby Malaria during pregnancy

  4. method1 Pregnancy malaria and IMR • highly endemic are in Northern Nigeria, • The garki project: more than 12,000 people were followed in 23 survey • Mother’s and baby’s data were linked base data collection time and birth dates and, compound ID, 417 pairs out of 747 deliveries • Rate ratio for infection during first and second half of pregnancy on IMR were computed by Poisson regression model

  5. results1 Pregnancy malaria and IMR Time of infection IMR First half 0.69 Second half 1.47 Any time 0.94 Offspring malaria rate 0.73 1.52 1.0 Malaria during the first half of pregnancy is a protective factor, however during the second half is a risk factor for IM and also contracting infection after birth

  6. results2 Pregnancy malaria and IMR Adjusted for baby’s malaria RR PAF 0.76 - 1.74 0.16 1.15 0.06 Malaria during crude RR PAF First half 0.67 - Second half 1.47 0.12 Any time 0.94 - Adjusted > crude Why? Might be due to maternal immunity The effect of malaria in the first and second half of pregnancy is different

  7. results3 Pregnancy malaria and IMR SPR and risk of infection in pregnant and non-pregnant women Group pregnant non-pregnant SPR 0.14 0.16 Risk of infection 18.5 34.7 • Whypregnant women has less chance of infection? • Higher immunity • Lower risk of exposure

  8. WHO recommendation: Prompt treatment for all demonstrable disease Prophylaxes for all pregnant women Conclusion: Pregnancy malaria and IMR Although it is correct, to make more precise plan we should think about The difference between infection and disease • Endemisity of malaria • Drug resistance • Pregnancy age • Socio-economic and nutritional status of people

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