The Effect of HIV Infection on the Risk, Frequency, and Intensity of Plasmodium falciparum Parasitemia in Primigravid and Multigravid Women in Malawi

Nkhoma, Ella T.; Bowman, Natalie M.; Kalilani-Phiri, Linda; Mwapasa, Victor; Rogerson, Stephen J.; Meshnick, Steven R.

doi:10.4269/ajtmh.2012.12-0392

Cited by 7 publications

(5 citation statements)

References 23 publications

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“…Another recent study of 32 maternal deaths in a tertiary hospital in Malawi in 2011 found that 13 (40%) of the women were HIV positive, 9 HIV negative and 10 had an unknown HIV status and classified 6 (19%) of the maternal deaths as due to sepsis and a further 3 (9%) due to HIV-related disease. 58 HIV infection may also predispose pregnant women to more severe malarial morbidity, [59][60][61] but data related to trends in malaria-related maternal complications are limited.…”

Section: Hiv Aids and Artmentioning

confidence: 99%

Maternal mortality in Malawi, 1977–2012

Colbourn¹,

Lewycka²,

Nambiar³

et al. 2013

BMJ Open

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BackgroundMillennium Development Goal 5 (MDG 5) targets a 75% reduction in maternal mortality from 1990 to 2015, yet accurate information on trends in maternal mortality and what drives them is sparse. We aimed to fill this gap for Malawi, a country in sub-Saharan Africa with high maternal mortality.MethodsWe reviewed the literature for population-based studies that provide estimates of the maternal mortality ratio (MMR) in Malawi, and for studies that list and justify variables potentially associated with trends in MMR. We used all population-based estimates of MMR representative of the whole of Malawi to construct a best-fit trend-line for the range of years with available data, calculated the proportion attributable to HIV and qualitatively analysed trends and evidence related to other covariates to logically assess likely candidate drivers of the observed trend in MMR.Results14 suitable estimates of MMR were found, covering the years 1977–2010. The resulting best-fit line predicted MMR in Malawi to have increased from 317 maternal deaths/100 000 live-births in 1980 to 748 in 1990, before peaking at 971 in 1999, and falling to 846 in 2005 and 484 in 2010. Concurrent deteriorations and improvements in HIV and health system investment and provisions are the most plausible explanations for the trend. Female literacy and education, family planning and poverty reduction could play more of a role if thresholds are passed in the coming years.ConclusionsThe decrease in MMR in Malawi is encouraging as it appears that recent efforts to control HIV and improve the health system are bearing fruit. Sustained efforts to prevent and treat maternal complications are required if Malawi is to attain the MDG 5 target and save the lives of more of its mothers in years to come.

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Section: Hiv Aids and Artmentioning

confidence: 99%

Maternal mortality in Malawi, 1977–2012

Colbourn¹,

Lewycka²,

Nambiar³

et al. 2013

BMJ Open

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“…However, estimates of the global burden of congenital infections and attributable stillbirths, neonatal disease, disability or deaths due to mother-to-child transmission (MTCT) of these infections in low-income countries (LIC) are limited on account of a generalized scarcity of data[ 5 ]. Despite the positive impact in terms of health outcomes shown by the introduction of screening and treatment policies for several pregnancy-relevant infections such as human immunodeficiency virus (HIV), syphilis or malaria[ 6 , 7 ]; pathogens that may also be vertically transmitted beyond these infections are rarely the focus of clinical practice and research[ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Congenital cytomegalovirus, parvovirus and enterovirus infection in Mozambican newborns at birth: A cross-sectional survey

et al. 2018

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BackgroundCongenital cytomegalovirus (cCMV) infection is the most prevalent congenital infection acquired worldwide, with higher incidence in developing countries and among HIV-exposed children. Less is known regarding vertical transmission of parvovirus B19 (B19V) and enterovirus (EV). We aimed to assess the prevalence of CMV, B19V and EV vertical transmission and compare results of screening of congenital CMV obtained from two different specimens in a semirural Mozambican maternity.MethodsA cross sectional study was conducted among pregnant mothers attending Manhiça District Hospital upon delivery. Information on maternal risk factors was ascertained. Dried umbilical cord (DUC) samples were collected in filter paper for CMV, B19V and EV detection by real-time polymerase chain reaction (RT-PCR), and nasopharyngeal aspirates (NPA) to test for CMV by RT-PCR. Maternal blood samples and placental biopsy samples were also obtained to investigate CMV maternal serology, HIV status and immunopathology.ResultsFrom September 2014 to January 2015, 118 mothers/newborn pairs were recruited. Prevalence of maternal HIV infection was 31.4% (37/118). CMV RT-PCR was positive in 3/115 (2.6%) of DUC samples and in 3/96 (6.3%) of NPA samples obtained from neonates. The concordance of the RT-PCR assay through DUC with their correspondent NPA sample was moderate (Kappa = 0.42 and p<0.001. No differences on cCMV prevalence were found among HIV-exposed and unexposed. All (100%) mothers were seropositive for CMV IgG. RT-PCR of EV and B19V in DUC were both negative in all screened cases. No histological specific findings were found in placental tissues. No risk factors associated to vertical transmission of these viral infections were found.ConclusionsThis study indicates the significant occurrence of vertical transmission of CMV in southern Mozambique. Larger studies are needed to evaluate the true burden, clinical relevance and consequences of congenital infections with such pathogens in resource-constrained settings.

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“…Despite pregnancy-relevant infections being an intensive field of research, their causes and possible co-infections are rarely specified on the pathogenic level in these countries. Only Plasmodium and HIV (co-) infections are often in the focus of research [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of pregnancy-relevant infections in a rural setting of Ghana

Völker

Cooper²,

Bader

et al. 2017

BMC Pregnancy Childbirth

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BackgroundAlthough infectious diseases still account for a high burden of morbidity and mortality in sub-Saharan Africa, simultaneous investigations on multiple infections affecting maternal and child health are missing.MethodsWe conducted a cross-sectional, single-centre pilot study in a rural area of Ghana to assess the infectiological profile during pregnancy. Screening of 180 expectant mothers was done by vaginal swabs and serology to detect the most common pregnancy-relevant infections. They were also interviewed for potential risk factors, outcome of previous pregnancies, and socio-economic aspects.ResultsWe found a high prevalence of infections caused by hepatitis B virus (16.7% HBs antigen positive). In contrast, infections caused by hepatitis C virus (1.1% anti-HCV) and HIV (0.6%) were rare. Maternal malaria was frequent (10.6%), despite increasing acceptance of intermittent preventive treatment during pregnancy (IPTp). Group B streptococci were present in 10.6% of all pregnant women. Absence of antibodies against varicella zoster virus in 43.2%, Toxoplasma gondii in 26.8%, parvovirus B19 in 20.0%, and rubella virus in 15.7% makes a significant proportion of pregnant women susceptible for acquiring primary infections. Whereas all study participants had specific IgG antibodies against human cytomegalovirus, infections with Listeria, Brucella, or Neisseria gonorrhoeae as well as active syphilis were absent.ConclusionsOur pilot study in a rural community in Ghana indicates an urgent need for action in dealing at least with high-prevalent pregnancy-relevant infections, such as hepatitis B, malaria and those caused by group B streptococci. In addition, the resulting prevalence rates of various other infections may offer guidance for health officials to prioritize possible future intervention schemes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-017-1351-3) contains supplementary material, which is available to authorized users.

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The Effect of HIV Infection on the Risk, Frequency, and Intensity of Plasmodium falciparum Parasitemia in Primigravid and Multigravid Women in Malawi

Cited by 7 publications

References 23 publications

Maternal mortality in Malawi, 1977–2012

Maternal mortality in Malawi, 1977–2012

Congenital cytomegalovirus, parvovirus and enterovirus infection in Mozambican newborns at birth: A cross-sectional survey

Prevalence of pregnancy-relevant infections in a rural setting of Ghana

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