Chimere O Agomo1, Wellington A Oyibo. 1. ANDI Centre of Excellence for Malaria Diagnosis, International Malaria, Microscopy Training and RDT QA Programme, WHO/TDR/FIND Malaria Specimen Bank Site, Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria. wellao@yahoo.com.
Abstract
BACKGROUND: Pregnant women living in an area of stable malaria transmission such as Lagos, Nigeria, have been identified as being at an increased risk of the effects of malaria infection. In this area, most of the infections are asymptomatic which means they are overlooked and untreated much to the detriment of the mother and her foetus. The reality of scaled-up malaria interventions with long-lasting insecticide treated nets, vector control, artemisinin combination therapy (ACT) and intermittent preventive treatment of malaria pregnancy (IPTp) using sulphadoxine pyrimethamine (SP) is that it is also essential to determine the risk factors at play in these kinds of circumstances. This study was aimed at identifying the factors associated with risk of malaria infection in pregnant women in Lagos, Southwest Nigeria. METHODS: Demographic information and malaria prevention practices of the pregnant women studied were captured using structured questionnaire. Microscopy was used to establish malaria infection, species identification and parasite density. Relative risk and multivariate logistic regression analysis were used to compare factors associated with malaria in pregnant women. RESULTS: Malaria microscopy details, demographic information and malaria prevention practices of the pregnant women were obtained using a structured questionnaire. The prevalence of malaria using peripheral blood from 1,084 pregnant women that participated in the study was 7.7%. Plasmodium falciparum (P. falciparum) was seen in 95.2% of the cases as either mixed infection with P. malariae (3.6%) or as a mono infection (91.6%). Malaria preventive practices associated with a significant reduction (P<0.05) in the malaria infection was the use of insecticide sprays (RR = 0.36, 95 C.I. 0.24-0.54), and the combined use of insecticide spray and insecticide-treated nets (ITN) (RR= 6.53, 95% C.I. 0.92-46.33). Sleeping under ITN alone (RR = 1.07, 95% C.I. 0.55-2.09) was not associated with significant reduction in malaria infection among the study participants with malaria parasitaemia. Young maternal age (<20years) (RR = 2.86, 95% C.I. 1.48 - 5.50), but not primigravidity (RR = 1.36, 95% C.I. 0.90-2.05), was associated with an increased risk of malaria infection during pregnancy. After a multivariate logistic regression, young maternal age (OR = 2.61, 95% C.I. 1.13 - 6.03) and the use of insecticide spray (OR = 0.38, 95% C.I. 0.24-0.63) were associated with an increase and a reduction in malaria infection, respectively. CONCLUSION: Malaria prevalence was low among the pregnant women studied. Young maternal age and non-usage of insecticidal spray were the main factors associated with an increased risk of malaria infection among pregnant women in Lagos, Nigeria.
BACKGROUND: Pregnant women living in an area of stable malaria transmission such as Lagos, Nigeria, have been identified as being at an increased risk of the effects of malaria infection. In this area, most of the infections are asymptomatic which means they are overlooked and untreated much to the detriment of the mother and her foetus. The reality of scaled-up malaria interventions with long-lasting insecticide treated nets, vector control, artemisinin combination therapy (ACT) and intermittent preventive treatment of malaria pregnancy (IPTp) using sulphadoxine pyrimethamine (SP) is that it is also essential to determine the risk factors at play in these kinds of circumstances. This study was aimed at identifying the factors associated with risk of malaria infection in pregnant women in Lagos, Southwest Nigeria. METHODS: Demographic information and malaria prevention practices of the pregnant women studied were captured using structured questionnaire. Microscopy was used to establish malaria infection, species identification and parasite density. Relative risk and multivariate logistic regression analysis were used to compare factors associated with malaria in pregnant women. RESULTS:Malaria microscopy details, demographic information and malaria prevention practices of the pregnant women were obtained using a structured questionnaire. The prevalence of malaria using peripheral blood from 1,084 pregnant women that participated in the study was 7.7%. Plasmodium falciparum (P. falciparum) was seen in 95.2% of the cases as either mixed infection with P. malariae (3.6%) or as a mono infection (91.6%). Malaria preventive practices associated with a significant reduction (P<0.05) in the malaria infection was the use of insecticide sprays (RR = 0.36, 95 C.I. 0.24-0.54), and the combined use of insecticide spray and insecticide-treated nets (ITN) (RR= 6.53, 95% C.I. 0.92-46.33). Sleeping under ITN alone (RR = 1.07, 95% C.I. 0.55-2.09) was not associated with significant reduction in malaria infection among the study participants with malaria parasitaemia. Young maternal age (<20years) (RR = 2.86, 95% C.I. 1.48 - 5.50), but not primigravidity (RR = 1.36, 95% C.I. 0.90-2.05), was associated with an increased risk of malaria infection during pregnancy. After a multivariate logistic regression, young maternal age (OR = 2.61, 95% C.I. 1.13 - 6.03) and the use of insecticide spray (OR = 0.38, 95% C.I. 0.24-0.63) were associated with an increase and a reduction in malaria infection, respectively. CONCLUSION:Malaria prevalence was low among the pregnant women studied. Young maternal age and non-usage of insecticidal spray were the main factors associated with an increased risk of malaria infection among pregnant women in Lagos, Nigeria.
Authors: C T Happi; G O Gbotosho; O A Folarin; A Sowunmi; O M Bolaji; B A Fateye; D E Kyle; W Milhous; D F Wirth; A M J Oduola Journal: Parasitol Res Date: 2006-07-28 Impact factor: 2.289
Authors: Robert D Newman; Afework Hailemariam; Daddi Jimma; Abera Degifie; Daniel Kebede; Aafje E C Rietveld; Bernard L Nahlen; John W Barnwell; Richard W Steketee; Monica E Parise Journal: J Infect Dis Date: 2003-05-15 Impact factor: 5.226
Authors: Augustine Ankomah; Samson B Adebayo; Ekundayo D Arogundade; Jennifer Anyanti; Ernest Nwokolo; Olaronke Ladipo; Martin M Meremikwu Journal: BMC Public Health Date: 2012-02-06 Impact factor: 3.295
Authors: Wendy Prudhomme O'Meara; Mazie Barcus; Chansuda Wongsrichanalai; Sinuon Muth; Jason D Maguire; Robert G Jordan; William R Prescott; F Ellis McKenzie Journal: Malar J Date: 2006-12-12 Impact factor: 2.979
Authors: Colin Ohrt; Peter Obare; Ampon Nanakorn; Christine Adhiambo; Ken Awuondo; Wendy Prudhomme O'Meara; Shon Remich; Kurt Martin; Earnest Cook; Jean-Paul Chretien; Carmen Lucas; Joseph Osoga; Peter McEvoy; Martin Lucas Owaga; James Sande Odera; Bernhards Ogutu Journal: Malar J Date: 2007-06-12 Impact factor: 2.979
Authors: Maryam Muhammad Aliyu; Idris Abdullahi Nasir; Yahaya Abdullahi Umar; Anthony Philip Vanstawa; Jessy Thomas Medugu; Anthony Uchenna Emeribe; Dele Ohinoyi Amadu Journal: Ci Ji Yi Xue Za Zhi Date: 2017 Apr-Jun