Malaria and anaemia in pregnant women in urban Zanzibar, Tanzania.
Severe anaemia in pregnancy is a major obstetric problem in malaria-endemic areas. This study reports a cross-sectional investigation of malaria infection and haematological values at delivery in 440 women from urban Zanzibar. Severe anaemia [with haemoglobin (Hb) < or = 7 g/dl] was identified in 36 women (9.3%) and mild anaemia (7 < Hb < 10 g/dl) in 269 (69.7%) while 81 women (21.0%) had normal Hb values. Malaria infection was diagnosed in 187/385 women (48.6%) on the basis of either peripheral blood examination or placental histology. Univariate analysis indicated that the proportion of women with anaemia was similar in those with (85%) and without (80%) malaria infection. However, when primigravidae were considered alone, malaria infection was significantly more frequent among anaemic women (65.2%) than in those with normal Hb values (40.0%). In the logistic regression analysis, including age, parity, education level, malaria and free serum iron as independent variables and anaemia (Hb < or = 10 g/dl) as response variable, the odds ratio (OR) for malaria infection was 1.2 (P > 0.1). However, a similar analysis indicated that malaria was significantly associated with anaemia in the primigravidae, with an OR of 3.2 (95% confidence interval: 1.1-9.6; P < 0.05). In conclusion, this cross-sectional investigation indicated that malaria plays a significant role in the determination of anaemia in primigravidae, but not in multiparae, in the urban study area.
Matteelli
A
A
Clinic of Infectious and Tropical Diseases, University of Brescia, Piazzale Spedali Civili 1, Italy.
Donato
F
F
Shein
A
A
Muchi
J A
JA
Leopardi
O
O
Astori
L
L
Carosi
G
G
D000328:Adult; D000740:Anemia / Q000453:epidemiology / Q000469:parasitology*; D003430:Cross-Sectional Studies; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D016778:Malaria, Falciparum / Q000097:blood* / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000469:parasitology*; D015597:Pregnancy Complications, Parasitic / Q000097:blood*; D015995:Prevalence; D013636:Tanzania / Q000453:epidemiology; D014505:Urban Population
D006454:Hemoglobins; D005293:Ferritins