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In Kenya, 275 women were studied in an antenatal clinic (Shulman et al. 1996). It was found that Plasmodium falciparum malaria was strongly associated with moderate and severe anemia (P<0.003) in primigravidae. In multigravidae, iron deficiency and hookworm infection were the dominant risk factors. In another study of 912 women conducted by the same author (Shulman et al. 2001), 14% were severely anemic (Hb < 7g/dL) prior to delivery. Severe anemia was associated with HIV infection (P = 0.01) and malaria was more common in HIV-positive women.