Malaria preventive practices and delivery outcomes: A cross-sectional study of parturient women in a tertiary hospital in Eastern Uganda
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
PloS one
Abstract
Uganda ranks third in the number of deaths attributable to malaria and has some of the highest
recorded malaria transmission rates in the general population. Malaria in Pregnancy is associated
with detrimental effects for the mother and unborn baby and these effects seem to have
long term effects and consequences on the life of the baby. Despite the preventive measures
put in place by the World Health Organization in antenatal care, the burden of malaria in pregnancy
is still high. We determined the use of malaria preventive strategies during pregnancy
and the presence of plasmodium infection, anemia, and low birth weight babies at delivery
among parturient women at Mbale regional referral hospital in eastern Uganda.
Methods
A cross-sectional study was conducted among 210 women delivering at MRRH between
July 2017 and January 2018. Information on demographics, antenatal care, and prevention
practices was collected using an interviewer-administered questionnaire. Maternal venous
blood and cord blood samples were screened for Plasmodium infection by both microscopy
of Giemsa-stained blood films and Plasmodium falciparum rapid diagnostic test (pf. HPR2
mRDT). Polymerase Chain Reaction (PCR) was done on cord blood. The presence of anemia
was determined by the use of an automated hemoglobin analyzer. Data were analyzed
using descriptive and analytical statistics.
Results
Of the 210 women, 3 (1.4%) and 19(9.1%) tested positive for malaria by using Giemsa
stained blood smear microscopy and malaria rapid diagnosticMRDT tests respectively.
PCR detected 4(%) of Plasmodium in cord blood. Twenty-nine percent of the women had
anaemia and 11 (5.2%) had low birth weight babies. Only 23.3% of the women received at least three doses of IPTp-SP and 57.9% reported sleeping under an Insecticide Treated Net
the night before the survey. The women who reported sleeping under a mosquito net the
previous night (OR 0.67, 95% CI: 0.24–1.86) and those who reported taking fansidar as a
directly observed therapy (OR 0.31, 95% CI: 0.04–2.39) appeared to have few chances of
getting plasmodium infection though the findings were not statistically significant.
Conclusion
The effective use of malaria preventive strategies (IPT-SP and Insecticide Treated Nets)
was generally low. Most of the women took less than three doses of SP and there was no
strict adherence to the recommended directly observed therapy. The prevalence of Plasmodium
infection during pregnancy was low though maternal anaemia and low birth weight
were relatively high.
Description
Keywords
Malaria, Preventive practices, Delivery, Parturient women, Tertiary hospital
Citation
Nekaka R, Nteziyaremye J, Oboth P, Iramiot JS, Wandabwa J (2020) Malaria preventive practices and delivery outcomes: A cross-sectional study of parturient women in a tertiary hospital in Eastern Uganda. PLoS ONE 15(8): e0237407. https://doi.org/10.1371/journal.pone.0237407