Abstract：
Background Malaria in pregnancy (MIP) is a major public health problem due to the vulnerability of pregnant women to infections, resulting in adverse maternal/foetal outcomes in endemic areas. Methods We did a field-based study to assess the burden of MIP (prevalence at the time of enrolment and follow-up) and to identify risk factors for MIP in the Birsa and Baihar blocks of district Balaghat in Madhya Pradesh, which have perennial malaria transmission. Malaria screening (during 2015-2017) was done by microscopy and bivalent rapid diagnostic test (SD Bioline RDT, malaria antigen Plasmodium falciparum/Plasmodium vivax Pf/Pv). Dried blood spots were used for haemoglobin estimation. Sociodemographic details with past and present pregnancy status were obtained. A subset of pregnant women were followed up for malaria during pregnancy. Women were also screened for malaria post delivery. Malaria treatment was given as per the National Guidelines of 2013. Multivariate analysis was done to assess independent risk factors for malaria. Results A total of 1728 pregnant women were screened, of which 1651 were included in the final analysis. Malaria prevalence at first screening was 23.4% (Pf 88%). Prevalence and Pf parasitaemia both were significantly higher among primigravid (G1) compared to multigravid (G>2; p value 0.012 and 0.019, respectively). Pregnant women of the Baiga ethnic group were more likely to have malaria compared to those belonging to the Gond group (OR [95% CI]; 2.4 [1.7-3.4]; p<0.00001) and non-indigenous group (OR [95% CI]; 8.3 [3.9-19.7]; p<0.00001). Primigravid status of women, first and second trimester of pregnancy, women belonging to indigenous ethnic tribal group and cash crop insufficiency for whole year (a socioeconomic indicator) in the family were the independent risk factors for malaria. Conclusion MIP is a major public health problem in forested tribal settlements of Birsa and Baihar blocks of Balaghat district in Madhya Pradesh and requires immediate intervention.
摘要：
背景由于孕妇容易受到感染，妊娠期疟疾（MIP）是一个主要的公共卫生问题。导致流行地区的不良孕产妇/胎儿结局。方法我们进行了一项基于现场的研究，以评估MIP的负担（注册和随访时的患病率），并确定中央邦Balaghat区Birsa和Baihar街区的MIP风险因素，有多年生的疟疾传播。疟疾筛查（2015-2017年）通过显微镜和二价快速诊断测试（SDBiolineRDT，疟疾抗原恶性疟原虫/间日疟原虫Pf/Pv）。干燥的血斑用于血红蛋白估计。获得了过去和现在怀孕状态的社会人口统计学细节。部分孕妇在怀孕期间接受了疟疾随访。分娩后还对妇女进行了疟疾筛查。疟疾治疗按照2013年国家指南进行。多因素分析评估疟疾的独立危险因素。结果共筛查1728例孕妇,其中1651年被列入最终分析。首次筛查时的疟疾患病率为23.4％（Pf88％）。初孕（G1）的患病率和Pf寄生虫血症均显着高于多次妊娠（G>2；p值分别为0.012和0.019）。与Gond组(OR[95%CI];2.4[1.7-3.4];p<0.00001)和非土著组(OR[95%CI];8.3[3.9-19.7];p<0.00001)相比，Baiga族孕妇患疟疾的可能性更高。妇女的原始地位，怀孕的第一和第二三个月，属于土著民族部落群体的妇女和家庭中全年经济作物不足(社会经济指标)是疟疾的独立危险因素。结论MIP是中央邦Balaghat区Birsa和Baihar街区森林部落定居点的主要公共卫生问题，需要立即干预。
