Comparison of reported and confirmed malaria during pregnancy: findings from hospital and community studies in Sudan.
Hospital case-control and community follow-up studies were conducted to compare the results of laboratory confirmed malaria against the reliability of maternal reported malaria at time of delivery. The studies were carried out in Sudan in Gezira area where malaria is stable and in Sennar area where malaria is unstable. In the hospital study, 348 cases were compared with 812 controls. In the community study, 275 cases were compared with 1248 controls. Overall, reported or confirmed malaria was significantly associated with low birth weight. The results were consistent between the hospital and community populations in Wad Medani (Gezira) area. However, the association of malaria with low birth weight was weaker and inconsistent between the hospital and the community in Sennar area. This discrepancy is related to unbalanced exposure to malaria among cases and controls in the Sennar area where malaria prevalence is higher among urban than among rural populations. The results suggest that maternal history is a reasonably accurate method of assessing clinical episodes of malaria during pregnancy especially where malaria is stable and therefore justifies presumptive treatment of malaria. The unique patterns of malaria transmission in Sennar area emphasise the need for through evaluation of local epidemiological factors for better malaria control activities.
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Johns Hopkins University Research Project, Blantyre, Malawi.
D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008288:Malaria / Q000097:blood / Q000175:diagnosis*; D008487:Medical History Taking / Q000592:standards*; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000097:blood / Q000175:diagnosis*; D015995:Prevalence; D015203:Reproducibility of Results; D013397:Sudan