Burden of Malaria in Pregnancy in India

描述（由申请人提供）：疟疾是对孕妇及其未出生婴儿健康的最严重威胁之一。妊娠期疟疾（MIP）与胎儿死亡、早产、宫内生长迟缓（IUGR）、低出生体重（LBW）和孕产妇贫血的风险增加有关。近年来，疟疾再次成为印度的一个公共卫生问题，印度国家疟疾控制方案每年报告的记录病例为150万至200万，尽管这些数字可能大大低估了疾病的真实负担。由于缺乏关于怀孕期间疟疾相关发病率和疟疾对分娩结果影响的详细信息，印度制定和实施有效的预防和控制疟疾感染政策的工作受到了阻碍。为了解决这些问题，我们提议在印度恰蒂斯加尔邦的两个地区进行一项研究，其中一个地区疟疾传播稳定，另一个地区传播不稳定。我们的目标是确定MIP对孕产妇贫血、分娩结局（低体重、IUGR和死产）的影响，以及恶性疟原虫和间日疟原虫疟疾相关发病率的相对贡献。此外，我们将评估目前MIP干预措施的可用性，如氯喹预防和经杀虫剂处理的蚊帐，以及影响此类干预措施利用的患者/诊所层面因素。该项目将由波士顿大学国际卫生与发展中心、印度贾布巴尔国家疟疾研究中心和亚特兰大疾病控制与预防中心疟疾处的科学家共同努力。该项目将有助于加强这些机构之间的合作关系，同时提高印度研究人员设计、实施和分析应用研究数据的能力。该研究产生的信息也将有助于制定新的方案，以预防和减轻印度MIP的影响。

DESCRIPTION (provided by applicant): Malaria is one of the gravest threats to the health of pregnant women and their unborn babies. Malaria in pregnancy (MIP) is associated with an increased risk of fetal death, prematurity, intrauterine growth retardation (IUGR), low birth weight (LBW), and maternal anemia. In recent years, malaria has reemerged as a public health problem in India, with 1.5-2 million documented cases reported annually by India's National Malaria Control Programme, though these figures probably substantially underestimate the true burden of disease. The development and implementation of effective policies for the prevention and control of MIP in India has been hampered by a lack of detailed information on malaria-associated morbidity during pregnancy and the impact of malaria on birth outcomes. To address these issues, we are proposing a study to be conducted in two districts of Chhattisgarh state, India, one with stable malaria transmission and one with unstable transmission. We aim to establish the impact of MIP on maternal anemia, birth outcomes (LBW, IUGR, and stillbirths), and the relative contributions of Plasmodium falciparum and P. vivaxto malaria-associated morbidity. In addition, we will assess the current availability of MIP interventions, such as chloroquine prophylaxis and insecticide treated bednets, and patient/clinic level factors that influence the utilization of such interventions. This project will be a collaborative effort between scientists at Boston University's Center for International Health and Development, the National Malaria Research Center in Jabalbur, India, and the Malaria Branch of the Centers for Disease Control and Prevention in Atlanta. This project will serve to strenghten the collaborative relationship of these institutions while enhancing the capacity of Indian researchers to design, implement, and analyze data from applied research studies. The information generated by the study will also be instrumental in the development of new programs for preventing and mitigating the impact of MIP in India.