{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T23:43:47Z","timestamp":1782949427205,"version":"3.54.5"},"reference-count":57,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"University of North Carolina at Chapel Hill, Gillings School of Public Health"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Infection"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Malaria during pregnancy contributes to significant perinatal morbidity and mortality, accounting for almost 25% of global maternal mortality. However, the epidemiology and risk factors for subclinical malaria among pregnant women living in refugee settlements is poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To determine the prevalence and predictors of subclinical malaria among pregnant women in refugee settlements in Northern Uganda.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>We conducted a multi-center, cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The study was conducted between April and June 2023 and involved pregnant women aged 18\u201345\u2009years attending routine antenatal care (ANC) at three health facilities serving refugee communities in Adjumani district, Uganda. We collected sociodemographic, environmental, maternal, and obstetric factors using a structured questionnaire. Both CareStart Malaria HRP-2\/pLDH (Pf\/Pan) combo rapid diagnostic test (RDT) and blood smear microscopy with 3% Giemsa staining were simultaneously performed on samples from each patient. Logistic regression analysis identified factors independently associated with subclinical malaria, reported as adjusted odds ratios (aORs) and 95% confidence intervals (CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We enrolled 304 pregnant women, with a mean age of 25\u2009years. In total, 68.8% ( n\u2009=\u2009209) had lived in the settlement for over 12\u2009months, 25.7% ( n\u2009=\u200978) were primigravida, and 1.0% ( n\u2009=\u20093) were living with HIV. Malaria prevalence was 5.3% ( n\u2009=\u200916) by RDT and 3.2% ( n\u2009=\u200910; seven Plasmodium falciparum and three P. malariae) by microscopy. Only 4 (25.0%) of the RDT-positive cases were also positive by microscopy (Cohen\u2019s kappa: 0.278\u2014Fair agreement). All participants were asymptomatic. Factors associated with higher odds of subclinical malaria included primiparity (aOR: 2.79, 95% CI: 1.25\u20136.25, p\u2009=\u20090.013), \u2a7e4 ANC visits (aOR: 2.41, 95% CI: 1.34\u20134.34, p\u2009=\u20090.003), and residence in the settlement for less than 12\u2009months (aOR: 2.54, 95% CI: 2.0\u20133.22, p\u2009&lt;\u20090.001). Living in the settlement for over 3\u2009years, being primigravida, and being married were associated with 68%, 50%, and 68% lower odds of subclinical malaria, respectively (aOR: 0.32, 95% CI: 0.13\u20130.79, p\u2009=\u20090.014; aOR: 0.50, 95% CI: 1.22\u20135.52, p\u2009=\u20090.016; aOR: 0.32, 95% CI: 0.13\u20130.78, p\u2009=\u20090.012).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our study reveals the high prevalence of subclinical malaria among pregnant women in refugee settlements, particularly among primiparous women and recent arrivals. The poor agreement between RDT and microscopy suggests the need for dual screening in asymptomatic pregnant women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20499361241296002","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T08:12:36Z","timestamp":1730880756000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Subclinical malaria among pregnant women living in refugee settlements in Northern Uganda"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8837-1954","authenticated-orcid":false,"given":"Winnie","family":"Kibone","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, P. O. Box 166, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4515-8517","authenticated-orcid":false,"given":"Felix","family":"Bongomin","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Lebu","sequence":"additional","affiliation":[{"name":"Department of Environmental Sciences and Engineering, Gillings School of Public Health, University of North Carolina at Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Ochaya","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritah","family":"Nantale","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Busitema University, Mbale, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerom","family":"Okot","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byron","family":"Awekonimungu","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Beardsley","sequence":"additional","affiliation":[{"name":"Department of Environmental Sciences and Engineering, Gillings School of Public Health, University of North Carolina at Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chimdi","family":"Muoghalu","sequence":"additional","affiliation":[{"name":"Department of Environmental Sciences and Engineering, Gillings School of Public Health, University of North Carolina at Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musa","family":"Manga","sequence":"additional","affiliation":[{"name":"Department of Environmental Sciences and Engineering, the University of North Carolina at Chapel Hill, 0300 Michael Hooker Research Center, 135 Dauer Drive, Campus Box # 7431, Chapel Hill, NC 27599, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,11,6]]},"reference":[{"key":"bibr1-20499361241296002","doi-asserted-by":"crossref","first-page":"1229735","DOI":"10.3389\/fitd.2023.1229735","volume":"4","author":"Berhe AD","year":"2023","journal-title":"Front Tropical Dis"},{"issue":"3","key":"bibr2-20499361241296002","doi-asserted-by":"crossref","DOI":"10.1093\/cid\/ciac417","volume":"76","author":"Hauser M","year":"2023","journal-title":"Clin Infect Dis"},{"key":"bibr3-20499361241296002","volume-title":"World malaria report 2023","author":"World Health Organization","year":"2023"},{"key":"bibr4-20499361241296002","volume-title":"Monthly malaria surveillance status report - 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