A study of anemia in pregnant women with Plasmodium falciparum at district hospitals in Vientiane, Lao PDR.

ABSTRACT

A descriptive cross-sectional study was carried out among pregnant women attending antenatal care at the district hospital, with suspected clinical manifestation of malaria in order to determine the prevalence of anemia and malaria among pregnant women and to determine any correlation between degree of anemia and degree of malaria parasitemia in pregnancy with malaria infection. This is a quantitative research method using face-to-face questionnaire. This study was undertaken at the district hospitals of Vientiane Prefecture and Vientiane Province. Sixty-eight pregnant women with suspected malarial clinical manifestations attending the antenatal care at these hospitals were recruited during June - October, 1998. The subjects were asked about their sociodemographic, socio-economic characteristics, gravida and parity, gestational age, last pregnancy and past history of hematology diseases. Blood samples (dry smear for thick and thin blood films) were examined at the same time for Plasmodium falciparum. The study showed that the prevalence of anemia (Hb < 11 g/dl) and severe anemia (Hb 4-6.9 g/dl) in the total sample population was 48.5% and 8.8% respectively. However, the prevalence of anemia among pregnant women with malaria was 68.75% compared to those without malaria infection (42.31%), but the difference was not statistically significant (p=0.117). A plausible explanation could be small sample size. The prevalence of severe anemia in pregnancy with malaria parasitemia was 18.8% compared to those without parasitemia (5.8%). The difference was not statistically significant (p=0.102). The difference of the mean hemoglobin level in falciparum positive cases and falciparum negative cases was clinically and statistically significant (RR = 1.63 and p=0.00679). There was some evidence of a negative correlation between the degree of anemia and parasitemia count (r= -0.19 and r2= -0.04). In conclusion this population had high prevalence of anemia in pregnant women and P. falciparum may be the main factor associated with anemia. There is a need to investigate other causes of anemia among pregnant women. Our results suggest that frequent and regular antenatal monitoring is necessary for the pregnant women. They should be encouraged to attend antenatal clinics through health education, increased health personnel awareness of proper management for the pregnant women with fevers from malarial endemic areas. There is a need for further research in this area in order to obtain adequate sample size.