English

Abstract

Malaria in pregnancy is a significant contributor to adverse pregnancy outcome. In low resource setting of India to contain malaria in the vast chloroquine resistant endemic zone LLIN (Long lasting insecticide treated Nets) has been introduced as an intervention to prevent malarial morbidity and mortality in the population among anemic pregnant women in malarias zone is quite high, oral ferrous ascorbate has an edge over commonly available ferrous sulfate to rectify Anemia with least side effect in those pregnant women. INTRODUCTION: Malaria in pregnancy is an important public health problem that affects 25 million pregnant women in endemic zones of world and contributes heavily on maternal and infant morbidity and mortality. Acquired immunity in endemic zones is compromised in pregnant state. Maternal Anemia (70%) still birth, premature birth and LBW are adverse outcome in pregnant women in endemic zones of Malaria, especially in chloroquine resistant areas. Although in 2004 WHO recommended prophylactic two doses of sulfadoxine pyrimethamine (Ref-5) in 2nd trimester of pregnancy in endemic zones, sub optimal drug adherence and increasing sulfadoxine pyrimethamine resistance has stood as an obstacle for Malaria containment. Now effect of long lasting insecticide net (LLIN) insecticide treated net (ITN) is being promoted through UNICEF and Govt. in endemic zones resistant to chloroquine chemoprophylaxis. Here is a camp based study in one heavily affected Malarias zone of Odisha on effect of LLIN in pregnant women and effect of Oral ferrous Ascorbate in improving the anaemic status of pregnant women in malarious zone. MATERIALS & METHODS: Ramagiri PHC was selected for study as it comes under Intensive Falciparum zone of Koraput district, API-32 in 2012. A pre-camp advertisement in the area was performed. A three member doctor team along with four paramedical assistants, one lab technician and two Divine Life Society volunteers were employed for the camp and 100 nos. of Antenatal cases were registered out of which only 50 cases were randomly studied whose socio economic status was noted to be poor. Antenatal check up Height of Uterus, Abdominal girth/ Wt, BP, HB, urine ALB, splenic examination and Cervical smear and peripheral blood smear were studied. In all cases MP was studied by thick blood sample. Hemoglobin was instantly estimated by hemocue instrument (HB301) after finger prick. Only 10 cases gave their consent for vaginal cytology inspite of maintenance of privacy in presence of a female attendant. Ferrous sulfate 45 tab and Ferrous Ascorbate (Elferri xt supplied by Svizera Health Care - Constituent Per tab Ferrous Ascorbate 100 mg, Folic Acid-1.5 mg, Zinc -22.5 mg ) 45 tabs were given on alternate making them Group 'A' and Group 'B' respectively. HB was reestimated after 45 days in both groups by same