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Mukala J, Mogere D, Kirira P, Kanoi B, Akisa V, Kobia F, Waweru H, Gitaka J. Knowledge, attitude and practices on intermittent preventive treatment in pregnant women with malaria: a mixed method facility-based study in Western Kenya. Pan Afr Med J 2024; 48:22. [PMID: 39220560 PMCID: PMC11364888 DOI: 10.11604/pamj.2024.48.22.42196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 05/09/2024] [Indexed: 09/04/2024] Open
Abstract
Introduction intermittent preventive treatment remains a core strategy for malaria prevention in pregnancy. Sulfadoxine-pyrimethamine is recommended for all pregnant women in malaria-prone zones. It is scheduled monthly at each antenatal care visit for up to 36 weeks. Here, we sought to assess the knowledge, attitude, and practices of intermittent preventive treatment among pregnant women with malaria in Webuye Hospital. Methods a total of 140 participants aged between 18 and 49 years and at approximately 16 weeks of gestation were enrolled in this study, which utilized a mixed qualitative-quantitative method. Before enrollment, malaria testing was conducted using microscopy, and participants were divided into two cohorts: malaria-positive and malaria-negative. Close-ended and open-ended questionnaires were used. Qualitative-quantitative data analyses were performed. Results our analysis revealed a significant difference between the proportion of mothers in the negative and positive groups in terms of their knowledge about side effects (p ≤ 0.001) and different doses (p ≤ 0.012) of intermittent preventive treatment. The proportion of mothers who knew side effects and different doses was higher among the malaria-positive group as compared to malaria-negative group with 37(52.9%, n=70) versus 18(25.7%, n=70) and 14(20.0%, n=70) versus 4(5.7%, n=70) respectively. Additionally, there was also a significant difference in knowledge about intermittent preventive treatment before administration (p ≤ 0.003) between the two groups. Conclusion good knowledge, attitude and practices on intermittent preventive treatment (IPT) benefits, side effects, safety, doses and other prior information should be leveraged to empower pregnant women in malaria-endemic zones.
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Affiliation(s)
- Joseph Mukala
- School of Public Health, Mount Kenya University, Thika, Kenya
| | - Dominic Mogere
- School of Public Health, Mount Kenya University, Thika, Kenya
| | - Peter Kirira
- School of Applied Sciences, Mount Kenya University, Thika, Kenya
| | - Bernard Kanoi
- Centre for Malaria Elimination, Institute of Tropical Medicine, Mount Kenya University, Thika, Kenya
| | | | - Francis Kobia
- Centre for Malaria Elimination, Institute of Tropical Medicine, Mount Kenya University, Thika, Kenya
| | - Harrison Waweru
- Centre for Malaria Elimination, Institute of Tropical Medicine, Mount Kenya University, Thika, Kenya
| | - Jesse Gitaka
- Centre for Malaria Elimination, Institute of Tropical Medicine, Mount Kenya University, Thika, Kenya
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Jain V, Sharma RK, Shukla MM, Khosla KK, Singh N, Shanmugam R. Burden of malaria during pregnancy in perennial transmission settings of two densely forested and remote blocks (Baihar and Birsa) of district Balaghat, Madhya Pradesh, central India. THE NATIONAL MEDICAL JOURNAL OF INDIA 2023; 36:351-357. [PMID: 38909309 DOI: 10.25259/nmji_535_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/24/2024]
Abstract
Background Malaria in pregnancy (MIP) is a major public health problem due to the vulnerability of pregnant women to infections, resulting in adverse maternal/foetal outcomes in endemic areas. Methods We did a field-based study to assess the burden of MIP (prevalence at the time of enrolment and follow-up) and to identify risk factors for MIP in the Birsa and Baihar blocks of district Balaghat in Madhya Pradesh, which have perennial malaria transmission. Malaria screening (during 2015-2017) was done by microscopy and bivalent rapid diagnostic test (SD Bioline RDT, malaria antigen Plasmodium falciparum/Plasmodium vivax Pf/Pv). Dried blood spots were used for haemoglobin estimation. Sociodemographic details with past and present pregnancy status were obtained. A subset of pregnant women were followed up for malaria during pregnancy. Women were also screened for malaria post delivery. Malaria treatment was given as per the National Guidelines of 2013. Multivariate analysis was done to assess independent risk factors for malaria. Results A total of 1728 pregnant women were screened, of which 1651 were included in the final analysis. Malaria prevalence at first screening was 23.4% (Pf 88%). Prevalence and Pf parasitaemia both were significantly higher among primigravid (G1) compared to multigravid (G>2; p value 0.012 and 0.019, respectively). Pregnant women of the Baiga ethnic group were more likely to have malaria compared to those belonging to the Gond group (OR [95% CI]; 2.4 [1.7-3.4]; p<0.00001) and non-indigenous group (OR [95% CI]; 8.3 [3.9-19.7]; p<0.00001). Primigravid status of women, first and second trimester of pregnancy, women belonging to indigenous ethnic tribal group and cash crop insufficiency for whole year (a socioeconomic indicator) in the family were the independent risk factors for malaria. Conclusion MIP is a major public health problem in forested tribal settlements of Birsa and Baihar blocks of Balaghat district in Madhya Pradesh and requires immediate intervention.
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Affiliation(s)
- Vidhan Jain
- ICMR-National Institute of Research in Tribal Health, Garha, Jabalpur 482003, Madhya Pradesh, India
| | - Ravendra Kumar Sharma
- ICMR-National Institute of Research in Tribal Health, Garha, Jabalpur 482003, Madhya Pradesh, India
| | - Man Mohan Shukla
- ICMR-National Institute of Research in Tribal Health, Garha, Jabalpur 482003, Madhya Pradesh, India
| | | | - Neeru Singh
- ICMR-National Institute of Research in Tribal Health, Garha, Jabalpur 482003, Madhya Pradesh, India
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Unger HW, Acharya S, Arnold L, Wu C, van Eijk AM, Gore-Langton GR, Ter Kuile FO, Lufele E, Chico RM, Price RN, Moore BR, Thriemer K, Rogerson SJ. The effect and control of malaria in pregnancy and lactating women in the Asia-Pacific region. Lancet Glob Health 2023; 11:e1805-e1818. [PMID: 37858590 DOI: 10.1016/s2214-109x(23)00415-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/10/2023] [Accepted: 08/23/2023] [Indexed: 10/21/2023]
Abstract
Half of all pregnancies at risk of malaria worldwide occur in the Asia-Pacific region, where Plasmodium falciparum and Plasmodium vivax co-exist. Despite substantial reductions in transmission, malaria remains an important cause of adverse health outcomes for mothers and offspring, including pre-eclampsia. Malaria transmission is heterogeneous, and infections are commonly subpatent and asymptomatic. High-grade antimalarial resistance poses a formidable challenge to malaria control in pregnancy in the region. Intermittent preventive treatment in pregnancy reduces infection risk in meso-endemic New Guinea, whereas screen-and-treat strategies will require more sensitive point-of-care tests to control malaria in pregnancy. In the first trimester, artemether-lumefantrine is approved, and safety data are accumulating for other artemisinin-based combinations. Safety of novel antimalarials to treat artemisinin-resistant P falciparum during pregnancy, and of 8-aminoquinolines during lactation, needs to be established. A more systematic approach to the prevention of malaria in pregnancy in the Asia-Pacific is required.
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Affiliation(s)
- Holger W Unger
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; Department of Obstetrics and Gynaecology, Royal Darwin Hospital, Tiwi, NT, Australia; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
| | - Sanjaya Acharya
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Lachlan Arnold
- Royal Melbourne Hospital Clinical School, The University of Melbourne, Parkville, VIC, Australia
| | - Connie Wu
- Royal Melbourne Hospital Clinical School, The University of Melbourne, Parkville, VIC, Australia
| | - Anna Maria van Eijk
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Georgia R Gore-Langton
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Feiko O Ter Kuile
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Elvin Lufele
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; Vector-Borne Diseases Unit, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - R Matthew Chico
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Ric N Price
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Brioni R Moore
- Curtin Medical School, Curtin University, Bentley, WA, Australia; Curtin Health Innovation Research Institute, Curtin University, Bentley, WA, Australia; Telethon Kids Institute, Perth Children's Hospital, Nedlands, WA, Australia
| | - Kamala Thriemer
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Stephen J Rogerson
- Department of Infectious Diseases, University of Melbourne, The Doherty Institute, Melbourne, VIC, Australia; Department of Medicine, University of Melbourne, The Doherty Institute, Melbourne, VIC, Australia
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Kojom Foko LP, Singh V. Malaria in pregnancy in India: a 50-year bird's eye. Front Public Health 2023; 11:1150466. [PMID: 37927870 PMCID: PMC10620810 DOI: 10.3389/fpubh.2023.1150466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 09/25/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction In 2021, India contributed for ~79% of malaria cases and ~ 83% of deaths in the South East Asia region. Here, we systematically and critically analyzed data published on malaria in pregnancy (MiP) in India. Methods Epidemiological, clinical, parasitological, preventive and therapeutic aspects of MiP and its consequences on both mother and child were reviewed and critically analyzed. Knowledge gaps and solution ways are also presented and discussed. Several electronic databases including Google scholar, Google, PubMed, Scopus, Wiley Online library, the Malaria in Pregnancy Consortium library, the World Malaria Report, The WHO regional websites, and ClinicalTrials.gov were used to identify articles dealing with MiP in India. The archives of local scientific associations/journals and website of national programs were also consulted. Results Malaria in pregnancy is mainly due to Plasmodium falciparum (Pf) and P. vivax (Pv), and on rare occasions to P. ovale spp. and P. malariae too. The overall prevalence of MiP is ~0.1-57.7% for peripheral malaria and ~ 0-29.3% for placental malaria. Peripheral Pf infection at antenatal care (ANC) visits decreased from ~13% in 1991 to ~7% in 1995-1996 in Madhya Pradesh, while placental Pf infection at delivery unit slightly decreased from ~1.5% in 2006-2007 to ~1% in 2012-2015 in Jharkhand. In contrast, the prevalence of peripheral Pv infection at ANC increased from ~1% in 2006-2007 to ~5% in 2015 in Jharkhand, and from ~0.5% in 1984-1985 to ~1.5% in 2007-2008 in Chhattisgarh. Clinical presentation of MiP is diverse ranging from asymptomatic carriage of parasites to severe malaria, and associated with comorbidities and concurrent infections such as malnutrition, COVID-19, dengue, and cardiovascular disorders. Severe anemia, cerebral malaria, severe thrombocytopenia, and hypoglycemia are commonly seen in severe MiP, and are strongly associated with tragic consequences such as abortion and stillbirth. Congenital malaria is seen at prevalence of ~0-12.9%. Infected babies are generally small-for-gestational age, premature with low birthweight, and suffer mainly from anemia, thrombocytopenia, leucopenia and clinical jaundice. Main challenges and knowledge gaps to MiP control included diagnosis, relapsing malaria, mixed Plasmodium infection treatment, self-medication, low density infections and utility of artemisinin-based combination therapies. Conclusion All taken together, the findings could be immensely helpful to control MiP in malaria endemic areas.
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Nana RRD, Hawadak J, Foko LPK, Kumar A, Chaudhry S, Arya A, Singh V. Intermittent preventive treatment with Sulfadoxine pyrimethamine for malaria: a global overview and challenges affecting optimal drug uptake in pregnant women. Pathog Glob Health 2023; 117:462-475. [PMID: 36177658 PMCID: PMC10337642 DOI: 10.1080/20477724.2022.2128563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Malaria in Pregnancy (MiP) leading to morbidity and mortality is a major public health problem that poses significant risk to pregnant women and their fetus. To cope with this alarming situation, administration of Sulfadoxine-pyrimethamine (SP) drugs to pregnant women as an intermittent preventive treatment (IPT) from 16 weeks of gestation is recommended by the World Health Organization (WHO) guidelines. We conducted a comprehensive search of published articles related to MiP in last 10 years with predefined keywords or their synonyms. The mapping of malaria in pregnant women showed a prevalence rate up to 35% in many countries. Although IPTp-SP has been implemented in endemic regions since several years but the IPTp-SP coverage percentage vary from country to country and continue to remain below the target of 80%. Major reasons for low IPTp-SP involve gestational age at first prenatal visit, level of education, place of residence, knowledge of IPTp-SP benefits, and use of antenatal services. Several challenges including the emergence of septuple and octuple SP-resistant parasites is reported from many countries which make the prophylactic use of IPTp-SP currently debatable. This narrative review addresses the barriers for optimal use of IPTp-SP and discusses alternative approaches to increase the use and effectiveness of SP intervention for preventing MiP. The COVID pandemic has drastically affected the public health disrupting the management of diseases worldwide. In view of this, a brief summary of COVID impact on MiP situation is also included.
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Affiliation(s)
- Rodrigue Roman Dongang Nana
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
- Parasitology laboratory, Institute of Medical Research and Medicinal Plants Studies (IMPM), Yaoundé, Cameroon
| | - Joseph Hawadak
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
| | - Loick Pradel Kojom Foko
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
| | - Amit Kumar
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
| | - Shewta Chaudhry
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
| | - Aditi Arya
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
| | - Vineeta Singh
- Parasite Host Biology group, ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
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Kotepui M, Kotepui KU, Masangkay FR, Mahittikorn A, Wilairatana P. Prevalence and proportion estimate of asymptomatic Plasmodium infection in Asia: a systematic review and meta-analysis. Sci Rep 2023; 13:10379. [PMID: 37369862 DOI: 10.1038/s41598-023-37439-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 06/21/2023] [Indexed: 06/29/2023] Open
Abstract
Asymptomatic Plasmodium infection raises a problem for the persistent transmission of malaria in low-endemic areas such as Asia. This systematic review was undertaken to estimate the prevalence and proportion of asymptomatic Plasmodium infection in Asia. The systematic review was registered at PROSPERO (ID: CRD42022373664). The research followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A comprehensive search of five databases, Ovid, Scopus, MEDLINE, PubMed, and Embase, was conducted to identify studies of asymptomatic Plasmodium infection in Asian countries. The pooled prevalence of asymptomatic Plasmodium infection, the pooled proportion of asymptomatic Plasmodium infection among all parasitised individuals, and the associated 95% confidence intervals were estimated using a random-effects model. A total of 916 articles were retrieved, and 87 articles that met the criteria were included in the systematic review. The pooled prevalence of asymptomatic Plasmodium infection among enrolled participants in Southeast Asia, South Asia, and Western Asia was 5.8%, 9.4%, and 8.4%, respectively. The pooled proportion of asymptomatic Plasmodium infection among all parasitised individuals in Southeast Asia, South Asia, and Western Asia was 89.3%, 87.2%, and 64.8%, respectively. There was a low prevalence of asymptomatic Plasmodium infection, but there was a high proportion of asymptomatic Plasmodium infection per all parasitised individuals in different parts of Asia. These results may support and facilitate elimination and control programs for asymptomatic Plasmodium infection in Asia.
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Affiliation(s)
- Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
| | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | | | - Aongart Mahittikorn
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Agyeman YN, Bassoumah B, Owusu-Marfo J. Predictors of optimal uptake of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine and outcome of pregnancy in selected health facilities: a cross-sectional study in Northern Ghana. Malar J 2023; 22:80. [PMID: 36879278 PMCID: PMC9987078 DOI: 10.1186/s12936-023-04501-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 02/18/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Ghana adopted the 2012 World Health Organization (WHO) policy on intermittent preventive treatment of malaria in pregnancy (IPTp) and implemented it in 2014 in all regions of Ghana. Despite the implementation of this policy, there has been an unacceptably low percentage of eligible women receiving the optimal dose of IPTp in Ghana which leaves millions of pregnant women unprotected from malaria. The study, therefore, assessed the predictors of three or more doses (optimal dose) of sulfadoxine-pyrimethamine (SP) in Northern Ghana. METHODS A cross-sectional study was conducted among 1188 women in four selected health facilities in Northern Ghana from September 2016 to August 2017. Information on socio-demographic and obstetric characteristics reported SP use, and maternal and neonatal outcomes were collected which was double-checked from the maternal health book as well as the antenatal care register. Pearson chi-Square and ordered logistic regression were used to determine the predictors of reported optimal SP use. RESULTS Out of the 1146 women, 42.4% received 3 or more doses of IPTp-SP as recommended by the national malaria control strategy. SP uptake was significantly associated with antenatal care (ANC) attendance (aOR 0.49, 95% CI 0.36-0.66, P < 0.001), primary education (aOR 0.70, 95% CI 0.52-0.95, P = 0.022), four or more antenatal care visits (aOR 1.65, 95% CI 1.11-2.45, P = 0.014), ANC care visit in second trimester (aOR 0.63, 95% CI 0.49-0.80, P < 0.001) and third trimester (aOR 0.38, 95% CI 0.19-0.75, P = 0.006) and malaria infection during late gestation (aOR 0.56, 95% CI 0.43-0.73, p < 0.001). CONCLUSION The percentage of pregnant women who received three or more doses is below the target of the National Malaria Control Programme (NMCP). The push factors for the optimal use of SP are higher educational attainment, four or more ANC visits, and early initiation of ANC. The study also confirmed earlier findings that IPTp-SP uptake of three or more doses prevents malaria in pregnancy and improves birth weight. The uptake of IPTp-SP among expectant women will be informed and increased by encouraging formal general education beyond the primary level and encouraging early initiation of ANC visits.
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Affiliation(s)
- Yaa Nyarko Agyeman
- Department of Population and Reproductive Health, School of Public Health, University for Development Studies, Tamale, Ghana.
| | - Bougangue Bassoumah
- Department of Population and Reproductive Health, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Joseph Owusu-Marfo
- Department of Epidemiology, Biostatistics and Disease Control, School of Public Health, University for Development Studies, Tamale, Ghana
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Balcha F, Menna T, Lombamo F. Prevalence of asymptomatic malaria and associated factors among pregnant women at Boset District in East Shoa Zone, Oromia Region, Ethiopia: a cross-sectional study. Malar J 2023; 22:28. [PMID: 36698185 PMCID: PMC9878930 DOI: 10.1186/s12936-023-04460-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/17/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Malaria infection during pregnancy is a significant public health problem that puts pregnant women at risk. Interruption of transmission of asymptomatic malaria among a population remained a challenge and the host serves as a reservoir for the malaria parasite; and is also recognized as a major barrier to malaria elimination. This study aimed to assess the prevalence of asymptomatic malaria and associated factors among pregnant women in the Boset District, East Shoa Zone, Oromia, Ethiopia. METHODS A community-based cross-sectional study was conducted to assess the prevalence of asymptomatic malaria and associated factors in pregnant women from February to March 2022. Using multistage sample techniques, 328 asymptomatic pregnant women were enrolled. Data were collected using a structured questionnaire. A rapid test and Giemsa-stained blood smear microscopy were used to diagnose Plasmodium infections. Epi info version 7 was used to code, enter, and clean data before being uploaded to SPSS version 25.0 for analysis. Bivariable and multivariable binary logistic regression were employed to find the associated factors. Variables in the multivariable model with a p-value < 0.05 were considered significantly associated with asymptomatic malaria. RESULTS Of the total 328 pregnant women who participated in this study, 9(2.74%) and 10(3.05%) were confirmed to be infected with Plasmodium species by microscopy and rapid diagnostic tests, respectively. Asymptomatic malaria during pregnancy was found to be significantly associated with not using an insecticide-treated bed net [(P = 0.002, AOR: 9.61; 95% CI (2.22-41.53)], lack of consultation and health education about malaria prevention during Antenatal care attendance [(P = 0.04, AOR: 4.05; 95% CI (1.02, 16.05)], and living close stagnant water [(P = 0.02, AOR: 4.43; 95% CI (1.17,16.82)]. CONCLUSIONS The current study showed that asymptomatic malaria is prevalent in pregnant women. Not using insecticide-treated bed nets, inadequate health education during antenatal care, and living close to stagnant water are significantly associated with malaria infection. Thus, using insecticide-treated bed nets, health education, and avoiding stagnant water from residential areas could play significant roles in preventing asymptomatic malaria among pregnant women in the study area.
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Affiliation(s)
- Fufa Balcha
- School of Public Health, Adama Hospital Medical College, Adama, Ethiopia
| | - Takele Menna
- grid.460724.30000 0004 5373 1026School of Public Health, St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Fantu Lombamo
- grid.460724.30000 0004 5373 1026School of Public Health, St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Atakorah EA, Afranie BO, Addy KD, Sarfo AD, Okyere BA. Assessment of intestinal and blood protozoan infections among pregnant women visiting ante-natal care at Tafo Hospital, Ghana. Heliyon 2022; 8:e09968. [PMID: 35958269 PMCID: PMC9358421 DOI: 10.1016/j.heliyon.2022.e09968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/06/2021] [Accepted: 07/12/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction Intestinal and blood protozoans cause morbidity and mortality in both pregnant women and developing foetuses worldwide. It constitutes a major health problem in many tropical areas in Africa. This study assessed the prevalence of intestinal and blood protozoans’ parasitic load and their risk factors among pregnant women visiting antenatal care at Tafo Hospital, Ghana from November 2016 to January 2017. Method A pilot cross-sectional study was conducted among consented pregnant women who visited antenatal care at Tafo Government Hospital, Kumasi Ghana. Structured questionnaires were administered to obtain socio-demographic data, knowledge on protozoan infections, and their risk factors among study participants. A stool sample was obtained from each participant for the microscopic examination of the intestinal protozoa. Venous blood was taken from participants for the detection of Plasmodium and Toxoplasma gondii infections. Wet mount and the faecal protozoan concentrated method were done for the identification of intestinal parasites. Blood films and serological examination for malaria rapid diagnostic tests (RDT) were done for identification of Plasmodium parasites while an Enzyme-linked immunosorbent assay (ELISA) was used for detecting the antibodies of T. gondii among participants. Data were analyzed using statistical packages for the social sciences (SPSS). Results The mean age of the study participants was 27.83, and ranges from 18 to 40 years. The majority of the participants (82.2%) had never experienced stillbirth nor spontaneous abortion. Intestinal parasites were found in 36.7% of participants. Giardia lamblia (28.1%), Cryptosporidium parvum (5.3%), and Entamoeba histolytica/dispar (3.3%) were among the intestinal protozoans detected. T. gondii antibodies were detected by high levels of immunoglobulins, resulting in IgG (48.0%) and IgM (11.3%) being found among participants, with 7.3% testing positive for both IgM and IgG. The prevalence of malaria infection among the study participants was 2.7%. The consumption of raw or cooked vegetables had significant influence on their intestinal and blood protozoan infections status (p = 0.004) (OR = 0.32, CI = 0.12–0.86). There was a significant association between Hb levels and malaria (p = 0.014) and that of intestinal protozoans (p = 0.035). Conclusion The prevalence of intestinal protozoans and blood protozoans such as T. gondii were high and therefore effective measures should be put in place to reduce the infectivity. Environmental hygiene should be improved and education by relevant agencies should be intensified on the possible transmission of intestinal and blood parasite infections given the possible role of these infections in adverse pregnancy outcomes.
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Jain K, Gupta P, Balodhi A, Deeba F, Salam N. Prevalence of Pregnancy Associated Malaria in India. Front Glob Womens Health 2022; 3:832880. [PMID: 35692947 PMCID: PMC9178198 DOI: 10.3389/fgwh.2022.832880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/28/2022] [Indexed: 12/03/2022] Open
Abstract
Malaria in pregnancy is a major public health concern. It results in impaired maternal health and adversely effects fetal and perinatal outcomes. The present systematic review was conducted to assess the prevalence, distribution and adverse pregnancy outcomes in malaria infected females in India. A comprehensive search and review of PubMed and Web of Science based on PRISMA guidelines was carried out to find articles reporting prevalence of malaria in pregnant women from India. Data from 16 studies were analyzed and prevalence of malaria among pregnant women in India was found to be 11.4 % (95 % CI: 7.3, 16.3). Prevalence of malaria among asymptomatic and symptomatic pregnant women was found to be 10.62% (95% CI: 6.05, 16.23) and 13.13% (95% CI: 7.2, 20.52), respectively. P. falciparum and P. vivax were both reported with in the same population. The geospatial distribution of malaria in pregnancy spanned over nine very populous states of India. The review also reported severe maternal and perinatal outcomes. Given the seriousness of malaria in pregnant women and its effects on the fetus and new-born, a stringent district wise guideline for early detection and prophylaxis in regions identified in this review will help in its better control.
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Affiliation(s)
- Khushi Jain
- Department of Microbiology, Central University of Punjab, Bathinda, India
| | - Palak Gupta
- Department of Microbiology, Central University of Punjab, Bathinda, India
| | - Ashutosh Balodhi
- Department of Microbiology, Central University of Punjab, Bathinda, India
| | - Farah Deeba
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi, India
| | - Nasir Salam
- Department of Microbiology, Central University of Punjab, Bathinda, India
- *Correspondence: Nasir Salam
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Prevalencia de malaria gestacional en Ecuador. BIOMÉDICA 2022; 42:127-135. [PMID: 35471175 PMCID: PMC9059921 DOI: 10.7705/biomedica.6184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Indexed: 11/21/2022]
Abstract
Introducción. La malaria gestacional, definida como la presencia de Plasmodium spp. en sangre periférica materna o el hallazgo del parásito en la placenta, es considerada un importante problema de salud pública en las regiones tropicales y subtropicales. Objetivo. Determinar la frecuencia de casos de malaria gestacional diagnosticados en Ecuador entre 2015 y 2018. Materiales y métodos. Se hizo un estudio descriptivo, retrospectivo y transversal. Resultados. Se determinaron 46 casos de malaria gestacional en el período evaluado, 25 por Plasmodium falciparum y 21 por Plasmodium vivax, siendo el 2018 el año con más casos. En cuanto a las variables de edad y trimestre de gestación, prevalecieron en el grupo de 20 a 29 años (46 %) y en el segundo trimestre (37 %). Solo se observó una diferencia significativa entre los casos por año y la especie parasitaria. Conclusión. La malaria gestacional en Ecuador ha aumentado en los últimos cinco años, por lo que es importante informar a las mujeres en estado de gravidez sobre las medidas preventivas para evitar el contagio con el parásito, dadas las graves consecuencias que conlleva para ellas y sus hijos.
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Abstract
BACKGROUND Plasmodium vivax infects an estimated 7 million people every year. Previously, vivax malaria was perceived as a benign condition, particularly when compared to falciparum malaria. Reports of the severe clinical impacts of vivax malaria have been increasing over the last decade. METHODS AND FINDINGS We describe the main clinical impacts of vivax malaria, incorporating a rapid systematic review of severe disease with meta-analysis of data from studies with clearly defined denominators, stratified by hospitalization status. Severe anemia is a serious consequence of relapsing infections in children in endemic areas, in whom vivax malaria causes increased morbidity and mortality and impaired school performance. P. vivax infection in pregnancy is associated with maternal anemia, prematurity, fetal loss, and low birth weight. More than 11,658 patients with severe vivax malaria have been reported since 1929, with 15,954 manifestations of severe malaria, of which only 7,157 (45%) conformed to the World Health Organization (WHO) diagnostic criteria. Out of 423 articles, 311 (74%) were published since 2010. In a random-effects meta-analysis of 85 studies, 68 of which were in hospitalized patients with vivax malaria, we estimated the proportion of patients with WHO-defined severe disease as 0.7% [95% confidence interval (CI) 0.19% to 2.57%] in all patients with vivax malaria and 7.11% [95% CI 4.30% to 11.55%] in hospitalized patients. We estimated the mortality from vivax malaria as 0.01% [95% CI 0.00% to 0.07%] in all patients and 0.56% [95% CI 0.35% to 0.92%] in hospital settings. WHO-defined cerebral, respiratory, and renal severe complications were generally estimated to occur in fewer than 0.5% patients in all included studies. Limitations of this review include the observational nature and small size of most of the studies of severe vivax malaria, high heterogeneity of included studies which were predominantly in hospitalized patients (who were therefore more likely to be severely unwell), and high risk of bias including small study effects. CONCLUSIONS Young children and pregnant women are particularly vulnerable to adverse clinical impacts of vivax malaria, and preventing infections and relapse in this groups is a priority. Substantial evidence of severe presentations of vivax malaria has accrued over the last 10 years, but reporting is inconsistent. There are major knowledge gaps, for example, limited understanding of the underlying pathophysiology and the reason for the heterogenous geographical distribution of reported complications. An adapted case definition of severe vivax malaria would facilitate surveillance and future research to better understand this condition.
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Affiliation(s)
| | - Prabin Dahal
- Infectious Diseases Data Observatory–IDDO, Oxford, United Kingdom
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Mayfong Mayxay
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Institute of Research and Education Development (IRED), University of Health Sciences, Ministry of Health, Vientiane, Laos
- Lao–Oxford–Mahosot Hospital–Wellcome Trust Research Unit, Mahosot Hospital, Vientiane, Laos
| | - Elizabeth A. Ashley
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Lao–Oxford–Mahosot Hospital–Wellcome Trust Research Unit, Mahosot Hospital, Vientiane, Laos
- * E-mail:
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Agyeman YN, Newton S, Annor RB, Owusu-Dabo E. Intermittent preventive treatment comparing two versus three doses of sulphadoxine pyrimethamine (IPTp-SP) in the prevention of anaemia in pregnancy in Ghana: A cross-sectional study. PLoS One 2021; 16:e0250350. [PMID: 33878140 PMCID: PMC8057609 DOI: 10.1371/journal.pone.0250350] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 04/06/2021] [Indexed: 11/30/2022] Open
Abstract
In 2012 the World Health Organisation (WHO) revised the policy on Intermittent Preventive Treatment with Sulphadoxine Pyrimethamine (IPTp-SP) to at least three doses for improved protection against malaria parasitaemia and its associated effects such as anaemia during pregnancy. We assessed the different SP dosage regimen available under the new policy to determine the dose at which women obtained optimal protection against anaemia during pregnancy. A cross-sectional study was conducted among pregnant women who attended antenatal clinic at four different health facilities in Ghana. The register at the facilities served as a sampling frame and simple random sampling was used to select all the study respondents; they were enrolled consecutively as they kept reporting to the facility to receive antenatal care to obtain the required sample size. The haemoglobin level was checked using the Cyanmethemoglobin method. Multivariable logistic regression was performed to generate odds ratios, confidence intervals and p-values. The overall prevalence of anaemia among the pregnant women was 62.6%. Pregnant women who had taken 3 or more doses of IPTp-SP had anaemia prevalence of 54.1% compared to 66.6% of those who had taken one or two doses IPTp-SP. In the multivariable logistic model, primary (aOR 0.61; p = 0.03) and tertiary education (aOR 0.40; p = <0.001) decreased the odds of anaemia in pregnancy. Further, pregnant women who were anaemic at the time of enrollment (aOR 3.32; p = <0.001) to the Antenatal Care clinic and had malaria infection at late gestation (aOR 2.36; p = <0.001) had higher odds of anaemia in pregnancy. Anaemia in pregnancy remains high in the Northern region of Ghana. More than half of the pregnant women were anaemic despite the use of IPTp-SP. Maternal formal education reduced the burden of anaemia in pregnancy. The high prevalence of anaemia in pregnancy amid IPTp-SP use in Northern Ghana needs urgent attention to avert negative maternal and neonatal health outcomes.
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Affiliation(s)
- Yaa Nyarko Agyeman
- Department of Population and Reproductive Health, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Sam Newton
- Department of Global and International Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Ellis Owusu-Dabo
- Department of Global and International Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Subussa BW, Eshetu T, Degefa T, Ali MM. Asymptomatic Plasmodium infection and associated factors among pregnant women in the Merti district, Oromia, Ethiopia. PLoS One 2021; 16:e0248074. [PMID: 33765017 PMCID: PMC7993780 DOI: 10.1371/journal.pone.0248074] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/18/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Asymptomatic Plasmodium infection (API) that occurs during pregnancy increases the risk of stillbirths, abortion, premature delivery, and low birth weight. API also hinders the control and prevention of malaria as infected hosts serve as silent reservoirs for transmission of Plasmodium species in the community. OBJECTIVE The aim of this study was to determine the prevalence of API and associated factors among pregnant women. This community-based cross-sectional study was conducted at Merti district, Oromia, Ethiopia among 364 pregnant women from March to September 2018. METHODS Sociodemographic and obstetrics features were collected using a structured questionnaire. About 2ml of blood was collected from participants to detect Plasmodium species, gametocyte carriage rate, parasite density, and anemia. RESULTS The prevalence of API among pregnant women was 3.6%. The proportion of Plasmodium falciparum and Plasmodium vivax was 6(46.2%) and 7(53.8%) respectively. Out of 13 Plasmodium species identified, Gametocyte carriage rate was 4(30.7%). The geometric mean density of the asexual stage of the parasites was 994.7(interquartile [IQR], 320 to 2200) parasites/ul. The geometric mean gametocyte density was 303.3 (interquartile range [IQR], 160 to 600). The proportion of anemia among Plasmodium-infected participants was 12(92.3%). Previous infection by Plasmodium species (AOR = 5.42; 95% CI: 1.19-29.03, p = 0.047), lack of insecticide-treated bed net use (AOR = 6.52; 95% CI: 1.17-36.44, p = 0.032), and living close to stagnant water (AOR = 4.18; 95% CI (1.12-17.36, p = 0.049) were significantly associated with API. Anemia was significantly higher among Plasmodium-infected than non-infected pregnant women (x2 = 27.62, p <0.001). CONCLUSION In the current study, a relatively high prevalence of API was detected among pregnant women. Identifying API in the community is important to prevent the unwanted outcomes of Plasmodium infection and its transmission.
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Affiliation(s)
- Bereket Wake Subussa
- Department of Medical Laboratory Science, College of Health Science, Arsi University, Assella, Ethiopia
| | - Teferi Eshetu
- School of Medical Laboratory Science, College of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Teshome Degefa
- School of Medical Laboratory Science, College of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Musa Mohammed Ali
- Schools of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Olukosi AY, Olakiigbe A, Ajibaye O, Orok BA, Aina OO, Akindele SK, Akinyele OO, Onajole AT, Awolola ST, Arowolo T, Afolabi BM. Socio-economic behavioural indicators of falciparum malaria parasitaemia and moderate to severe anaemia among pregnant women attending antenatal clinics in Lagos, Southwest Nigeria. Malar J 2020; 19:393. [PMID: 33160357 PMCID: PMC7648425 DOI: 10.1186/s12936-020-03462-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 10/26/2020] [Indexed: 11/28/2022] Open
Abstract
Background Incidence of malaria and anaemia are of public health importance especially in pregnant women in endemic regions, due to the negative health consequences to the mother and fetus. This study aimed to assess the pattern of falciparum malaria infection and anaemia, based on malaria prevention methods practiced by participants. Methods A semi-structured tool was used to capture information on demographic, socio-economic and malaria prevention practices from 113 pregnant women attending antenatal clinics in 2 peri-urban health facilities in Lagos, southwest Nigeria. Malaria microscopy was conducted and haematocrit was measured. Logistic regression analysis was performed on the data collated from the survey. Results The prevalence of anaemia among pregnant women was 87.2%. The mean (± sd) packed cell volume (PCV) (%) of the 22 (19.5%) infected subjects (26.8 ± 6.6), was significantly lower (t = −2.60, P value = 0.007) than that of the 91 (80.5%) uninfected subjects (30.8 ± 6.0). The prevalence of infection was highest in the 3rd trimester (n = 40, 35.4%) at 27.5% (11/40) and among those in their first pregnancy (n = 32, 28.3%) at 25.0% (8/32). There was a significant difference (t = −2.23, P-value = 0.01) in the mean PCV % of pregnant women who consumed herbal teas in pregnancy (28.2 ± 5.2) compared to those who did not (30.8 ± 6.6). Regression analysis showed that first pregnancy, anti-malarial use and insecticide-treated nets use the night before study had increased odds of malaria infection in participants (OR = 1.35, P = 0.006, 95% CI 0.52−2.49; OR = 2.3, P = 0.005, 95% CI 0.14−0.41; OR = 1.92, P = 0.001, 95% CI 0.62−5.98) while intermittent preventive treatment (IPT) participation and formal education were strongly and significantly associated with lower risk of parasitaemia (OR = 0.95, P = 0.025, 95% CI 0.41−2.26; OR = 0.44, P = 0.005, 95% CI 0.34−10.50). Conclusion Interventions that will reduce malaria and moderate to severe anaemia, especially in a first pregnancy, should include education on the correct use of long-lasting insecticide-treated bed nets (LLIN), IPT and the dangers of herbal teas in pregnancy.
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Affiliation(s)
- Adeola Y Olukosi
- Nigerian Institute of Medical Research, 6, Edmund Crescent, PMB 2013, Yaba, Lagos, Nigeria.
| | - Abiodun Olakiigbe
- Nigerian Institute of Medical Research, 6, Edmund Crescent, PMB 2013, Yaba, Lagos, Nigeria
| | - Olusola Ajibaye
- Nigerian Institute of Medical Research, 6, Edmund Crescent, PMB 2013, Yaba, Lagos, Nigeria
| | - Bassey A Orok
- Nigerian Institute of Medical Research, 6, Edmund Crescent, PMB 2013, Yaba, Lagos, Nigeria
| | - Olugbenga O Aina
- Nigerian Institute of Medical Research, 6, Edmund Crescent, PMB 2013, Yaba, Lagos, Nigeria
| | - Samuel K Akindele
- Nigerian Institute of Medical Research, 6, Edmund Crescent, PMB 2013, Yaba, Lagos, Nigeria
| | - Olajumoke O Akinyele
- Nigerian Institute of Medical Research, 6, Edmund Crescent, PMB 2013, Yaba, Lagos, Nigeria.,College of Medicine, University of Lagos, Idi-araba, Lagos, Nigeria.,Health, Environment and Development Foundation, Surulere, Lagos, Nigeria
| | | | - Samson T Awolola
- Nigerian Institute of Medical Research, 6, Edmund Crescent, PMB 2013, Yaba, Lagos, Nigeria
| | - Tolulope Arowolo
- Nigerian Institute of Medical Research, 6, Edmund Crescent, PMB 2013, Yaba, Lagos, Nigeria.,College of Medicine, University of Lagos, Idi-araba, Lagos, Nigeria.,Health, Environment and Development Foundation, Surulere, Lagos, Nigeria
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Gontie GB, Wolde HF, Baraki AG. Prevalence and associated factors of malaria among pregnant women in Sherkole district, Benishangul Gumuz regional state, West Ethiopia. BMC Infect Dis 2020; 20:573. [PMID: 32758164 PMCID: PMC7405459 DOI: 10.1186/s12879-020-05289-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/26/2020] [Indexed: 12/02/2022] Open
Abstract
Background Malaria during pregnancy leads to serious adverse effects on mothers and the fetus. Approximately 25 million pregnant women in sub-Saharan Africa live at risk of malaria. This study would help to achieve Sustainable Development Goals (SDGs) by improving programs that deal with the prevention of malaria. Therefore, this study aimed to assess the prevalence and associated factors of malaria among pregnant women. Methods A community-based cross-sectional study was conducted from July to August 2018 in Sherkole district, West Ethiopia. A multi-stage sampling technique was used to select 504 pregnant women. The interviewer-administered semi-structured questionnaire was used for data collection. Malaria was also diagnosed using a rapid diagnostic test. The data was entered using EPI info version 7.2.2.2 and transferred to SPSS version 20 for analysis. Descriptive statistics were done using frequency and percentages. Both bivariable and multivariable logistic regression models were employed. Variables having p-value < 0.2 were included in the final multivariable model. Variables having p-values < 0.05 from the multivariable model were considered to be significantly associated with the dependent variable. The adjusted odds ratio with its 95% confidence interval (CI) was used as a measure of association. Results Of the total 498 pregnant women who participated in this study, 51(10.2, 95% CI: 7.72–13.24) were found to have malaria. Of these, 46 (90.2%) and 5 (9.8%) were caused by Plasmodium falciparum and Plasmodium vivax, respectively. Decreasing Age (Adjusted Odds Ratio (AOR) 0.78; 95% CI 0.67–0.911), not using insecticide-treated bed net (ITN) (AOR 12.5; 95% CI 4.86–32.21), lack of consultation and health education about malaria prevention (AOR 7.18; 95% CI 2.74–18.81), being on second-trimester pregnancy (AOR 7.58; 95% CI 2.84–20.2), gravidae II (AOR 5.99; 95% CI 1.68–21.44) were found to be significantly associated with malaria during pregnancy. Conclusion Malaria is still a public health problem among pregnant women in the Sherkole district. Age, ITN use, gravidity, gestational age, and health education had a significant association with malaria. Screening pregnant women for asymptomatic malaria infection and educating and consulting on the appropriate malaria preventive methods shall be provided.
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Affiliation(s)
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Nkunzimana E, Babale MS. Knowledge and Utilisation of Intermittent Preventive Treatment of Malaria among Pregnant Women in Muramvya Health District, Burundi, 2018. East Afr Health Res J 2020; 4:81-91. [PMID: 34308224 PMCID: PMC8279260 DOI: 10.24248/eahrj.v4i1.625] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 04/29/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Intermittent Preventive Treatment in pregnancy (IPTp) of malaria is a key component of malaria control strategy in Burundi. Sulfadoxine-pyrimethamine (SP) is the drug of choice. Despite the evidence of the effectiveness of IPTp strategy using SP in reducing the adverse effects of malaria during pregnancy, the uptake and coverage in Burundi is low. This study was carried out to assess the knowledge and utilisation of IPTp among pregnant women of Muramvya Health District and determine factors that influence the uptake. METHODS This was a community based cross sectional study conducted from 16th to 28th September 2018. A total of 370 pregnant women were recruited from selected settlements of MURAMVYA Health District. A structured questionnaire was administered to elicit information on socio-demographic characteristics, knowledge, and utilisation of IPTp. Epi-Info 7.2.2.6 and Microsoft Excel 2016 software was used to perform univariate, bivariate and multivariate analyses. RESULTS Among the 370 pregnant women, 310 (83.8%) had taken IPTp-SP at least once in the index pregnancy. However, only 76 (24.5%) had completed the minimum required three doses. Having formal education (aOR=2.5, 95% CI [1.2-5.2], P= .016), parity (aOR=2.1, 95% CI [1.1-4.2], P = .033), and living at less than 5 km from the health facility (aOR=4.1, 95% CI [1.7-9.6], P =0.001) were found to be independent determinants of utilisation (at least one) of IPTp-SP. Also, having formal education (aOR=5.0, 95% CI [2.1-24.3], P<.001), and gestational age at first ANC visit (aOR=3.3, 95% CI [1.4-7.7], P=.005) were found to be independent determinants of taking optimal dose (three+) of IPTp-SP in Muramvya Health District. CONCLUSION The findings of this study show the low rate of pregnant women receiving the optimal dose of IPTp-SP. The study established that the major factors for IPTp-SP utilisation are; educational level, distance from home to the health facility, parity and the gestational age at the first ANC visit. It is therefore recommended that healthcare providers in Muramvya district should intensify sensitization and awareness campaign on the importance of girl child education and early ANC attendance in order to increase uptake and utilization of IPTp-SP for improved health outcomes.
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Affiliation(s)
- Edouard Nkunzimana
- Ministry of Public Health and Fight against AIDS, Department of Pharmacy, Medicine and Laboratories, Bujumbura, Burundi
| | - Mu'awiyyah Sufiyan Babale
- Ahmdadu Bello University, Faculty of Clinical Sciences, Department of Community Medicine, Zaria, Nigeria
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Sixpence A, Nkoka O, Chirwa GC, Milanzi EB, Mangani C, Mathanga DP, Ntenda PAM. Levels of knowledge regarding malaria causes, symptoms, and prevention measures among Malawian women of reproductive age. Malar J 2020; 19:225. [PMID: 32580731 PMCID: PMC7315553 DOI: 10.1186/s12936-020-03294-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/17/2020] [Indexed: 12/29/2022] Open
Abstract
Background Malawi is a malaria-endemic country and approximately 6 million cases are reported annually. Improving knowledge of malaria causes and symptoms, and the overall perception towards malaria and its preventive measures is vital for malaria control. The current study investigated the levels of knowledge of the causes, symptoms and prevention of malaria among Malawian women. Methods Data from the 2017 wave of the Malawi Malaria Indicator Survey (MMIS) were analysed. In total, 3422 women of reproductive age (15–49 years) were sampled and analysed. The levels of women’s knowledge about: (1) causes of malaria; (2) symptoms of malaria; and, (3) preventive measures were assessed. The tertiles of the composite score were used as the cut-offs to categorize the levels of knowledge as ‘low’, ‘medium’ and ‘high’. Multinomial logistic regression models were constructed to assess the independent factors while taking into account the complex survey design. Results Approximately 50% of all respondents had high levels of knowledge of causes, symptoms and preventive measures. The high level of knowledge was 45% for rural women and 55% for urban dwellers. After adjusting for the a wide range of factors, women of age group 15–19 years adjusted odds ratio ((aOR): 2.58; 95% Confidence Interval (CI) 1.69–3.92), women with no formal education (aOR: 3.73; 95% CI 2.20–6.33), women whose household had no television (aOR: 1.50; 95% CI 1.02–2.22), women who had not seen/heard malaria message (aOR: 1.53; 95% CI 1.20–1.95), women of Yao tribe (aOR: 1.95; 95% CI 1.10–3.46), and women from rural areas had low levels of knowledge about the causes of malaria, symptoms of malaria and preventive measures. Additionally, the results also showed that women aged 15–19 years (beta [β] = − 0.73, standard error [SE] = 0.12); P < .0001, women with no formal education (β = − 1.17, SE = 0.15); P < .0001, women whose household had no radio (β = − 0.15, SE = 0.0816); P = 0.0715 and women who had not seen or heard malaria message (β = − 0.41, SE = 0.07); P < .0001 were likely to have a lower knowledge score. Conclusions The levels of malaria knowledge were reported to be unsatisfactory among adult women, underscoring the need to scale up efforts on malaria education. Beside insecticide-treated bed nets (ITNs) and prompt diagnosis, malaria can be best managed in Malawi by increasing knowledge of malaria causes, and symptoms especially for younger women, women with no formal education, women whose households have no media, women from Yao tribes, and rural dwellers.
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Affiliation(s)
- Alick Sixpence
- Malaria Alert Centre (MAC), College of Medicine (CoM), University of Malawi (Unima), Private Bag 360, Chichiri, Blantyre 3, Malawi
| | - Owen Nkoka
- School of Public Health (SPH), Taipei Medical University (TMU), No. 250, Wuxing Street, Xinyi District, Taipei City, 110, Taiwan.,Institute for Health Research and Communication (IHRC), P.O Box 1958, Lilongwe, Malawi
| | - Gowokani C Chirwa
- Department of Economics, Chancellor College (Chanco), University of Malawi (Unima), P.O. Box 280, Zomba, Malawi
| | - Edith B Milanzi
- Institute for Health Research and Communication (IHRC), P.O Box 1958, Lilongwe, Malawi.,MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, 90 High Holborn 2nd Floor, London, WC1V 6LJ, UK
| | - Charles Mangani
- Malaria Alert Centre (MAC), College of Medicine (CoM), University of Malawi (Unima), Private Bag 360, Chichiri, Blantyre 3, Malawi.,Department of Public Health, School of Public Health and Family Medicine (SPHFM), University of Malawi (Unima), Private Bag 360, Chichiri, Blantyre 3, Malawi
| | - Don P Mathanga
- Malaria Alert Centre (MAC), College of Medicine (CoM), University of Malawi (Unima), Private Bag 360, Chichiri, Blantyre 3, Malawi.,Department of Public Health, School of Public Health and Family Medicine (SPHFM), University of Malawi (Unima), Private Bag 360, Chichiri, Blantyre 3, Malawi
| | - Peter A M Ntenda
- Malaria Alert Centre (MAC), College of Medicine (CoM), University of Malawi (Unima), Private Bag 360, Chichiri, Blantyre 3, Malawi.
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Kumari S, Garg N, Kumar A, Guru PKI, Ansari S, Anwar S, Singh KP, Kumari P, Mishra PK, Gupta BK, Nehar S, Sharma AK, Raziuddin M, Sohail M. Maternal and severe anaemia in delivering women is associated with risk of preterm and low birth weight: A cross sectional study from Jharkhand, India. One Health 2019; 8:100098. [PMID: 31485474 PMCID: PMC6715890 DOI: 10.1016/j.onehlt.2019.100098] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 07/23/2019] [Accepted: 07/23/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Haemoglobin content is the well accepted indicator for anaemia assessment. The high prevalence of anaemia, maternal health care issues and adverse delivery outcome in Jharkhand, we investigated whether delivering women with anaemia would present a modifiable risk of preterm (PTB) and low birth weight (LBW). METHODS A facility-based cross-sectional study involving pregnant women, with screening for pregnancy endpoints and haemoglobin assay, were conducted. Anaemia was classified according to World Health Organization's definition of anaemia in pregnancy. Confounding variables were adjusted in a logistic model. The adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were used for analyzing the association among maternal anaemia, PTB and LBW. RESULTS We observed a high prevalence of anaemia (78.45%) in delivering women, whereas high prevalence of preterm birth (34.75%) and LBW (32.81%) in delivering women overall. In the adjusted analysis, overall anaemia in pregnancy was strongly associated with preterm birth (OR, 3.42; 95% CI, 1.98-5.88; P ≤ .0001) as compared to LBW (OR, 1.12; 95% CI, 0.65-1.61; P = .0003). The risk of PTB and LBW were dependent on the stratification of the anaemia group, as the strongest association was observed in severe (OR, 4.86) followed by mild (OR, 3.66) and moderate (OR, 3.18) anaemia in PTB; whereas risk of LBW was found in severe (OR, 2.5) followed by moderate (OR, 1.11) and mild (OR, 0.57) anaemia. The risk of PTB and LBW across six pregnancy haemoglobin groups were compared, haemoglobin of 10-10.9 g/dl (OR, 1.25) and ≤ 8 g/dl (OR, 1.03) have shown association with PTB and LBW, respectively. However, high haemoglobin concentration was not associated with either PTB or LBW. CONCLUSIONS Anaemia in delivering women was associated with an elevated risk of PTB and LBW and the risk increased with the severity of anaemia in pregnant women.
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Affiliation(s)
- Shweta Kumari
- Research Laboratory, University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
| | - Neelima Garg
- Centre for Tribal Health and Biotechnology Foundation, New Delhi, India
| | - Amod Kumar
- Research Laboratory, University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
| | - Pawas Kumar Indra Guru
- Research Laboratory, University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
| | - Sharafat Ansari
- Research Laboratory, University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
| | - Shadab Anwar
- SLS, Jawaharlal Nehru University, New-Delhi, India
- Centre for Tribal Health and Biotechnology Foundation, New Delhi, India
| | - Krishn Pratap Singh
- Research Laboratory, University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
- Centre for Tribal Health and Biotechnology Foundation, New Delhi, India
| | - Priti Kumari
- Research Laboratory, University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
- Centre for Tribal Health and Biotechnology Foundation, New Delhi, India
| | - Prashant Kumar Mishra
- University Department of Biotechnology, Vinoba Bhave University, Hazaribag, Jharkhand, India
| | - Birendra Kumar Gupta
- Research Laboratory, University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
| | - Shamshun Nehar
- Department of Zoology, Ranchi University, Ranchi, Jharkhand, India
| | - Ajay Kumar Sharma
- Research Laboratory, University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
| | - Mohammad Raziuddin
- Research Laboratory, University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
| | - Mohammad Sohail
- Research Laboratory, University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
- Centre for Tribal Health and Biotechnology Foundation, New Delhi, India
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20
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van Eijk AM, Sutton PL, Ramanathapuram L, Sullivan SA, Kanagaraj D, Priya GSL, Ravishankaran S, Asokan A, Sangeetha V, Rao PN, Wassmer SC, Tandel N, Patel A, Desai N, Choubey S, Ali SZ, Barla P, Oraon RR, Mohanty S, Mishra S, Kale S, Bandyopadhyay N, Mallick PK, Huck J, Valecha N, Singh OP, Pradhan K, Singh R, Sharma SK, Srivastava HC, Carlton JM, Eapen A. The burden of submicroscopic and asymptomatic malaria in India revealed from epidemiology studies at three varied transmission sites in India. Sci Rep 2019; 9:17095. [PMID: 31745160 PMCID: PMC6863831 DOI: 10.1038/s41598-019-53386-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 10/31/2019] [Indexed: 01/14/2023] Open
Abstract
Malaria in India, while decreasing, remains a serious public health problem, and the contribution of submicroscopic and asymptomatic infections to its persistence is poorly understood. We conducted community surveys and clinic studies at three sites in India differing in their eco-epidemiologies: Chennai (Tamil Nadu), Nadiad (Gujarat), and Rourkela (Odisha), during 2012-2015. A total of 6,645 subject blood samples were collected for Plasmodium diagnosis by microscopy and PCR, and an extensive clinical questionnaire completed. Malaria prevalence ranged from 3-8% by PCR in community surveys (24 infections in Chennai, 56 in Nadiad, 101 in Rourkela), with Plasmodium vivax dominating in Chennai (70.8%) and Nadiad (67.9%), and Plasmodium falciparum in Rourkela (77.3%). A proportional high burden of asymptomatic and submicroscopic infections was detected in community surveys in Chennai (71% and 71%, respectively, 17 infections for both) and Rourkela (64% and 31%, 65 and 31 infections, respectively). In clinic studies, a proportional high burden of infections was identified as submicroscopic in Rourkela (45%, 42 infections) and Chennai (19%, 42 infections). In the community surveys, anemia and fever were significantly more common among microscopic than submicroscopic infections. Exploratory spatial analysis identified a number of potential malaria hotspots at all three sites. There is a considerable burden of submicroscopic and asymptomatic malaria in malarious regions in India, which may act as a reservoir with implications for malaria elimination strategies.
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Affiliation(s)
- Anna Maria van Eijk
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Patrick L Sutton
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA.,GlaxoSmithKline, 5 Moore Drive, PO Box 13398, RTP, Raleigh, NC, 27709-3398, United States
| | - Lalitha Ramanathapuram
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA.,Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Steven A Sullivan
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Deena Kanagaraj
- Indian Council of Medical Research - National Institute of Malaria Research, IDVC Field Unit, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India
| | - G Sri Lakshmi Priya
- Indian Council of Medical Research - National Institute of Malaria Research, IDVC Field Unit, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India.,Department of Zoology, Madras Christian College, University of Madras, Tambaram, Chennai, 600 059, India
| | - Sangamithra Ravishankaran
- Indian Council of Medical Research - National Institute of Malaria Research, IDVC Field Unit, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India
| | - Aswin Asokan
- Indian Council of Medical Research - National Institute of Malaria Research, IDVC Field Unit, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India
| | - V Sangeetha
- Indian Council of Medical Research - National Institute of Malaria Research, IDVC Field Unit, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India
| | - Pavitra N Rao
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Samuel C Wassmer
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA.,London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, United Kingdom
| | - Nikunj Tandel
- Indian Council of Medical Research - National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India.,Institute of Science, Nirma University, Gujarat, 382481, India
| | - Ankita Patel
- Indian Council of Medical Research - National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India
| | - Nisha Desai
- Indian Council of Medical Research - National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India
| | - Sandhya Choubey
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1, Rourkela, Odisha, India
| | - Syed Zeeshan Ali
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1, Rourkela, Odisha, India
| | - Punam Barla
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1, Rourkela, Odisha, India
| | - Rajashri Rani Oraon
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1, Rourkela, Odisha, India
| | - Stuti Mohanty
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1, Rourkela, Odisha, India
| | - Shobhna Mishra
- Indian Council of Medical Research, National Institute of Malaria Research, Dwarka Sector 8, New Delhi, India
| | - Sonal Kale
- Indian Council of Medical Research, National Institute of Malaria Research, Dwarka Sector 8, New Delhi, India
| | - Nabamita Bandyopadhyay
- Indian Council of Medical Research, National Institute of Malaria Research, Dwarka Sector 8, New Delhi, India
| | - Prashant K Mallick
- Indian Council of Medical Research, National Institute of Malaria Research, Dwarka Sector 8, New Delhi, India
| | - Jonathan Huck
- Department of Geography Arthur Lewis Building, The University of Manchester, Manchester, England
| | - Neena Valecha
- Indian Council of Medical Research, National Institute of Malaria Research, Dwarka Sector 8, New Delhi, India
| | - Om P Singh
- Indian Council of Medical Research, National Institute of Malaria Research, Dwarka Sector 8, New Delhi, India
| | - K Pradhan
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1, Rourkela, Odisha, India
| | - Ranvir Singh
- Indian Council of Medical Research - National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India
| | - S K Sharma
- Indian Council of Medical Research, National Institute of Malaria Research, Dwarka Sector 8, New Delhi, India
| | - Harish C Srivastava
- Indian Council of Medical Research - National Institute of Malaria Research Field Unit, Civil Hospital, Nadiad, Gujarat, India
| | - Jane M Carlton
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA.
| | - Alex Eapen
- Indian Council of Medical Research - National Institute of Malaria Research, IDVC Field Unit, National Institute of Epidemiology Campus, Ayapakkam, Chennai, Tamil Nadu, India
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21
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Malarial anemia among pregnant women in the south-western coastal city of Mangaluru in India. INFORMATICS IN MEDICINE UNLOCKED 2019. [DOI: 10.1016/j.imu.2019.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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22
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Role of IL-1β, IL-6 and TNF-α cytokines and TNF-α promoter variability in Plasmodium vivax infection during pregnancy in endemic population of Jharkhand, India. Mol Immunol 2018; 97:82-93. [DOI: 10.1016/j.molimm.2018.03.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/18/2018] [Accepted: 03/22/2018] [Indexed: 12/17/2022]
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23
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Kumar A, Singh KP, Bali P, Anwar S, Kaul A, Singh OP, Gupta BK, Kumari N, Noor Alam M, Raziuddin M, Sinha MP, Gourinath S, Sharma AK, Sohail M. iNOS polymorphism modulates iNOS/NO expression via impaired antioxidant and ROS content in P. vivax and P. falciparum infection. Redox Biol 2017; 15:192-206. [PMID: 29268202 PMCID: PMC5738204 DOI: 10.1016/j.redox.2017.12.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 11/30/2017] [Accepted: 12/12/2017] [Indexed: 01/09/2023] Open
Abstract
Nitric oxide (NO) has dicotomic influence on modulating host-parasite interplay, synchronizing physiological orchestrations and diagnostic potential; instigated us to investigate the plausible association and genetic regulation among NO level, components of oxidative stress, iNOS polymorphisms and risk of malaria. Here, we experimentally elucidate that iNOS promoter polymorphisms are associated with risk of malaria; employing mutation specific genotyping, functional interplay using western blot and RT-PCR, quantitative estimation of NO, total antioxidant content (TAC) and reactive oxygen species (ROS). Genotyping revealed significantly associated risk of P. vivax (adjusted OR = 1.92 and 1.72) and P. falciparum (adjusted OR = 1.68 and 1.75) infection with SNP at iNOS-954G/C and iNOS-1173C/T positions, respectively; though vivax showed higher risk of infection. Intriguingly, mutation and infection specific differential upregulation of iNOS expression/NO level was observed and found to be significantly associated with mutant genotypes. Moreover, P. vivax showed pronounced iNOS protein (2.4 fold) and mRNA (2.5 fold) expression relative to healthy subjects. Furthermore, TAC and ROS were significantly decreased in infection; and differentially decreased in mutant genotypes. Our findings endorse polymorphic regulation of iNOS expression, altered oxidant-antioxidant components and evidences of risk association as the hallmark of malaria pathogenesis. iNOS/NO may serve as potential diagnostic marker in assessing clinical malaria. Polymorphism of iNOS revealed significantly associated risk of P. vivax and P. falciparum malaria and vivax showed higher risk of infection. We observed mutation and infection specific differential expression of iNOS/NO cascade. We investigated mutation specific antioxidant and ROS orchestration and observed lower TAC and ROS content in infection. Evaluated the clinical correlation among stratified axillary temperature, NO and haemoglobin content during infection.
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Affiliation(s)
- Amod Kumar
- University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
| | - Krishn Pratap Singh
- University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
| | - Prerna Bali
- National Institute of Malaria Research, Dawarka, Delhi, India
| | - Shadab Anwar
- School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Asha Kaul
- National Institute of Malaria Research, Dawarka, Delhi, India
| | - Om P Singh
- National Institute of Malaria Research, Dawarka, Delhi, India
| | - Birendra Kumar Gupta
- University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
| | - Nutan Kumari
- Department of Physiology, Patna Medical College and Hospital, Patna, India
| | - Md Noor Alam
- University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
| | - Mohammad Raziuddin
- University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
| | | | | | - Ajay Kumar Sharma
- University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India.
| | - Mohammad Sohail
- University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India.
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24
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Ibrahim H, Maya ET, Issah K, Apanga PA, Bachan EG, Noora CL. Factors influencing uptake of intermittent preventive treatment of malaria in pregnancy using sulphadoxine pyrimethamine in Sunyani Municipality, Ghana. Pan Afr Med J 2017. [PMID: 29515740 PMCID: PMC5839217 DOI: 10.11604/pamj.2017.28.122.12611] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introduction Malaria continues to pose a public health challenge in Ghana particularly in pregnant women. Ghana adopted intermittent preventive treatment of malaria in pregnancy policy using sulphadoxine pyrimethamine. Despite its implementation, its coverage still remains low. This study sought to investigate factors that influence the uptake of intermittent preventive treatment of malaria in pregnancy in the Sunyani Municipality. Methods This was a cross sectional study which employed a quantitative method. The study was conducted in five selected facilities in the Sunyani Municipality within the period of January to June 2015. Structured questionnaires were administered to 400 pregnant women randomly sampled from antenatal clinics of selected health facilities. Descriptive, bivariate and multivariate analysis of quantitative data was done using Stata12. Results A total of 400 pregnant women at 36 weeks or more gestational age were studied. The study revealed that 98.5% of the pregnant women received at least one (1) dose of sulphadoxine pyrimethamine during the current pregnancy with 71% receiving optimal (at least 3 doses) doses of sulphadoxine pyrimethamine for intermittent preventive treatment of malaria in pregnancy at the time of study. The study revealed that women who attended ANC ≥4 times (Adjusted OR = 4.7, 95% CI 1.31-17.2), knowledge of malaria in pregnancy (Adjusted OR = 2.2, 95% CI 1.03-4.62) and knowledge of intermittent preventive treatment for malaria in pregnancy (Adjusted OR = 1.8, 95% CI 1.15-2.96) were found to be positively associated with the uptake of optimal doses of sulphadoxine pyrimethamine. Conclusion This study has demonstrated that having a good knowledge of malaria in pregnancy and intermittent preventive treatment of malaria in pregnancy can significantly influence the uptake of optimal doses of sulphadoxine pyrimethamine. Encouraging women to attend antenatal care regularly (at least four visits) could also increase the optimal uptake of sulphadoxine pyrimethamine.
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Affiliation(s)
- Hajira Ibrahim
- Regional Health Directorate, Upper East Region, Bolgatanga, Ghana
| | - Ernest Tei Maya
- University of Ghana, Department of Population, Family and Reproductive Health, Accra, Ghana
| | - Kofi Issah
- Regional Health Directorate, Upper East Region, Bolgatanga, Ghana
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25
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Corrêa G, Das M, Kovelamudi R, Jaladi N, Pignon C, Vysyaraju K, Yedla U, Laxmi V, Vemula P, Gowthami V, Sharma H, Remartinez D, Kalon S, de Polnay K, De Smet M, Isaakidis P. High burden of malaria and anemia among tribal pregnant women in a chronic conflict corridor in India. Confl Health 2017. [PMID: 28649273 PMCID: PMC5477337 DOI: 10.1186/s13031-017-0113-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background With more than 200 million cases a year, malaria is an important global health concern, especially among pregnant women. The forested tribal areas of Andhra Pradesh, Telangana and Chhattisgarh in India are affected by malaria and by an on-going chronic conflict which seriously limits access to health care. The burden of malaria and anemia among pregnant women in these areas is unknown; moreover there are no specific recommendations for pregnant women in the Indian national malaria policy. The aim of this study is to measure the burden of malaria and anemia among pregnant women presenting in mobile clinics for antenatal care in a conflict-affected corridor in India. Methods This is a descriptive study of routine programme data of women presenting at first visit for antenatal care in Médecins sans Frontières mobile clinics during 1 year (2015). Burden of malaria and anemia were estimated using rapid diagnostic tests (SD BIOLINE® and HemoCue® respectively). Results Among 575 pregnant women (median age: 26 years, interquartile range: 25-30) 29% and 22% were in their first and second pregnancies respectively. Mid-Upper Arm Circumference (MUAC) was below 230 mm in 74% of them. The prevalence of anemia was 92.4% (95% Confidence Intervals (CI): 89.9–94.3), while severe anemia was identified in 6.9% of the patients. The prevalence of malaria was 29.3% (95%CI: 25.7–33.2) with 64% caused by isolated P. falciparum, 35% by either P. falciparum or mixed malaria and 1% by either P. vivax, or P.malariae or P. ovale. Malaria test was positive in 20.8% of asymptomatic cases. Malaria was associated with severe anemia (prevalence ratio: 2.56, 95%CI: 1.40–4.66, p < 0.01). Conclusions Systematic screening for malaria and anemia should be integrated into maternal and child health services for conflict affected populations in highly endemic tribal areas. Interventions should include the use of rapid diagnostic test for all pregnant women at every visit, regardless of symptoms. Further studies should evaluate the impact of this intervention alone or in combination with intermittent malaria preventive treatment.
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Affiliation(s)
- Gustavo Corrêa
- Médecins sans Frontières, Bhadrachalam, Khammam District, Telangana, 507111 India.,Médecins Sans Frontières, Brussels, 46, Rue de l'Arbre Bénit, 1050 Brussels, Belgium
| | - Mrinalini Das
- Médecins sans Frontières, Bhadrachalam, Khammam District, Telangana, 507111 India
| | - Rama Kovelamudi
- Médecins sans Frontières, Bhadrachalam, Khammam District, Telangana, 507111 India
| | - Nagendra Jaladi
- Government Hospital, Bhadrachalam, Khammam District, Telangana, 507111 India
| | - Charlotte Pignon
- Médecins sans Frontières, Bhadrachalam, Khammam District, Telangana, 507111 India
| | - Kalyan Vysyaraju
- Médecins sans Frontières, Bhadrachalam, Khammam District, Telangana, 507111 India
| | - Usha Yedla
- Médecins sans Frontières, Bhadrachalam, Khammam District, Telangana, 507111 India
| | - Vijya Laxmi
- Médecins sans Frontières, Bhadrachalam, Khammam District, Telangana, 507111 India
| | - Pavani Vemula
- Médecins sans Frontières, Bhadrachalam, Khammam District, Telangana, 507111 India
| | - Vijaya Gowthami
- Médecins sans Frontières, Bhadrachalam, Khammam District, Telangana, 507111 India
| | - Hemant Sharma
- Médecins sans Frontières, Bhadrachalam, Khammam District, Telangana, 507111 India
| | - Daniel Remartinez
- Médecins sans Frontières, Bhadrachalam, Khammam District, Telangana, 507111 India.,Médecins Sans Frontières, Brussels, 46, Rue de l'Arbre Bénit, 1050 Brussels, Belgium
| | - Stobdan Kalon
- Médecins sans Frontières, Bhadrachalam, Khammam District, Telangana, 507111 India.,Médecins Sans Frontières, Brussels, 46, Rue de l'Arbre Bénit, 1050 Brussels, Belgium
| | - Kirrily de Polnay
- Médecins Sans Frontières, Brussels, 46, Rue de l'Arbre Bénit, 1050 Brussels, Belgium
| | - Martin De Smet
- Médecins Sans Frontières, Brussels, 46, Rue de l'Arbre Bénit, 1050 Brussels, Belgium
| | - Petros Isaakidis
- Médecins sans Frontières, Bhadrachalam, Khammam District, Telangana, 507111 India.,Operational Research Unit, Médecins Sans Frontières, Luxembourg, 68, rue de Gasperich, L-1617 Luxembourg, Belgium
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26
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Ntonifor NH, Veyufambom S. Assessing the effective use of mosquito nets in the prevention of malaria in some parts of Mezam division, Northwest Region Cameroon. Malar J 2016; 15:390. [PMID: 27455995 PMCID: PMC4960689 DOI: 10.1186/s12936-016-1419-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 07/04/2016] [Indexed: 11/17/2022] Open
Abstract
Background In Cameroon, malaria continues to be endemic and the first major cause of morbidity and mortality among the most vulnerable groups—children under 5 years of age, pregnant women, people living with HIV/AIDS and the poor. The use of long-lasting insecticide-treated bed nets (LLINs) is one of the recommended measures to prevent malaria. The present study was aimed at accessing the acceptability and effective use of LLINs on the prevalence of malaria in PMI Nkwen, Bambui and its environs. Methods Hospital-based diagnosis consisted of 476 blood samples that were screened using the rapid diagnostic kits to determine the prevalence of malaria among users and non-users of LLINs. A structured questionnaire was also administered to pregnant women and children less than 5 years of age (476 hospital-based and 350 from the community) which consisted of demographic information, availability, accessibility affordability, acceptability, effective use and problems encountered with the use of LLINs. Results Result obtained showed that out of the 476 hospital-based patients, 29 tested positive for malaria giving an overall prevalence of 6.09 %. Equally, results of the questionnaire showed that 743 (89.9 %) of the respondents owned LLINs with up to 649 (87.3 %) having been given to them free-of-charge, and that 578 (77.8 %) were using their LLINs to sleep, even though 18.2 % of the respondents used their LLINs for other purposes, such as fishing, nursing seeds and footfall nets. Malaria was minimal among users of LLINs than non-users and the results were significant at P ≤ 0.05. Also 71.9 % of the respondents said that their nets were in good condition while 52.2 % of them said the major problem with the usage of LLINs was heat and the feeling of suffocation. Conclusion These results indicate that LLINs have significantly reduced the prevalence of malaria among the studied population, and so the government should not relent its efforts in the distribution of these nets especially to the vulnerable groups in order eliminate malaria and other mosquito-borne diseases. Utilization of LLINs needs to be encouraged to match ownership, while free distribution of ITNs to vulnerable groups needs to be continuous and consistent.
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Affiliation(s)
- Ngum Helen Ntonifor
- Department of Biological Sciences, University of Bamenda, North West Region, Bambili, Bamenda, Cameroon.
| | - Serophine Veyufambom
- Department of Public Health, Faculty of Health Sciences, Bamenda University of Science and Technology, North West Region, Bambili, Bamenda, Cameroon
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