Sickle cell trait, malaria and anaemia in pregnant Zambian women.

In a sample of 424 pregnant Zambian women a series of tests was carried out: sickle cell test, haemoglobin estimation and screening of a thick blood smear for malarial parasites. More anaemia was found in the primigravidae than in the multigravidae. The haemoglobin level was found to be lower with primigravidity and, independently of this gravidity effect, also with malaria. Taking into account the higher malaria frequency in primigravidae, this group must be considered as a high risk group for development of anaemia. There was no significant interaction between sickle cell trait, anaemia and malaria. In addition to the tests during pregnancy, the placentae and umbilical cords of 155 women were screened for malaria as were the mothers just before delivery. More malaria parasites were detected in the placentae of the primiparous than in those of multiparous women. Peripheral parasitaemia was strikingly less prevalent than infestation of the placenta.