ABSTRACT
Objectives: the aim of this study is to investigate the impact of plasmodium falciparum infection in parturient women in Central Sudan where malaria transmission is mesoendemic. The purpose of this paper is to find out the prevalence of malaria paracitemia and the risk of anemia among parturient women and to suggest appropriate strategies to lower their prevalence rates
Methods: this prospective study was conducted at Medani Teaching Hospital, Sudan a tertiary regional referral center, during the period January 1997 through to December 1997. All cases were admitted during labour to the delivery room and were clinically suspected to have malaria. History, examination and investigations were carried out on all patients
Results: the total number of patients enrolled in this study was 550, amounting to 14.9% of all women [N=3,687] who delivered during the study period. The prevalence of malaria paracitemia was 58.9% [N=550] while prevalence of anemia [defined as hemoglobin <9.0 g/dl] was 24.1% the mean hemoglobin levels in patients with positive and negative malaria paracitemia was 9.7251.62 and 9.85+ 1.60 gdl. Statistically the difference in the mean hemoglobin level was not significant, t=0.879, A significant negative correlation between parasite count in maternal blood and hemoglobin level of the mother, was observed, where r= 0.121 [P=0.032]. out of 17 [3.3%] patients who had used chloroquine tablets for prophylaxis, 11 patients still had positive paracitemia. Although there was a higher parasite count in those 11 patients, statistically the difference was not significance where P> 0.05
Conclusion: the study documents a high prevalence of malaria paracitemia and anemia among the parturient women in Central Sudan. There were 533 pregnant women [97%] who did not use chloroquine tablets as chemoprophylaxis and 17 [3%] had prophylaxis. Eleven of the later [N=17] had positive paracitemia. In view of the high prevalence of paracitemia and anemia, and although the sample of patient who used chloroquine tablets for prophylaxis and had positive paracitemia is small [17 out of 550], a wide scale prophylaxis placebo- controlled trial is recommended to test the impact of prophylaxis during pregnancy and to measure the effect on the mother, and the neonate. The drug that proves to be effective as a prophylactic should be an integral part of antenatal care along 14th iron and folic acid as anti-anemic therapy. Moreover, prompt treatment of malaria infection with the appropriate anti-malaria drug, spray of insecticides and the use of insecticide-impregnated bed-nets and curtains for preventing malaria are recommended