@article{fdi:010062350,
  title = {{I}ncidence of malaria-related fever and morbidity due to {P}lasmodium falciparum among {HIV}1-infected pregnant women : a prospective cohort study in {S}outh {B}enin},
  author = {{D}uvignaud, {A}. and {D}enoeud, {L}ise and {A}kakpo, {J}. and {A}gossou, {K}. {V}. and {A}fangnihoun, {A}. and {K}omongui, {D}. {G}. and {A}tadokpede, {F}. and {D}ossou-{G}bete, {L}. and {G}irard, {P}. {M}. and {Z}annou, {D}. {M}. and {C}ot, {M}ichel},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {M}alaria and {HIV} are two major causes of morbidity and mortality among pregnant women in sub-{S}aharan {A}frica. {F}oetal and neonatal outcomes of this co-infection have been extensively studied. {H}owever, little is known about maternal morbidity due to clinical malaria in pregnancy, especially malaria-related fever, in the era of generalized access to antiretroviral therapy and anti-malarial preventive strategies. {M}ethods: {A} cohort study was conducted in order to estimate the incidence rate and to determine the factors associated with malaria-related fever, as well as the maternal morbidity attributable to malaria in a high-transmission setting of {S}outh {B}enin among {HIV}-infected pregnant women. {F}our-hundred and thirty-two women who participated in a randomized trial testing strategies to prevent malaria in pregnancy were included and followed until delivery, with at least three scheduled visits during pregnancy. {C}onfirmed malaria-related fever was defined as axillary temperature >37.5 degrees {C} and a concomitant, positive, thick blood smear or rapid diagnostic test for {P}lasmodium falciparum. {S}uspected malaria-related fever was defined as an axillary temperature >37.5 degrees {C} and the concomitant administration of an anti-malarial treatment in the absence of parasitological investigation. {R}esults: {I}ncidence rate for confirmed malaria-related fever was of 127.9 per 1,000 person-year ({PY}) (95% confidence interval ({CI}): 77.4-211.2). {I}n multivariate analysis, {CD}4 lymphocytes ({R}elative {R}isk ({RR}) for a 50 cells/mm(3) variation = 0.82; {CI}: 0.71-0.96), antiretroviral treatment started before inclusion ({RR} = 0.34; {CI}: 0.12-0.98) and history of symptomatic malaria in early pregnancy ({RR} = 7.10; {CI}: 2.35-22.49) were associated with the incidence of confirmed or suspected malaria-related fever. {M}ore than a half of participants with parasitaemia were symptomatic, with fever being the most common symptom. {T}he crude fraction of febrile episodes attributable to malaria was estimated at 91%. {C}onclusions: {T}his work highlights that malaria is responsible for a substantial morbidity in {HIV}-infected pregnant women, with cellular immunodepression as a major determinant, and establishes the possible advantage offered by the early initiation of antiretroviral treatment.},
  keywords = {{M}alaria ; {P}regnancy ; {HIV} ; {F}ever ; {I}ncidence rate ; {A}ttributable fraction ; {M}orbidity ; {BENIN}},
  booktitle = {},
  journal = {{M}alaria {J}ournal},
  volume = {13},
  numero = {},
  pages = {art. 255},
  ISSN = {1475-2875},
  year = {2014},
  DOI = {10.1186/1475-2875-13-255},
  URL = {https://www.documentation.ird.fr/hor/fdi:010062350},
}