title: Population-based prevalence of malaria among pregnant women in Enugu State, Nigeria: the Healthy Beginning Initiative.
abstract: BACKGROUND
  Malaria adversely affects pregnant women and their fetuses or neonates. Estimates of the malaria burden in pregnant women based on health facilities often do not present a true picture of the problem due to the low proportion of women delivering at these facilities in malaria-endemic regions.
  
  
  METHODS
  Data for this study were obtained from the Healthy Beginning Initiative using community-based sampling. Self-identified pregnant women between the ages of 17-45 years were recruited from churches in Enugu State, Nigeria. Malaria parasitaemia was classified as high and low based on the malaria plus system.
  
  
  RESULTS
  Of the 2069 pregnant women for whom malaria parasitaemia levels were recorded, over 99 % tested positive for malaria parasitaemia, 62 % showed low parasitaemia and 38 % high parasitaemia. After controlling for confounding variables, odds for high parasitaemia were lower among those who had more people in the household (for every one person increase in a household, OR = 0.94, 95 % CI 0.89-0.99).
  
  
  CONCLUSIONS
  Results of this study are consistent with hospital-based estimates of malaria during pregnancy in southeastern Nigeria. Based on the high prevalence of malaria parasitaemia in this sample, education on best practices to prevent malaria during pregnancy, and resources in support of these practices are urgently needed.
authors.affiliation: Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave Drachman Hall, PO Box 245163, Tucson, AZ, 85724, USA. gunnj@email.arizona.edu.
authors.forename: Jayleen K L
authors.initials: JK
authors.lastname: Gunn
authors.affiliation: Department of Health Promotion Sciences/Global Health Institute, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA. jehiri@email.arizona.edu.
authors.forename: John E
authors.initials: JE
authors.lastname: Ehiri
authors.affiliation: Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave Drachman Hall, PO Box 245163, Tucson, AZ, 85724, USA. jacobse@email.arizona.edu.|University of Arizona Cancer Center, Tucson, AZ, USA. jacobse@email.arizona.edu.
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Jacobs
authors.affiliation: Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave Drachman Hall, PO Box 245163, Tucson, AZ, 85724, USA. kernst@email.arizona.edu.
authors.forename: Kacey C
authors.initials: KC
authors.lastname: Ernst
authors.affiliation: Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave Drachman Hall, PO Box 245163, Tucson, AZ, 85724, USA. sydneyp@email.arizona.edu.
authors.forename: Sydney
authors.initials: S
authors.lastname: Pettygrove
authors.affiliation: Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave Drachman Hall, PO Box 245163, Tucson, AZ, 85724, USA. lschulz@email.arizona.edu.
authors.forename: Lindsay N
authors.initials: LN
authors.lastname: Kohler
authors.affiliation: Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave Drachman Hall, PO Box 245163, Tucson, AZ, 85724, USA. shaenchen@email.arizona.edu.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Haenchen
authors.affiliation: Prevention, Education, Treatment, Training and Research-Global Solutions-PeTR-GS, Enugu, Enugu State, Nigeria. mobiefune.ihv@gmail.com.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Obiefune
authors.affiliation: Healthy Sunrise Foundation, Castle Ridge Avenue, Las Vegas, NV, USA. anolue76@yahoo.com.
authors.forename: Chinenye O
authors.initials: CO
authors.lastname: Ezeanolue
authors.affiliation: Prevention, Education, Treatment, Training and Research-Global Solutions-PeTR-GS, Enugu, Enugu State, Nigeria. aogidi.petrgs@gmail.com.
authors.forename: Amaka G
authors.initials: AG
authors.lastname: Ogidi
authors.affiliation: Global Health and Implementation Science Initiative, School of Community Health Sciences, University of Nevada, Las Vegas, NV, USA. echezona.ezeanolue@unlv.edu.
authors.forename: Echezona E
authors.initials: EE
authors.lastname: Ezeanolue
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008288:Malaria / Q000453:epidemiology* / Q000469:parasitology; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D018512:Parasitemia / Q000453:epidemiology* / Q000469:parasitology; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology* / Q000469:parasitology; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult