Table 6.
Risk of P. vivax and P. falciparum in the postpartum period
| Study | Country | Postpartum period | Plasmodium vivax | Magnitude (95% CI) | Plasmodium falciparum | Magnitude (95% CI) |
|---|---|---|---|---|---|---|
| Risk/odds of infection compared to pregnancy | ||||||
| Bray and Anderson (1979) | The Gambia | At 1 mo. | N/A | N/A | Similara | OR = 0·81 (0·41, 1·53)b |
| Brabin et al. (1990) | Papua New Guinea | Across 4 mos. | Increaseda | IRR = 4·89 (1·92, 11·59)b | Increaseda | IRR = 1·28 (0·78, 2·00)b |
| Steketee et al. (1996) | Malawi | At 2 mos. | N/A | N/A | Similara | OR = 0·80 (0·72, 0·88)b |
| Fievet et al. (1997) | Cameroon | At 6 mos. | N/A | N/A | Decreaseda,c | OR = 0·19 (0·05, 0·68)b |
| Diagne et al. (2000) | Senegal | Across 2 mos. | N/A | N/A | Increaseda,d | IRR = 1·75 (0·75, 3·76)b |
| Green et al. (2007) | Kenya | At 2 mos. | N/A | N/A | Decreaseda | OR = 0·20 (0·00, 1·80)b |
| Menendez et al. (2008) | Mozambique | At 2 mos. | N/A | N/A | Decreaseda | OR = 0·36 (0·22, 0·58)b |
| Serra-Casas et al. (2011) | Mozambique | At 2 mos. | N/A | N/A | Decreasede | OR = 0·35 (0·19, 0·61) |
| Risk/odds of clinical malaria compared to pregnancy | ||||||
| Diagne et al. (2000) | Senegal | Across 2 mos. | N/A | N/A | Increasedf | IRR = 1·98 (0·84, 4·36)b |
| Risk/odds of infection compared to non-pregnant women | ||||||
| Diagne et al. (2000) | Senegal | Across 2 mos. | N/A | N/A | Increaseda,d | RR = 1·8 (1·1, 2·7)g |
| Ramharter et al. (2005) | Gabon | Across 2·5 mos. | N/A | N/A | Increaseda | IRR = 2·7 (1·0, 8·2) |
| Boel et al. (2013) | Thailand | Across 3 mos. | Increaseda | HR = 1·34 (1·05, 1·72) | Decreaseda | HR = 0·39 (0·21, 0·72) |
| Risk/odds of clinical malaria compared to non-pregnant women | ||||||
| Diagne et al. (2000) | Senegal | Across 2 mos. | N/A | N/A | Increasedf | RR = 4·1 (1·8, 9·5)g |
| Ramharter et al. (2005) | Gabon | Across 2·5 mos. | N/A | N/A | Increasedh | IRR = 9·8 (1·4, 420·0) |
NB – ratios within 0·2 of 1 were considered similar to 1. All measures of association are unadjusted unless otherwise specified.
Abbreviations: mos., months; LM, light microscopy; OR, odds ratio; IRR, incidence rate ratio; RR, risk ratio; HR, hazard ratio.
Detected by light microscopy.
Calculated from data in the paper.
Study restricted to primigravid women only.
Asymptomatic infection.
Detected by PCR.
Clinical malaria defined as any case of fever or fever-related symptoms associated with a ratio of parasites to leucocytes that exceeds a pyrogenic threshold.
Adjusted for exposure, parity, duration of residence in village and effects within study subjects.
Clinical malaria defined as asexual P. falciparum parasitemia with >100 parasites μL−1 of blood, fever (current or within the previous 24 h), or presence of other symptoms associated with malaria.