Abstract
BackgroundIncidence of malaria and anaemia are of public health importance especially in pregnant women in endemic regions, due to the negative health consequences to the mother and fetus. This study aimed to assess the pattern of falciparum malaria infection and anaemia, based on malaria prevention methods practiced by participants.MethodsA semi-structured tool was used to capture information on demographic, socio-economic and malaria prevention practices from 113 pregnant women attending antenatal clinics in 2 peri-urban health facilities in Lagos, southwest Nigeria. Malaria microscopy was conducted and haematocrit was measured. Logistic regression analysis was performed on the data collated from the survey.ResultsThe prevalence of anaemia among pregnant women was 87.2%. The mean (± sd) packed cell volume (PCV) (%) of the 22 (19.5%) infected subjects (26.8 ± 6.6), was significantly lower (t = −2.60, P value = 0.007) than that of the 91 (80.5%) uninfected subjects (30.8 ± 6.0). The prevalence of infection was highest in the 3rd trimester (n = 40, 35.4%) at 27.5% (11/40) and among those in their first pregnancy (n = 32, 28.3%) at 25.0% (8/32). There was a significant difference (t = −2.23, P-value = 0.01) in the mean PCV % of pregnant women who consumed herbal teas in pregnancy (28.2 ± 5.2) compared to those who did not (30.8 ± 6.6). Regression analysis showed that first pregnancy, anti-malarial use and insecticide-treated nets use the night before study had increased odds of malaria infection in participants (OR = 1.35, P = 0.006, 95% CI 0.52−2.49; OR = 2.3, P = 0.005, 95% CI 0.14−0.41; OR = 1.92, P = 0.001, 95% CI 0.62−5.98) while intermittent preventive treatment (IPT) participation and formal education were strongly and significantly associated with lower risk of parasitaemia (OR = 0.95, P = 0.025, 95% CI 0.41−2.26; OR = 0.44, P = 0.005, 95% CI 0.34−10.50).ConclusionInterventions that will reduce malaria and moderate to severe anaemia, especially in a first pregnancy, should include education on the correct use of long-lasting insecticide-treated bed nets (LLIN), IPT and the dangers of herbal teas in pregnancy.
Highlights
Incidence of malaria and anaemia are of public health importance especially in pregnant women in endemic regions, due to the negative health consequences to the mother and fetus
32 (28.3%), 32 (28.3%) and 49 (34.4) were primigravida, secundigravida and multigravida, respectively, while 19 (16.8%), 54 (47.8%) and 40 (35.4%) were in their first, second and third trimester, respectively. Those that had moderate to severe anaemia were 80 (70.8%) contrasting with 33 (29.2%) that presented with no or mild anaemia
A total of 19 (86.4%) of those infected with falciparum malaria parasites (FMP) had moderate to severe anaemia
Summary
Incidence of malaria and anaemia are of public health importance especially in pregnant women in endemic regions, due to the negative health consequences to the mother and fetus. In areas of stable transmission, it is estimated that malaria during pregnancy causes up to 10,000 maternal deaths each year, mainly as a result of severe anaemia, and accounts for approximately 8–14% of low birth weight (LBW), and 3–8% of infant mortality [3]. Infectious diseases, including malaria, iron and other micronutrient deficiencies, are contributing factors to this pervasive global situation of anaemia, the commonest medical condition in pregnancy which has a global prevalence of 41.8% and rises to as high as 75% in The Gambia [4]. Mechanisms of anaemia causing malaria include lysis of infected and uninfected red blood cells (RBCs), splenic sequestration of RBCs, dyserythropoietic, and bone marrow suppression [7]
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