Patterns of treatment of reported malaria cases during pregnancy in a Nigerian hospital

Abstract

Prompt and effective case management is one of the control measures for malaria during pregnancy. The objective of the study was to assess treatment patterns of presumed cases of malaria during pregnancy in a Nigerian tertiary health care facility. A cross-sectional study involving immediate postpartum women admitted to the maternity wards of the University of Benin Teaching Hospital was undertaken. History of occurrence and treatment practices of presumed malaria during the immediate past pregnancy were obtained from the women's medical case files and by interview, using a pre-developed data collection form. Two hundred and ninety-seven of the 428 study participants (69.4%) reported a total number of 544 cases of malaria in pregnancy (MiP). More than 85% (n = 469/544) of the reported MiP cases occurred after the first trimester, while 55.5% (302/544) occurred during the second trimester. Among the reported MiP cases, parasite-based diagnosis was done for only 8.6% (n = 47). The use of antimalarial medications was reported in the treatment of 86.6% of the total number of cases. Antimalarial medication was used across the 3 trimesters, including artemisinin-based combination therapy (49.6%), artemisinin monotherapy (15.2%), and other monotherapies, such as sulfadoxine-pyrimethamine, chloroquine, amodiaquine (33.3%), and oral quinine (2%). Sulfadoxine-pyrimethamine and artemisinin derivatives were used in the treatment of 38.8% and 34.7% of first trimester malaria cases, respectively. Parasite-based diagnosis prior to treatment was poorly practiced, and inappropriate antimalarial drug management of MiP was observed. Addressing these observed deficiencies is necessary in order to achieve success in the fight against malaria during pregnancy in Nigeria.