Maternal and child health in Papua-Indonesia : the epidemiology of malaria and strategies for its treatment and prevention

TL;DRAbstract

\n \t\t\tMultidrug resistant P. falciparum and P. vivax infections are associated with high morbidity and mortality in Timika, Papua (Indonesia). This thesis sets out to define the burden of malaria in pregnant women and infants and determine the impact of better treatment protocols in reducing these. We established a systematic surveillance system at a local hospital. From April 2004 to June 2009, clinical and laboratory data on more than 6000 pregnant women and 1500 infants attending the hospital were collected. We found that pregnant women and infants in this region are affected by the adverse outcomes of malaria, including those with P. vivax infections. Maternal peripheral parasitaemia at delivery is associated with maternal severe anaemia (OR=1.9), low birth weight babies (OR=1.9), preterm delivery (OR=1.5), stillbirths (OR=2.3) and congenital malaria (OR=4.5). The risk of malaria starts at birth and it is often without symptoms. The majority of symptomatic malaria in the first 6

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