title: Decreased susceptibility to placental malaria in anaemic women in an area with unstable malaria transmission in central Sudan.
abstract: The interaction between iron level, iron supplementation, and susceptibility to infection, including malaria, remains a concern. A cross-sectional study was conducted at Medani hospital in central Sudan to investigate the relationship between anaemia and placental malaria. Obstetrical  history was obtained; haemoglobin levels were determined. Placental tissue was obtained and malaria histology classified as active, chronic, past or no malaria infection. Among 324 women investigated, 7 (2·2%), 4 (1·2%), and 44 (13·6%) of the placentae showed active, chronic  and past infection on histology examination respectively, while 269 (83·0%) of them showed no infection. Anaemia (haemoglobin <11 g/dl) was less frequent in women with placental Plasmodium falciparum infection, 27/55 (49·1%) vs 174/269 (64·7%), P=0·02.  Anaemia was associated with a decreased risk for placental malaria, and the odds ratio for placental malaria (in both primiparae and multiparae group) was 0·2, 95% CI: 0·1-0·6, P=0·002 and it was 0·2, 95% CI: 0·03-0·7;  P=0·02 for primiparae group. Thus, there is a strong relationship between anaemia and the absence of placental malaria.
authors.affiliation: University of Khartoum, Khartoum, Sudan. ishagadam@hotmail.com
authors.forename: Ishag
authors.initials: I
authors.lastname: Adam
authors.forename: Elhassan M
authors.initials: EM
authors.lastname: Ehassan
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Mohmmed
authors.forename: Magdi M
authors.initials: MM
authors.lastname: Salih
authors.forename: Mustafa I
authors.initials: MI
authors.lastname: Elbashir
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000150:complications* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000150:complications* / Q000453:epidemiology*; D010920:Placenta / Q000469:parasitology*; D010963:Plasmodium falciparum / Q000302:isolation & purification* / Q000472:pathogenicity; D011247:Pregnancy; D013397:Sudan / Q000453:epidemiology; D055815:Young Adult