Asymptomatic Malaria In Pregnancy: Prevalence Of Peripheral Parasitemia And Anemia, In Kinshasa, Democratic Republic Of The Congo

ABSTRACT

Background: Malaria infection in pregnancy is an enormous public health problem in Sub-Saharan Africa. In areas of high malaria transmission, P. falciparum infection during pregnancy is usually characterized by malaria related anemia in the mother and placental malaria. This situation has been associated with poor pregnancy outcomes across many populations. The aim of this study was to determine the extent of asymptomatic P. falciparum infection and its relation with anemia in healthy pregnant women living in Kinshasa, Democratic Republic of the Congo, an endemic area for malaria transmission.

Methods: A cross-sectional study was conducted in healthy pregnant women attending prenatal care consultations. Information on socio-demographic characteristics was collected using a questionnaire. P. falciparum infection was diagnosed using Rapid diagnostic test (RDT), microscopy and Polymerase Chain Reaction. Hemoglobin concentration was determined at the same time. Bivariate and multivariate logistic regression models were used to determine the association between variables.

Results: From 332 pregnant women enrolled, complete RDT and microscopy data was available for 332 blood samples and of these 166 samples were analyzed by PCR. The prevalence of asymptomatic P. falciparum infection using microscopy TBS, RDTs and PCR, were respectively 21.6% (95% CI 17.4-26.6%), 27.4% (95% CI 22.7-32.6%) and 29.5% (95% CI 22.7-37.1%). The medium parasite density was 126 (IQR =105-162). Women who spent last night under a mosquito net were less

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likely to have asymptomatic P. falciparum infection compared to women who did not use a mosquito net (OR 0.1; 95%CI:0.03-0.5, p