Malaria and anemia in antenatal women in Blantyre, Malawi: a twelve-month survey.

Malaria and anemia are common in pregnant African women. We screened 4,764 Malawian women at first antenatal visits for malaria and anemia. A total of 42.7% had a malaria infection, which was more common and of higher density in primigravidae (prevalence = 47.3%, geometric mean = 332 parasitesl/mu l ) and teenagers (49.8%, 390/mu l) than in multigravidae (40.4%, 214/mu l) o r older women (40.6%, 227/mu l). However, 35% of gravida 3+ women were para sitemic. A total of 57.2% of the women was anemic (hemoglobin < 11 g/dl), w ith moderate anemia (7.0-8.9 g/dl) in 14.9% and severe anemia (< 7 g/dl) in 3.2%. Prevalences of malaria and anemia were highest in the rainy season. Women with moderate/severe anemia had higher parasite prevalences and densi ties than women with mild/no anemia. Logistic regression showed that age, s eason, and trimester of presentation were significantly associated with the prevalence of malaria, but gravidity was not. In this urban setting, age a nd season are more important than gravidity as predictors of malaria at fir st antenatal visit, and parasitemia is frequent in women of all gravidities .