High burden of malaria and anemia among tribal pregnant women in a chronic conflict corridor in India

• Published in: Conflict and health 2017-06, Vol.11 (1), p.10-10, Article 10
• Main Authors: Corrêa, Gustavo, Das, Mrinalini, Kovelamudi, Rama, Jaladi, Nagendra, Pignon, Charlotte, Vysyaraju, Kalyan, Yedla, Usha, Laxmi, Vijya, Vemula, Pavani, Gowthami, Vijaya, Sharma, Hemant, Remartinez, Daniel, Kalon, Stobdan, de Polnay, Kirrily, De Smet, Martin, Isaakidis, Petros
• Format: Article
• Language: English
• Subjects: Age; Anemia; Antenatal care; Arm circumference; Circumferences; Confidence intervals; Demographic aspects; Diagnostic systems; Diagnostic tests; Epidemiology; Global health; Health aspects; Health care; Infections; Intervention; Malaria; Medical screening; Microscopy; Patients; Population; Populations; Pregnancy; Pregnant women; Rapid diagnostic test; Risk factors; Vector-borne diseases; Womens health
• ISSN: 1752-1505; 1752-1505
• DOI: 10.1186/s13031-017-0113-1

With more than 200 million cases a year, malaria is an important global health concern, especially among pregnant women. The forested tribal areas of Andhra Pradesh, Telangana and Chhattisgarh in India are affected by malaria and by an on-going chronic conflict which seriously limits access to health care. The burden of malaria and anemia among pregnant women in these areas is unknown; moreover there are no specific recommendations for pregnant women in the Indian national malaria policy. The aim of this study is to measure the burden of malaria and anemia among pregnant women presenting in mobile clinics for antenatal care in a conflict-affected corridor in India. This is a descriptive study of routine programme data of women presenting at first visit for antenatal care in Médecins sans Frontières mobile clinics during 1 year (2015). Burden of malaria and anemia were estimated using rapid diagnostic tests (SD BIOLINE® and HemoCue® respectively). Among 575 pregnant women (median age: 26 years, interquartile range: 25-30) 29% and 22% were in their first and second pregnancies respectively. Mid-Upper Arm Circumference (MUAC) was below 230 mm in 74% of them. The prevalence of anemia was 92.4% (95% Confidence Intervals (CI): 89.9-94.3), while severe anemia was identified in 6.9% of the patients. The prevalence of malaria was 29.3% (95%CI: 25.7-33.2) with 64% caused by isolated , 35% by either or mixed malaria and 1% by either , or or . Malaria test was positive in 20.8% of asymptomatic cases. Malaria was associated with severe anemia (prevalence ratio: 2.56, 95%CI: 1.40-4.66,