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Detecting temporal and spatial malaria patterns from first antenatal care visits.

Publicat a: - 2023-02-20 (), DOI: 10.21203/rs.3.rs-2592126/v1

Autors: Pujol A; Brokhattingen N; Matambisso G; Mbeve H; Cisteró P; Escoda A; Maculuve S; Cuna B; Melembe C; Ndimande N; Munguambe H; Lopez JM; Nhamussa L; Simone W; Tetteh K; Drakeley C; Gamain B; Chitnis C; Chauhan VS; Quintó L; Chidimatembue A; Soler HM; Galatas B; Guinovart C; Saute F; Aide P; Macete E; Mayor A

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Pregnant women attending first antenatal care (ANC) visits represent a promising malaria surveillance target in Sub-Saharan Africa. Here we assessed the spatio-temporal relationship between malaria at ANC (n=6,471), in children at the community(n=9,362) and at health facilities (n=15,467) in southern Mozambique (2016-2019). ANC P. falciparum rates detected by quantitative polymerase chain reaction mirrored rates in children, regardless of gravidity and HIV status (Pearson correlation coefficient [PCC]>0.8, χ²<1.1), with a 2-3 months lag. Only at rapid diagnostic test detection limits at moderate-to-high transmission, multigravidae showed lower rates than children (PCC=0.61, 95%CI[-0.12-0.94]). Seroprevalence against the pregnancy-specific antigen VAR2CSA reflected declining malaria trends (PCC=0.74, 95%CI[0.24-0.77]). 80% (12/15) of hotspots detected from health facility data using a novel hotspot detector, EpiFRIenDs, were also identified with ANC data. The results show that ANC-based malaria surveillance offers contemporary information on temporal trends and the geographic distribution of malaria burden in the community.

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