Volume 77, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Malaria infection during pregnancy (MiP) is heterogeneously distributed even in malaria-endemic countries. Program planners require data to facilitate identification of highest-priority populations for MiP control. Using data from two cross-sectional studies of 5,528 pregnant women in 8 neighboring sites in Mozambique, we described factors associated with maternal peripheral parasitemia by using logistic regression. Principal multivariate predictors of maternal peripheral parasitemia were gravidity (odds ratio [OR] = 2.29, 95% confidence interval [CI] = 1.60–3.26 for primigravidae and OR = 1.61, 95% CI = 1.29–2.01 for secundigravidae compared with gravidity ≥ 3); age (OR = 0.96 per year, 95% CI = 0.94–0.99); study site (OR = 1.45, 95% CI = 1.34–1.56 to 5.32, 95% CI = 4.92–5.75) for comparison with the reference site; and no maternal education (OR = 1.38, 95% CI = 1.15–1.66) compared with any education. Other predictors (in subgroups) were bed net use (OR = 0.49, 95% CI = 0.48–0.50); preventive sulfadoxine-pyrimethamine doses (OR = 0.25, 95% CI = 0.24–0.25); and infection with human immunodeficiency virus (HIV) (OR = 1.49, 95% CI = 1.11–2.00). Programmatic priorities should respond to heterogeneous distribution of multiple risk factors, including prevalance of malaria and infection with HIV, and maternal socioeconomic status.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Steketee R, Nahlen B, Parise M, Menendez C, 2001. The burden of malaria in pregnancy in malaria-endemic areas. Am J Trop Med Hyg 64 (Suppl 1,2): S28–35. [Google Scholar]
  2. Guyatt H, Snow R, 2001. The epidemiology and burden of Plasmodium falciparum-related anemia among pregnant women in sub-Saharan Africa. Am J Trop Med Hyg 64 : 36–44. [Google Scholar]
  3. Bouvier P, Doumbo O, Breslow N, Robert C-F, Mauris A, Picquet M, Kouriba B, Dembele H, Delley V, Rougemont A, 1997. Seasonality, malaria, and impact of prophylaxis in a West African village. 1. Effect on anemia in pregnancy. Am J Trop Med Hyg 56 : 378–383. [Google Scholar]
  4. World Health Organization, 2004. A Strategic Framework for Malaria Prevention and Control during Pregnancy in the African Region. Brazzaville: World Health Organization Regional Office for Africa, AFR/MAL/04/01
  5. Shulman C, Dorman E, Cutts F, Kawuondo K, Bulmer J, Peshu N, Marsh K, 1999. Intermittent sulphadoxine-pyrimethamine to prevent severe anaemia secondary to malaria in pregnancy: a randomised placebo-controlled trial. Lancet 353 : 632–636. [Google Scholar]
  6. Njagi J, Magnussen P, Estambale E, Ouma J, Mugo B, 1993. Prevention of anaemia in pregnancy using insecticide-treated bednets and sulfadoxine-pyrimethamine in a highly malarious area of Kenya: a randomized controlled trial. Trans R Soc Trop Med Hyg 97 : 277–282. [Google Scholar]
  7. D’Alessandro U, Langerock P, Bennett S, Francis N, Cham K, Greenwood BM, 1996. The impact of a national impregnated bednet programme on the outcome of pregnancy in primigravidae in The Gambia. Trans R Soc Trop Med Hyg 90 : 487–492. [Google Scholar]
  8. Dolan G, Ter Kuile F, Jacoutot V, White NJ, Luxemburger C, Malanki Chongsuphajaisiddhi T, Nosten F, 1993. Bed nets for the prevention of malaria and anaemia in pregnancy. Trans R Soc Trop Med Hyg 87 : 620–626. [Google Scholar]
  9. Parise M, Ayisi J, Nahlen B, Schultz L, Roberts J, Misore A, Muga R, Oloo A, Steketee R, 1998. Efficacy of sulfadoxine-pyrimethamine for prevention of placental malaria in an area of Kenya with a high prevalence of malaria and human immunodeficiency virus infection. Am J Trop Med Hyg 59 : 813–822. [Google Scholar]
  10. Parise M, Lewis L, Ayisi J, Nahlen B, Slutsker L, Muga R, Sharif S, Hill J, Steketee R, 2003. A rapid assessment approach for public health decision-making related to the prevention of malaria during pregnancy. Bull World Health Organ 81 : 316–323. [Google Scholar]
  11. Ter Kuile F, Parise M, Verhoeff F, Udhayakumar V, Newman R, van Eijk A, Rogerson S, Steketee R, 2004. The burden of co-infection with human immunodeficiency virus type 1 and malaria in pregnant women in sub-Saharan Africa. Am J Trop Med Hyg 71 (Suppl 2): 41–54. [Google Scholar]
  12. Steketee R, Wirima J, Bloland P, Chilima B, Mermin J, Chitsulo L, Breman J, 1996. Impairment of a pregnant woman’s acquired ability to limit Plasmodium falciparum by infection with human immunodeficiency virus type-1. Am J Trop Med Hyg 55 : 42–49. [Google Scholar]
  13. Montoya P, Lukehart S, Brentlinger P, Blanco AJ, Floriano F, Sairosse J, Gloyd S, 2006. Comparison of the diagnostic accuracy of a rapid immunochromatographic test and the rapid plasma reagin test for antenatal syphilis screening in Mozambique. Bull World Health Organ 84 : 97–104. [Google Scholar]
  14. Brentlinger PE, Dgedge M, Correia MA, Blanco Rojas AJ, Saute F, Gimbel-Sherr KH, Stubbs B, Mercer MA, Gloyd S, 2007. Lessons from the field: intermittent preventive treatment of malaria in pregnancy in central Mozambique. Bull World Health Organ: (in press). [Google Scholar]
  15. Haghighi L, Doust JY, Boroomand K, 1970. Biological false positive VDRL test in malaria. Trop Geog Med 22 : 482–485. [Google Scholar]
  16. Erbelding EJ, Vlahov D, Nelson KE, Rompalo AM, Cohn S, Sanchez P, Quinn TC, Brathwaite W, Thomas DL, 1997. Syphilis serology in human immunodeficiency virus infection: evidence for false-negative fluorescent treponemal testing. J Infect Dis 176 : 1397–1400. [Google Scholar]
  17. República de Moçambique, 2005. Programa Nacional de Controle das DTS/HIV/SIDA. Relatório sobre a Revisão dos Dados de Vigilância Epidemiológica do HIV—Ronda 2004. Maputo: Ministério de Saúde.
  18. Brentlinger P, Correia MA, Chinhacata F, Gimbel-Sherr K, Stubbs B, Mercer MA, 2007. Lessons learned from bednet distribution in central Mozambique. Health Policy Plan 22 : 103–110. [Google Scholar]
  19. Ministério de Plano e Finanças, 2002. Mapeamento de Vulnerabilidade. Maputo, Mozambique.
  20. UNICEF Mozambique, 2005. A Statistical Profile of Disparities in Mozambique. An Overview of the Situation of Children and Women Based on Findings from the 2003 Demographic and Health Survey. Maputo, Mozambique: UNICEF Mozambique.
  21. Adam I, Khamis A, Elbashir M, 2005. Prevalence and risk factors for Plasmodium falciparum malaria in pregnant women of eastern Sudan. Malaria J 4 : 18. [Google Scholar]
  22. Antelman G, Msamanga G, Spiegelman D, Urassa E, Narh R, Hunter D, Fawzi W, 2000. Nutritional factors and infectious disease contribute to anemia among pregnant women with human immunodeficiency virus in Tanzania. J Nutr 130 : 1950–1957. [Google Scholar]
  23. Verhoeff F, Brabin B, Chimsuku L, Kazembe P, Broadhead R, 1999. An analysis of the determinants of anaemia in pregnant women in rural Malawi—a basis for action. Ann Trop Med Parasitol 93 : 119–133. [Google Scholar]

Data & Media loading...

  • Received : 25 Sep 2006
  • Accepted : 12 Apr 2007

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error