Prevalence of Plasmodium Falciparum Malaria and the Antenatal Health Care Utilization for Prevention Among Pregnant Women in a Secondary Health Facility in Enugu State, Nigeria

Abstract

Pregnant women in endemic areas are highly susceptible to malaria, and both the frequency and severity of the disease are higher in pregnant women than non- pregnant women.[1] In pregnancy, there is a transient depression of cell mediated immunity that allows foetal allograft retention but also interferes with resistance to various infectious diseases. Malaria infection during pregnancy is a major public health problem in the tropics and subtropics. It affects approximately 24 million pregnant women.[2] In the area of Africa with stable malaria transmission, plasmodium falciparum infection during pregnancy is estimated to cause as many as 10,000 maternal death each year, 8-14% of all low birth weight babies and 75,000-200,000 of all infant death.[3] In Nigeria, there is an estimated 25-30% of mortality in children under the age of five and 300,000 death each year due to malaria.[3] Studies have shown that 40% of pregnant African women start attending antenatal clinics in the first and second trimester of their pregnancy. [3] In addition, pregnant women are at immense risk of malaria due to natural immune depression in pregnancy. [4] The symptoms and complications of malaria during pregnancy differ with the intensity of malaria transmission and thus with the level of immunity the pregnant woman acquired. [5] Malaria cases and death have been increasing in the country mainly due to injudicious use of anti-malaria drugs, delayed health seeking and reliance on clinical judgment without laboratory confirmation in most of the peripheral health facilities. [6] There have been considerable numbers of reports about knowledge, attitude and practices relating to malaria and its control from different parts of Africa. Misconceptions concerning malaria still exist and the practices for the control of malaria have been unsatisfactory. [7] The promising news is that during the past decade, potentially more effective strategies for control of malaria in pregnancy have been developed and demonstrated to have a remarkable impact on improving the health of mothers and their new born. However, less than 5% of pregnant women have access to effective plasmodium specie prevention during pregnancy. [8] Malaria in pregnancy increases the chances of maternal anemia, miscarriages, stillbirths, low birth weight, abortion, growth retardation and death. It therefore becomes pertinent to study the prevalence of Plasmodium falciparum malaria among pregnant women attending antenatal clinic in Bishop Shanahan Hospital Nsukka as well as to ascertain their use of some of the antenatal health care services for prevention during pregnancy.