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Peer reviewedOpen accessMalaria

Hidden burden of malaria in pregnancy in hard-to-reach areas of Odisha, India: challenges to elimination and the case for integrating molecular surveillance

Frontiers in Public Health·

Sonali Sandeepta, Ramakanta Rana, Jyoti Ghosal, Arundhuti Das, Debarpita Mohanty, Biswadeep Das, Manoranjan Ranjit, Shubhashisha Mohanty, Debakanta Sandhibigraha, Sanghamitra Pati, Madhusmita Bal

DOI
10.3389/fpubh.2026.1862569
PMID
PMCID
OpenAlex
W7203678509
Study type
Cross-sectional study
Publisher
Frontiers Media SA
Article type
journal-article
Integrity
current

Why this research matters now

Undetected parasitic carriage among expectant mothers complicates regional disease eradication initiatives. Integrating advanced diagnostic capabilities into routine antenatal monitoring could improve intervention targeting and support national health objectives.

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Structured evidence summary

Research question

What characterizes the prevalence and distribution of parasitic infections among expectant mothers in remote Indian districts, and which demographic or environmental variables correlate with these outcomes?

Study design

Researchers implemented repeated cross-sectional community assessments across multiple years. Diagnostic protocols combined rapid antigen screening, microscopic evaluation, and genetic amplification techniques. Multivariable modeling evaluated correlations between infection status and participant characteristics.

Population and setting

The sample comprised 861 expectant mothers residing in underserved, endemic districts of Odisha, India. Data collection occurred during three distinct survey periods spanning recent years.

Main findings

Overall parasitic carriage reached thirty-three percent, displaying notable variation across survey years. Most confirmed cases presented without clinical symptoms, and a large majority harbored low-density infections requiring genetic detection. Seasonal transmission peaks strongly correlated with infection likelihood, while vector control measures showed inverse associations, and diagnosed infections did not independently predict reduced hemoglobin levels after statistical adjustment.

Public-health relevance

Undetected parasitic carriage among expectant mothers complicates regional disease eradication initiatives. Integrating advanced diagnostic capabilities into routine antenatal monitoring could improve intervention targeting and support national health objectives.

Important limitations

The cross-sectional methodology restricts the ability to determine temporal sequences between exposures and outcomes. Community-based sampling may not fully represent populations with limited geographic mobility or healthcare engagement.

GIDS interpretation

This report outlines localized parasitic carriage patterns and diagnostic gaps within a defined geographic area. The documented metrics establish historical context for regional transmission ecology and surveillance infrastructure without validating current operational signals.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 9 auditable classifier relationships to diseases, places, topics, and study design.

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