Prevalence, predictors and adverse perinatal outcomes of placental malaria in sub-Saharan Africa: a systematic review and meta-analysis
Bibliographic record
Abstract
BACKGROUND: Placental malaria (PM) is among the leading public health problems associated with adverse outcomes for the mother, the foetus, and the newborn, particularly in sub-Saharan Africa (SSA). Although there are many studies published on PM in SSA, comprehensive evidence for targeted interventions is limited. Thus, this study aimed to synthesize evidence on the prevalence, predictors, and adverse perinatal outcomes of PM in SSA. METHODS: Pertinent studies online searching, selection, data extraction, and quality assessment were conducted. Data were extracted using Microsoft Excel and analyzed by STATA Version 17.0. Pooled estimates were determined by random-effect meta-analyses. Sub-group analysis was conducted to account for sources of heterogeneity. RESULTS: Overall, 178 observational studies published from 2000 to 2024 involving 93,809 parturient women from 23 countries were included. The overall pooled prevalence of PM in SSA was 25.1% (95% CI: 22.0-28.3), which was 16.9% (95% CI: 12.3-21.6), 19.1% (95% CI: 17.4-20.9), 24.8% (95% CI: 20.9-28.8), and 34.8% (95% CI: 29.3-40.2) by RDT, microscopy, PCR, and histopathology, respectively. Predictors of PM were: younger age (OR = 2.50 95% CI: 1.89-3.12), primigravidae (OR = 2.65 95% CI: 2.12-3.18), primiparae (OR = 1.62 95% CI: 1.23-2.01), not using insecticide-treated nets (OR = 2.11 95% CI: 1.34-2.89), not using ANC (OR = 7.43 95% CI: 2.47-12.40), not using intermittent preventive treatment during pregnancy (OR = 1.98 95% CI: 1.42-2.54), MiP history (OR = 3.05 95% CI: 1.85-4.25), HIV infection (OR = 2.67 95% CI: 1.22-4.62), and delivering during rainy season (OR = 2.24 95% CI: 1.05-4.07). The pooled prevalence of gestational malaria and congenital malaria was 22.1% (95% CI: 19.8-24.5) and 7.6% (95% CI: 6.5-8.8), respectively. The pooled prevalence of LBW, maternal anaemia, preterm delivery, small-for-gestational age, stillbirth and neonatal malaria was 12.7% (95% CI: 11.1-14.3), 39.0% (95% CI: 34.1-44.0), 11.2% (95% CI: 9.0-13.4), 17.9% (95% CI: 13.7-22.1), 3.4% (95% CI: 2.0-5.1), and 6.9% (95% CI: 3.9-9.8), respectively. PM increased the odds of maternal anaemia (OR = 2.18 95% CI: 1.73-2.63) and LBW (OR = 1.71 95% CI: 1.26-2.16). CONCLUSION: Placental malaria was a multifactorial and multifaceted significant health problem with many adverse perinatal outcomes in SSA. Concerted efforts targeting the identified predictors through multidimensional approaches are needed. The protocol of this systematic review and meta-analysis was registered on PROSPERO with the code number: CRD42024528199.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.011 | 0.002 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".