INCIDENCE OF CLINICAL MALARIA IN PREGNANT-WOMEN EXPOSED TO INTENSE PERENNIAL TRANSMISSION

The interaction between pregnancy and malaria attacks was investigated from 1990 to 1994 among women in the village of Dielmo, a holoendemic area in Senegal where malaria transmission is intense and perennial. Clinical and parasitological data collected during the daily follow-up of 48 pregnancies among 31 women were compared with those collected f rom the same women using the same methods during the year which preced ed or followed their pregnancy. The parasite prevalence, mean and maxi mum parasite density in Plasmodium falciparum infections were signific antly higher during pregnancy. The incidence rate of malaria attacks w as, on average, 4.2 times higher during pregnancy than during the cont rol period. Although most pregnancies were not associated with a malar ia attack and the incidence of malaria attacks decreased as the number of previous pregnancies increased, a significant increase in risk of malaria attacks among multigravidae was noted until the fifth pregnanc y.