Maternal anaemia as an indicator for monitoring malaria control in pregnancy in sub‐Saharan Africa

Design Malarial anaemia is a major problem in many developing countries and often occurs more frequently in first pregnancies, as primigravidae are more susceptible to Plasmodium falciparum malaria and are at excess risk of malarial anaemia. Objective and methods To analyse the excess risk of anaemia in primigravidae as a potential indicator of malaria control and exposure in pregnant women living in sub‐Saharan Africa. The sensitivity, specificity and predictive values for anaemia in first compared with later pregnancies are calculated for 27 studies from malarious and 7 studies from nonmalarious areas. Setting Surveys of pregnancy anaemia reported for highly malarious and nonmalarious areas. Results In malarious areas, the weighted odds ratio for excess anaemia (haemoglobin [Hb]