Malaria Parasitemia during delivery
Abstract
Objectives:
The aim of this study is to investigate the impact of plasmodium falciparum infection in parturient women in Central Sudan where malaria transmission is mesoendemic. The purpose of this paper is to find out the prevalenceof malaria parasitemia and the risk of anemia among parturient women and to suggest appropriate strategies to lower their prevalence rates.
Methods:
This prospective study was conducted at Medani Teaching Hospital, Sudan a tertiary regional referral center, during the period January 1997 through to December 1997. All cases were admitted during labor to the delivery room and were clinically suspected to have malaria. History, examination and investigations were carried out on all patients.
Results:
The total number of patients enrolled in this study was 550, amounting to 14.9% of all women (N=3,687) who delivered during the study period. The prevalence of malaria parasitemia was 58.9% (N=550) while prevalence of anemia (defined as hemoglobulin ….9.0 g/dl) was 24.1% the mean hemoglobuin levels in patients with positive and negative malaria parasitemia was 9.72+ 1.62 and 9.85+ 1.60 g/dl. Statistically the difference in the mean hemoglobulin level was not significant, t=0.879, A significant negative correlation between parasite count in maternal blood and hemoglobulin level of the mother, was observed, where r=0.121 (P=0.032). out of 17 (3.3%) patients who had used chloroquine tablets for prophylaxis, 11patients still had positive parasitemia. Although there was a higher parasite count in those 11 patients, statistically the difference was not significance where P< 0.05
References
2. World Health Organization (WHO). WHO Expert Committee on Malaria. World Health Organization Tech Rep Ser 2000 892 (4),1-v,p1-72,Geneva;2000.
3. Janssen PG,Wery M. Malaria in Africa South of the Sahara. Ann Trop Med parasitol 1987;81:487-498.
4. Kochar DK, Thansi L, Jochi A, Subhakaran, Asen S, Kumawan BL, Falciparum malaria and pregnancy.Indian j Malariol 1988;35:123-130.
5. Menegndez C, fleming AF, Alonso PL. Malaria –related anaemia. Parasitol Today 2000;16:469-476.
6. Shulman CE. Malaria in pregnancy:its relevance to safe- motherhood programmes. Ann Trop Med prasitol 1999;6 Suppl 1:59-66.
7. World Health Organization (WHO). Severe and Complicated Malaria Division of control of Tropical disease Vol. 84. Suppl 2,1990;p.43.
8. Fleming AF, Allan N, stenhouse NS. Haemolytic anaemia in pregnancy in Nigeria recognition by simple laboratory procedure West A fr Med j 1969;8:82-88.
9. Fleming AF, Allan NC. Haemolytic anaemia in pregnancy in Nigeria treated with prednisolone. Br Med j 1969;461-466.
10. Taha TE. Comparison of reported and confirmed malaria during findings from hospital and community studies in Sudan. East Afr Med j 1996;73:571-574.
11. Taha TT, Gray RH. Malaria and perinatal mortality in Central Sudan. Am j Epidemiol 1993;138:563-568.
12. El Gaddal A A. Malaria control in Gezira – Managil Irrigated Scheme of Sudan, j Trop Med Hyg 1985;88:153-159.
13. Baker fj, Silverton RE, Canning D, Kilshaw D, Law j, Shannon R, editors. Introduction to medical laboratory technology. 5 th ed. London (UK):Butterworths; 1976.p. 598-599.
14. Singh N, Shukla MM, sharma vp. Epidemiology of malaria in pregnancy in Cental India Bull WHO 1999;77:567-572.
15. Omer AHS. Species prevalence of malaria in Northern and southern Sudan and the control by mass chemoprophylaxis. Am j Trop Med Hyg 1978;27:858-863.
16. Taha TT, broadhead RL.A comparative epidemiological study of malaria between children of North and Southern Sudan,j Trop pediatr 1986;32:117-119.
17. Omer AH. Species prevalence of malaria in Northern and southern Sudan and Control by mass Chemopropjlaxix. Am j Trop Med Hyg 1978;27:858-863.
18. Mnyika SK. Kabalimu TK, Mbaruku G, Masisila R, Mpanju- shumbusho W. Randomized trial alternative malaria chemoprophylaxis strategies among pregnant women in Kigoma, Tanzania:II. Results from baseline studies. East Afr Med j 2000; 77:105-110.
19. Rogerson SJ. Van den Broek NR, Chaluluka E, Qongwane C, Mhango CG, Molyneux ME. Malaria and anaemia in antenatal women in Blantyre, Malawi: a twelve-month survey. Am J Trop Med Hyg 200;62:335-340.
20. Mockenhaupt FP, Rong B, Till H, Eggelte TA, Beck S, Gyasi- Sarpong C. Submicroscopic plasmodium falciparum infections in pregnancy in Ghana. Trop Med Int Health 2000; 5:167-173.
21. Donald I. Practical Obstetrical Problems. 5 th ed. Lioyed Luke:London (UK); 1997.p.136-137.
22. Salihu HM, Tchuinguem G, Ratard R. Effect of chloroquine prophylaxis on birth weight and malaria parasite load among pregnant women delivering in a regional hospital in Cameroon. West Indian J200; 49:143-147,
23. Ndyomugyenyi R, Magnussen P, Chloroquine prophylaxis, iron- folic acid supplementation or case management of malaria attacks in a primigravidae in Western Uganda; effects on maternal parasitaemia and haemoglobin levels and on birth weight. Trans R Soc Trop Med Hyg 2000; 94:413- 418.
