Malaria preventive practices and delivery outcomes :

Abstract

Globally, 125 million pregnant women are at risk of plasmodium falciparum infection each year and 30 million of these are from Sub Saharan African. Pregnant women are three times more likely to suffer from severe disease as a result of malarial infection compared with their non-pregnant counterparts. Malaria causes maternal anaemia and adversely affects birth outcome leading to low birth weight, preterm deliveries, abortions and stillbirths. Despite the availability of malaria preventive measures, the burden of malaria among pregnant women is still high. Objective: The aim of this study therefore was to determine the use of malaria preventive strategies during pregnancy and the presence of malaria infection, anemia and low birth weight babies at delivery among parturient women at Mbale regional referral hospital in eastern Uganda. Methods: A cross-sectional survey was conducted among 210 women delivering at MRRH between July 2017 and January 2018. Information on demographics, ANC and prevention practices was collected using an interviewer-administered questionnaire. Maternal venous blood and cord blood samples were screened for malaria infection by both microscopy of Giemsa-stained blood films and pf. HPR2 RDT. The presence of anemia was determined by use of an automated hemoglobin analyzer. Data was analyzed using descriptive and analytical statistics. Results: Of the 210 women, 3 (1.4 %) and 19(9.1%) tested positive for malaria by using Giemsia stained blood smear microscopy and malaria pf (HRP2) Ag RDT tests respectively. Twenty nine percent of the women had anaemia and 11 (5.2 %) had LBW babies. Mothers aged below 25years were mostly affected. Only 23.3% of the women received at least three doses of IPTp-SP and 57.9% slept under ITN the night before the survey. The women who slept under a mosquito net the previous night (OR 0.67, 95% CI: 0.24-1.86) and those who took fansidar as a directly observed therapy (OR 0.31, 95% CI: 0.04-2.39) appeared to have less chances of getting malaria infection though the findings were not statistically significant Conclusion: The use of malaria preventive strategies (IPT-SP and ITN) has improved as most of the women had taken IPT-SP during antenatal period. Most of them took less than three doses and there was no strict adherence to the recommended directly observed therapy. Prevalence of malaria infection during pregnancy has gone down though maternal anaemia and low birth weight are still above unacceptable levels in this region.