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Impact of maternal malaria during pregnancy on Infant Mortality Rate in an highly endemic area Ali-Akbar Haghdoost, London school of hygiene and tropical.

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Presentation on theme: "Impact of maternal malaria during pregnancy on Infant Mortality Rate in an highly endemic area Ali-Akbar Haghdoost, London school of hygiene and tropical."— Presentation transcript:

1 Impact of maternal malaria during pregnancy on Infant Mortality Rate in an highly endemic area Ali-Akbar Haghdoost, London school of hygiene and tropical medicine Neal Alexander, London school of hygiene and tropical medicine Tom Smith, Swiss Tropical Institute Department of Public Health & Epidemiology Royal Society of Tropical Medicine and Hygiene Manson House 12th December 2002

2 Why malaria during pregnancy is important? Pregnant Women: pregnancy immunityseverity

3 Maternal immunity Malaria during pregnancy Baby Anaemia in woman Placental infection Severe disease and/or infection decrease Congenital malaria (rare) LBW and anaemia mortality increase

4  highly endemic are in Northern Nigeria,  The garki project: more than 12,000 people were followed in 23 survey  Mother’s and baby’s data were linked base data collection time and birth dates and, compound ID, 417 pairs out of 747 deliveries  Rate ratio for infection during first and second half of pregnancy on IMR were computed by Poisson regression model

5 Time of infectionIMR First half0.69 Second half1.47 Any time0.94 Offspring malaria rate Malaria during the first half of pregnancy is a protective factor, however during the second half is a risk factor for IM and also contracting infection after birth

6 Malaria during crude RR PAF First half Second half Any time Adjusted for baby’s malaria Adjusted for baby’s malaria RRPAF Adjusted > crude Why? Might be due to maternal immunity The effect of malaria in the first and second half of pregnancy is different

7 SPR and risk of infection in pregnant and non- pregnant women Grouppregnantnon-pregnant SPR SPR Risk of infection Risk of infection Whypregnant women has less chance of infection? Why pregnant women has less chance of infection? 1.Higher immunity 2.Lower risk of exposure

8 WHO recommendation: Prompt treatment for all demonstrable disease Prophylaxes for all pregnant women Although it is correct, to make more precise plan we should think about The difference between infection and disease  Endemisity of malaria  Drug resistance  Pregnancy age  Socio-economic and nutritional status of people


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