Hamer, Davidson H.Singh, Mrigendra P.Wylie, Blair J.Yeboah-Antwi, KojoTuchman, JordanDesai, MeghnaUdhayakumar, VenkatachalamGupta, PritiBrooks, Mohamad I.Shukla, Manmohan M.Awasthy, KiranSabin, LoraMacLeod, William B.Dash, Aditya P.Singh, Neeru2012-01-092012-01-0920092009-9-3Hamer, Davidson H, Mrigendra P Singh, Blair J Wylie, Kojo Yeboah-Antwi, Jordan Tuchman, Meghna Desai, Venkatachalam Udhayakumar, Priti Gupta, Mohamad I Brooks, Manmohan M Shukla, Kiran Awasthy, Lora Sabin, William B MacLeod, Aditya P Dash, Neeru Singh. "Burden of malaria in pregnancy in Jharkhand State, India" Malaria Journal 8:210. (2009)1475-2875https://hdl.handle.net/2144/2948BACKGROUND. Past studies in India included only symptomatic pregnant women and thus may have overestimated the proportion of women with malaria. Given the large population at risk, a cross sectional study was conducted in order to better define the burden of malaria in pregnancy in Jharkhand, a malaria-endemic state in central-east India. METHODS Cross-sectional surveys at antenatal clinics and delivery units were performed over a 12-month period at two district hospitals in urban and semi-urban areas, and a rural mission hospital. Malaria was diagnosed by Giemsa-stained blood smear and/or rapid diagnostic test using peripheral or placental blood. RESULTS 2,386 pregnant women were enrolled at the antenatal clinics and 718 at the delivery units. 1.8% (43/2382) of the antenatal clinic cohort had a positive diagnostic test for malaria (53.5% Plasmodium falciparum, 37.2% Plasmodium vivax, and 9.3% mixed infections). Peripheral parasitaemia was more common in pregnant women attending antenatal clinics in rural sites (adjusted relative risk [aRR] 4.31, 95%CI 1.84-10.11) and in those who were younger than 20 years (aRR 2.68, 95%CI 1.03-6.98). Among delivery unit participants, 1.7% (12/717) had peripheral parasitaemia and 2.4% (17/712) had placental parasitaemia. Women attending delivery units were more likely to be parasitaemic if they were in their first or second pregnancy (aRR 3.17, 95%CI 1.32-7.61), had fever in the last week (aRR 5.34, 95%CI 2.89-9.90), or had rural residence (aRR 3.10, 95%CI 1.66-5.79). Malaria control measures including indoor residual spraying (IRS) and untreated bed nets were common, whereas insecticide-treated bed nets (ITN) and malaria chemoprophylaxis were rarely used. CONCLUSION The prevalence of malaria among pregnant women was relatively low. However, given the large at-risk population in this malaria-endemic region of India, there is a need to enhance ITN availability and use for prevention of malaria in pregnancy, and to improve case management of symptomatic pregnant women.enCopyright 2009 Hamer et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.http://creativecommons.org/licenses/by/2.0Article10.1186/1475-2875-8-210197288822744702