PLoS ONE (Jan 2012)

Effect of early detection and treatment on malaria related maternal mortality on the north-western border of Thailand 1986-2010.

  • Rose McGready,
  • Machteld Boel,
  • Marcus J Rijken,
  • Elizabeth A Ashley,
  • Thein Cho,
  • Oh Moo,
  • Moo Koh Paw,
  • Mupawjay Pimanpanarak,
  • Lily Hkirijareon,
  • Verena I Carrara,
  • Khin Maung Lwin,
  • Aung Pyae Phyo,
  • Claudia Turner,
  • Cindy S Chu,
  • Michele van Vugt,
  • Richard N Price,
  • Christine Luxemburger,
  • Feiko O ter Kuile,
  • Saw Oo Tan,
  • Stephane Proux,
  • Pratap Singhasivanon,
  • Nicholas J White,
  • François H Nosten

DOI
https://doi.org/10.1371/journal.pone.0040244
Journal volume & issue
Vol. 7, no. 7
p. e40244

Abstract

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IntroductionMaternal mortality is high in developing countries, but there are few data in high-risk groups such as migrants and refugees in malaria-endemic areas. Trends in maternal mortality were followed over 25 years in antenatal clinics prospectively established in an area with low seasonal transmission on the north-western border of Thailand.Methods and findingsAll medical records from women who attended the Shoklo Malaria Research Unit antenatal clinics from 12(th) May 1986 to 31(st) December 2010 were reviewed, and maternal death records were analyzed for causality. There were 71 pregnancy-related deaths recorded amongst 50,981 women who attended antenatal care at least once. Three were suicide and excluded from the analysis as incidental deaths. The estimated maternal mortality ratio (MMR) overall was 184 (95%CI 150-230) per 100,000 live births. In camps for displaced persons there has been a six-fold decline in the MMR from 499 (95%CI 200-780) in 1986-90 to 79 (40-170) in 2006-10, pConclusionsFrequent antenatal clinic screening allows early detection and treatment of falciparum malaria and substantially reduces maternal mortality from P. falciparum malaria. No significant decline has been observed in deaths from sepsis or other causes in refugee and migrant women on the Thai-Myanmar border.