ABSTRACT
Aim:To evaluate predisposing factors, burden and management of malaria amongst pregnant women in some agrariansettlements southeast Nigeria.Study Design:Cross-sectional survey conducted in 4 randomly selected agrarian communities was conducted Place and Duration of Study:Isi-Uzo Local Government Area (Eha-Amufu, Ikem, Mbu, Neke and Umualor). The study lasted six months.Methodology: A total of 385 respondents participated. A cross-sectional survey was conducted in 4 randomly selected agrarian communities was conducted. Data were collected using a structured questionnaire.Results: Obstetric and socio-demographic characteristics of the participants showed that majority were age-bracket 25-34 (42.6%), 1sttrimester (56.4%) and multigravidae (52.8%), primary education group (32.2%), secondary education group (55.6%), farmers (73.1%) and Christians (93.5%). All the respondents (100%) agreed to the presence of overgrown bushes in their environs, many farming activities which is the main source of income and staying out late at night for relaxation. A high percentage of the women experienced fever (57.9), headache (61.6), cough & catarrh (54.5) and anorexia (53.8) monthly reflecting high malaria frequency in the locale. 20.3% had experienced stillbirth, 82.6% neonatal death and 65.5% infant mortality once, twice or more. And according to (58.7%) and (38.7%) of respondents, malaria moderately and highly affects their productivity during pregnancy respectively. Respondents that seek health/treatment in hospitals (50.9) differ insignificantly from those that seek health through traditional remedies (49.1). Cost of treatment was reported to be high and moderate by 31.9% and 65.5% respondents respectively. Poor healthcare delivery was implicated as major dissatisfaction with treatment by 76.4% of respondents.Conclusion:Malaria is a major health problem encountered by pregnant women in agrarian locales. Hence, girls should be exposed to malaria awareness programs an earlier stage of life
ABSTRACT
Malaria during pregnancy can be severe in non-immune women, but in areas of stable transmission, where women are semi-immune and often asymptomatic during infection, malaria is an insidious cause of disease and death for mothers and their offspring. Sequelae, such as severe anaemia and hypertension in the mother and low birth weight and infant mortality in the offspring, are often not recognised as consequences of infection. Pregnancy malaria, caused by Plasmodium falciparum, is mediated by infected erythrocytes (IEs) that bind to chondroitin sulphate A and are sequestered in the placenta. These parasites have a unique adhesion phenotype and distinct antigenicity, which indicates that novel targets may be required for development of an effective vaccine. Women become resistant to malaria as they acquire antibodies against placental IE, which leads to higher haemoglobin levels and heavier babies. Proteins exported from the placental parasites have been identified, including both variant and conserved antigens, and some of these are in preclinical development for vaccines. A vaccine that prevents P. falciparum malaria in pregnant mothers is feasible and would potentially save hundreds of thousands of lives each year.