“Malaria parasitaemia and associated preventive factors among pregnant women in Nyamagana and Misungwi districts, Mwanza region, 2012

Abstract

Background: Malaria is still a problem during pregnancy in Tanzania and is associated with maternal anemia, premature delivery, intrauterine growth retardation and low birth weight. Tanzania adopted The World Health Organization (WHO) recommendation that all pregnant women living in sub-Saharan Africa countries with stable malaria transmission to receive Intermittent Preventive Treatment during pregnancy (IPTp) using two doses of Sulphadoxine Pyrimethamine, use Insecticide treated bed nets (ITNs) and effective case management of malaria and anemia. There is increased SP resistance and low uptake of IPTp-SP and unequal distribution of prevention tools like ITNs between rural and urban settings in the country. This study aims at determining preventive factors that are associated with presence of malaria parasitaemia and anemia among pregnant women. Methods: A cross-sectional hospitalbased study was conducted between May and June 2012, where a pretested questionnaire was administered to 400 pregnant women at selected nine antenatal clinics in Misungwi and Nyamagana districts in Mwanza and blood samples were collected for determining malaria parasitaemia and anaemia. The antenatal booklets were inspected for timing and number of visits to the clinic, obstetric history and use and timing of IPTp-SP. Data were entered, cleaned and analyzed using STATA software version 10. Data were summarized using frequency distribution tables for categorical variables and by calculating means and standard deviations for continuous variables. For categorical variables proportions were compared using X2 test or Fisher’s exact test, logistic regression were used to identify independent predictors of malaria and SP use. Results: Of the 400 pregnant women studied, 5.5% (22/400) had P.falciparum malaria. The prevalence of anaemia was 48.6% (194/399). Coverage of SP for at least one dose was 40% and for second dose was 16%. About 98% of respondents reported to own and use ITNs. No significant association was observed between malaria parasitaemia and anaemia (OR=0.87,95%CI, 0.36-2.02, P=0.7). Risk factors for malaria parasitaemia were primigravidae (AOR=2.53, 95%CI, 0.97-6.58, P=0.05) and non- use of SP (AOR=7.68, 95%CI, 1.74-33.75. P=0.007). Conclusion: 5.5% of pregnant women had malaria parasitaemia, About 50% had mild anaemia. However given the health impact of the diseases in pregnancy, antenatal interventions such as IPTp-SP are needed to be improved to reach the recommended coverage.