PREVALENCE AND PATTERN OF PLACENTAL MALARIA IN WOMEN DELIVERING AT NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL, NNEWI

Abstract

Background:
Placental malaria is a recognised complication of malaria in pregnancy and is associated
with adverse outcomes for the mother and her baby especially in endemic areas.
Placental malaria has been associated with low birth weight and as such contributes
significantly to the high perinatal mortality in Africa. Despite the burden of this condition
in this environment, there is paucity of local data and documentation on the pattern of
placental malaria and its effects on pregnancy outcome.
Materials and methods:
This was a cross sectional study conducted between April and November 2010. Maternal
blood, cord blood and placental blood samples were collected from 390 mother-baby
pairs to assess for malaria parasites using thick films. Placental biopsies were also taken
for histological assessment of malaria parasitisation. Semi structured questionnaire was
used to collect the socio-demographic characteristics of the parturients as well as the
birth weight. Descriptive analysis of the results was done using the Statistical Package for
Social Sciences Version 17 (SPSS, Chicago, IL, USA). P<0.05 was considered significant
(providing 95% confidence interval).
Results:
Of the 365 placentas analysed, 254 showed an evidence of malaria parasitisation giving a
prevalence of 69.6%. The commonest form of parasitisation was active on past infection
(77.2%) followed by past infection (13.7%) and active infection (9.1%). The significant
factors associated placental malaria were HIV positive status, place of residence,
haemoglobin genotype and non use of Intermittent Preventive Treatment for malaria.
The severity of parasitaemia was higher in the primigravidas. Low birth weight occurred
in 4.3% of cases of placental malaria but did not reach significant levels. The prevalence
of cord parasitaemia was 41.9%. Maternal PCV was significantly lower in women with
placental malaria.
Conclusion:
The result of this study has highlighted the high prevalence of placental malaria in
asymptomatic women delivering at Nnamdi Azikiwe University Teaching Hospital, Nnewi.
Non use of intermittent preventive treatment for malaria was a very strong factor
associated with placental malaria. The pregnancy outcome was generally good
essentially because of the low levels of parasitaemia. Evidence based interventions that
prevent malaria in pregnancy should be promoted.

PREVALENCE AND PATTERN OF PLACENTAL MALARIA IN WOMEN DELIVERING AT NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL, NNEWI