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.
Clinic of Infectious and Tropical Diseases, University of Brescia, Piazzale Spedali Civili 1, Italy.
A
A
Matteelli
F
F
Donato
A
A
Shein
J A
JA
Muchi
O
O
Leopardi
L
L
Astori
G
G
Carosi
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