Malarial Infection and Curable Sexually Transmitted and Reproductive Tract Infections Among Pregnant Women in a Rural District of Zambia.
Malarial infection and curable sexually transmitted and reproductive tract infections (STIs/RTIs) are important causes of adverse birth outcomes. Reducing the burden of these infections in pregnancy requires interventions that can be easily integrated into the antenatal care (ANC) package. However, efforts to integrate the control of malarial infection and curable STIs/RTIs in pregnancy have been hampered by a lack of evidence related to their coinfection. Thus, we investigated the prevalence of coinfection among pregnant women of rural Zambia. A prospective cohort study was conducted in Nchelenge District, Zambia, involving 1,086 first ANC attendees. We screened participants for peripheral malarial infection and curable STIs/RTIs (syphilis, Chlamydia, gonorrhea, trichomoniasis, and bacterial vaginosis), and collected relevant sociodemographic data at booking. Factors associated with malarial and STI/RTI coinfection were explored using univariate and multivariate regression models. Among participants with complete results (N = 1,071), 38.7% (95% confidence interval [CI] = 35.7-41.6) were coinfected with malaria parasites and at least one STI/RTI; 18.9% (95% CI = 16.5-21.2) were infected with malaria parasites only; 26.0% (95% CI = 23.5-28.8) were infected with at least one STI/RTI but no malaria parasites, and 16.4% (95% CI = 14.1-18.6) had no infection. Human immunodeficiency virus (HIV)-infected women had a higher risk of being coinfected than HIV-uninfected women (odds ratio [OR] = 3.59 [95% CI = 1.73-7.48], P < 0.001). The prevalence of malarial and STI/RTI coinfection was high in this population. An integrated approach to control malarial infection and STIs/RTIs is needed to reduce this dual burden in pregnancy.
Department of Biological Sciences, University of Zambia, Lusaka, Zambia. enesia.chaponda@gmail.com.|Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Enesia Banda
EB
Chaponda
Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
R Matthew
RM
Chico
Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Jane
J
Bruce
Department of Public Health, University of Zambia School of Medicine, Lusaka, Zambia.
Charles
C
Michelo
Department of Obstetrics and Gynaecology, University of Zambia School of Medicine, Lusaka, Zambia.
Bellington
B
Vwalika
Faculty of Health Sciences, Africa University, Mutare, Zimbabwe.|Department of Medical Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Sungano
S
Mharakurwa
Department of Clinical Sciences, Tropical Diseases Research Centre, Ndola, Zambia.
Mike
M
Chaponda
Department of Paediatrics and Child Health, University of Zambia School of Medicine, Lusaka, Zambia.
James
J
Chipeta
Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Daniel
D
Chandramohan
D000328:Adult; D060085:Coinfection / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008288:Malaria / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D011446:Prospective Studies; D060737:Reproductive Tract Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology; D012424:Rural Population; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology; D012959:Socioeconomic Factors; D014245:Trichomonas Infections / Q000453:epidemiology; D016585:Vaginosis, Bacterial / Q000453:epidemiology / Q000469:parasitology; D055815:Young Adult; D015024:Zambia / Q000453:epidemiology
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