Malaria prevalence and risk analysis among pregnant women in Bungoma county Kenya
Introduction:
Malaria during pregnancy has adverse consequences on the mother and fetus. Information describing the prevalence Plasmodium species types and the influence of socio-economic risk factors of malaria in pregnancy is scarce. In order to determine the distribution of malaria parasite species and risk factors among pregnant women in rnBungoma County a cross sectional hospital based study was carried out between March 2016 and January 2017 among 750 consented expectant mothers seeking antenatal rnservices at the Bungoma County hospital. Malaria positivity and species identification were determined microscopically using Giemsa stain technique. Socio economic rnrisk factors were collected using a structured pre-tested questionnaire. Data was analysed using STATA version 12. Descriptive analysis was used to determine malaria rnprevalence. Chi-square X2rn and regression analyses were used to determine the association between malaria and risk factors with P-0.05 and 95 CI. A total of 162/750 rn21.6 of expectant mothers had malaria parasites. Plasmodium falciparum being the most prevalent species 83.3 Plasmodium malariae 10.5 Plasmodium ovale rn1.2 and mixed infection of Plasmodium falciparum and plasmodium malariae 4.9. Risk factors were unemployment OR 2.134 1.228-3.371 P-value 0.006 lack rnof malaria treatment OR 3.6151.285-10.167 P-value 0.015 lack of mosquito net use 3.220 2.019-5.138 P-value 0.0001. Participants in first and second trimesters of rnpregnancy were at higher risk of infection by malaria OR 2.126 1.238-6.651 P-value 0.006. Routine screening of pregnant women for malaria parasites and treatment is rnessential during all trimesters. Provision of treated mosquito nets and continuous health education are important in preventing malaria in pregnancy.
Objectives:
to determine the distribution of malaria parasite species and risk factors among pregnant women in rnBungoma County
Methodology:
A cross sectional hospital based study was adopted. Consecutive rnsampling was used to recruit participants who met inclusion rncriteria from March 2016 to January 2017
Findings:
Results:
Malaria Prevalence and Density rnThe overall malaria prevalence was 21.6 n162 with rnPlasmodium falciparum being the most prevalent species 83.3 rnn135 Plasmodium malariae 10.5 n17 Plasmodium rnovale 1.2 n2 and mixed infection of Plamodium falciparumrnand Plasmodium malariae 4.9 n8. The mean malaria parasite rndensity in pregnant women was as follows Plasmodium falciparum rn528 CI 405-751 Plasmodium malariae 312 CI 254-370 and rnPlasmodium ovale 132 CI 48-74 parasites per micro litter of rnblood Parasites/l Table1. rnSocial Economic Risk Factors rnExpectant mothers of age group 18-27 years were more likely rnto be infected with malaria parasites 79 n128 22.151 rnp0.341 compared to higher age groups for instance 28-37years rn19.8 n32 25.086 p0.079 38-49 years 1.2 n2 20.341 rnp0.184. rnMalaria prevalence was higher in expectant mothers residing rnin rural areas 129 79.6 22.709 p0.001 compared to those rnin urban areas 33 20.4 2 0.330 p0.467. Similarly study rnparticipants who lived in semi-permanent houses houses build of rnmud walls earthen floors and iron -roofed were more infected rnwith malaria 110 67.9 28.174 p0.002 compared to those rnresiding in permanent houses houses build of cement walls rncement floors and iron sheet roofs 5232.1 20.871 p0.201.rnExpectant mothers with primary level of education were more rnlikely to be infected with malaria 79 48.8 222.786 p0.001 rncompared to those who had attained tertiary and higher education rn22 13.6 24.366 p0.359. Unemployed study participants rnwere more likely to be infected with malaria 87 53.7 2 rn11.999 p0.007 compared to those employed 23 14.2 28.738 rnp 0.033. Expectant mothers in their 2nd trimester were more rnlikely to be infected with malaria 10766.1 2 3.478 p0.176 rnthan those in 1st trimester 3119.1 2 8.327 p 0.16 and 3rd rntrimester 24 14.8 2 4.309 p0.116.rnMultivariate Analysis of Risk Factors for Malaria in PregnancyrnThe risk factors for malaria infection among expectant mothers rnconsidered in the study included unemployment P0.002 OR rn9.588 2.281-40.304 lack of malaria treatment P0.015 OR rn3.6151.285-10.167 not sleeping under treated mosquito net rnP0.001 OR 3.220 2.019-8.138 and 2nd trimester of pregnancy rnP0.006 OR 2.126 1.238-3.651. The analyzed variables are
Conclusion:
A multipronged strategy should be employed in the control of rnmalaria in expectant women. The strategy should incorporate rnaspects relating to the age of the mothers parity socio-economic rnstatus as well as stage in pregnancy.rnApart from Plasmodium falciparum being prevalent the study rnfindings revealed that Plasmodium malariae and Plasmodium rnovale were also common in the study area. Principal risk factors rnwere primary education unemployment lack of malaria treatment rnlack of mosquito nets and second trimester pregnancy. Exposure rnto malaria in pregnancy was associated mainly with the failure to rnuse treated mosquito nets and unemployment. These findings are rnuseful in designing control and management strategies for malaria rnamong pregnant women in Bungoma County
Publication Information
Author(s):
Focus County(s):
Bungoma County
Programme Area(s):
Infectious and Parasitic Diseases
Research Priority Area(s):
Maternal health
Disease Domain(s):
MALARIA
Document History:
Publication Date: 11.Jan.2019
Conference Title:
Venue: