Table 1.
Influence of maternal parasitemia on malaria in infants
| Cohort | Study design and simple size | Time period | Transmission setting | Malaria prevention strategy during pregnancy | Treatment drug regime | Proportion of maternal peripheral parasitemia at delivery | Proportion of placental parasitemia | Proportion of neonatal parasitemia | Infant follow-up period | Median time to first parasitemia (days, min, max) | Association of infant malaria with PAM | Early infant parasitemia <3 months |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mangochi [21] (Malawi) |
Clinical trial on comparative efficacy of CQ or MQ; infant cohort follow-up (1766 women at delivery and 1289 infants) |
1988-1990 |
Perennial with seasonal peaks |
CQ and MQ |
CQ |
CQ: 20.3% MQ: 4.1% |
CQ: 25.1% MQ: 6.2% |
CQ: 8.6% MQ: 3.1% |
12 months |
199 (192-207) |
at 3 months: 1.1 (0.7-1.9) |
18.5% |
| Ebolowa [13] (Cameroon) |
Infant cohort follow-up (197) |
1993-1995 |
Perennial with seasonal peaks |
CQ |
CQ |
|
22.84% (Primigravid: 69%; Multigravid: 31%) |
|
24 months |
PM+: 217; PM-:350 |
at 6 months: PM+: 36%; PM-: 14%, p<0.05 at 2 years: PM+: 46.5%; PM-: 38.5%, p=0.6 |
≈12% |
| Muheza [14] (Tanzania) |
Infant cohort follow-up (453) |
2002-2004 |
Perennial with seasonal peaks (400 infective mosquito bites each year) |
SP (area with 68% resistance 14-day treatment failure rate) |
|
|
15.2% (Primigravid≤2: 24%; Multigravid>2: 5.6%) |
|
12 months |
266 (238–294) PM-:273 (245-322) PM+: 244 (147-266); |
Primigravidae: PM+:AOR= 0.21, (0.09–0.47) PM-: Reference*** Multigravidae: PM+: AOR =1.59, (1.16–2.17) PM-:AOR=0.67, (0.50–0.91) |
PM+ ≈20%; PM-≈10% |
| Lambarené [15] (Gabon) |
Infant cohort follow-up (527) |
2002-2004 |
Perennial |
No |
|
10.5%* |
9.48% |
|
30 months |
Primigravidae: PM+:107 (83-139) PM-:102 (29-205) Multigravidae: PM+:111 (13-189) PM-:92 (27-208) |
PM+:AOR= 2.1, (1.2–3) PM-: Reference** |
PM+ ≈2%; PM-≈0% |
| Manhiça [22] (Mozambique) |
Clinical trial on the efficacy of SP compared to placebo; infant cohort follow-up (1030 women at delivery and 997 infants) |
2003-2005 |
Perennial with seasonal peaks |
ITNs vs ITNs+SP |
SP-AQ |
ITNs+ placebo:15.15% ITNs+SP: 7.1% |
ITNs+ placebo:52.27% ITNs+SP: 52.11% |
ITNs+ placebo:1.15% ITNs+SP: 0.92% |
12 months |
|
Clinical PAM: AOR=1.96 (1.13–3.41) Acute PM: AOR= 4.63 (2.1-10.24) Chronic PM: AOR=3.95 (2.07-7.55) PM-: Reference |
|
| Tori Bossito [17,23] (Benin) |
Infant cohort follow-up (550) |
2007-2008 |
Perennial with seasonal peaks (400 infective mosquito bites each year) |
SP |
AL |
|
11% |
0.83% |
12 months |
PM+: 34 (4-83); PM-: 43 (4-85) |
ITN:AOR=2.13 (1.24–3.67) No ITN: AOR=1.18 (0.60–2.33) |
20.3% |
| Mono [24] (Benin) | Mother and infant cohort follow-up (218) | 2008-2010 | Mesoendemic (1-35 bites/person/year) | SP | Quinine or SP | 3.67% | 12 months | PAM+: 362 (18-390) PAM-: 365 (64-449) | PAM during the 3rd trimester of pregnancy: AOR= 4.6 (1.7; 12.5) PAM during the 1st and 2nd trimesters non significant |
PM: Placental malaria, PAM: Pregnancy associated malaria and AOR: Adjusted Odds Ratio.
*data from a reference article.
**the association between placental malaria and malaria in the child was only statistically significant for children who were randomized to receive the sulphadoxine-pyrimethamine intervention (AHR=3 (1.5-6)).
***Analysis of the effect of IPTp on parasitemia of the offspring was performed for 882 women of this cohort. Among them, 21.6% received no IPTp, 42% one dose, and 36.4% two or more doses.