scholarly journals Prevalence of PfDHFR and PfDHPS Mutations Associated with Drug Resistance Among Pregnant Women Receiving IPTp-SP at Msambweni County Referral Hospital, Kwale County, Kenya

2019 ◽  
Author(s):  
Stella Wanjiku Gikunju ◽  
Eric L. Agola ◽  
Raphael Omusebe Ondondo ◽  
Johnson Kangethe Kinyua ◽  
Francis Kimani ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Venous Blood ◽  
Malaria Prevention ◽  
Referral Hospital ◽  
High Prevalence ◽  
Malaria During Pregnancy ◽  
Resistance Markers ◽  
Treat All

Abstract Background: Prevention and treatment of malaria during pregnancy is crucial in dealing with maternal mortality and adverse fetal outcomes. WHO’s recommendation to treat all pregnant women with sulphadoxine-pyrimethamine (SP) through antenatal care structures was implemented in Kenya in the year 1998 but concerns about its effectiveness in preventing malaria in pregnancy has arisen due to the spread of parasites resistant to SP. We aimed to determine the prevalence of SP resistance markers in Plasmodium falciparum parasites isolated from pregnant women seeking antenatal care at Msambweni County Referral Hospital, located in coastal Kenya, between the year 2013 and 2015. Methods: This hospital-based study included 106 malaria positive whole blood samples for analysis of SP resistance markers within the PfDHFR gene (codons 51,59 &108) and PfDHPS gene (codons 437 & 540). The venous blood collected from all pregnant women was tested for malaria via light microscopy, then thereafter separated into plasma and red cells and stored in a -86⁰ freezer for further studies. Archived red blood cells were processed for molecular characterization of SP resistance markers within the PfDHFR gene and PfDHPS using real time PCR platform. Results: All samples had at least one mutation in the genes associated with drug resistance; polymorphism prevalence of PfDHFR51I, 59R and 108N was at 88.7%, 78.3% and 93.4%, respectively, while PfDHPS polymorphism accounted for 94.3% and 91.5% at 437G and 540K, respectively. Quintuple mutations (at all the five codons) conferring total SP resistance had the highest prevalence of 86%. Quadruple mutations were observed at a frequency of 10.4%, and 24.5% had a heterogeneous outcome with both wildtype and mutant genotypes in the genes of interest. Conclusion: The data suggest a high prevalence of Pf genetic variations conferring resistance to SP among pregnant women, which may explain reduced efficacy of IPTp treatment in Kenya. There is need for extensive SP resistance profiling in Kenya to inform IPTp drug choices for successful malaria prevention during pregnancy.

scholarly journals Prevalence and determinants of anaemia in pregnant women receiving antenatal care at a tertiary referral hospital in Northern Ghana

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Anthony Wemakor
Keyword(s):  
Antenatal Care ◽  
Haemoglobin Level ◽  
Pregnant Women ◽  
Referral Hospital ◽  
Northern Ghana ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
High Prevalence ◽  
Anaemia In Pregnancy ◽  
In Pregnancy

Abstract Background Anaemia during pregnancy is a major public health problem in developing countries. It is important to regularly monitor haemoglobin level in pregnancy and factors associated with it to inform clinical and preventive services. The aim of this study was to assess the prevalence and determinants of anaemia in pregnant women attending antenatal clinic (ANC) of a tertiary referral hospital in Northern Ghana. Methods An analytical cross-sectional study involving 400 pregnant women receiving antenatal care in Tamale Teaching Hospital was conducted. Using a semi-structured questionnaire and 24-h dietary recall, data were collected on socio-demographic characteristics, health practices, dietary diversity, anaemia knowledge and haemoglobin level of the women. Anaemia was defined as haemoglobin concentration less than 11 g/dl. Chi-square test and logistic regression analysis were used to identify the independent determinants of pregnancy anaemia. Results The mean age and haemoglobin of the women were 28.3 (±4.5) years and 10.81 (±1.41) g/dl respectively. About half of the women 50.8% [95% Confidence Interval (CI): 45.8–55.7] were anaemic and the prevalence of anaemia increased with pregnancy trimester. Among a host of socio-demographic, dietary, and preventive health service factors evaluated, the women’s knowledge on anaemia and pregnancy trimester at interview were the independent determinants of anaemia in pregnancy. Compared to women of the highest anaemia knowledge tertile, women belonging to the lowest (AOR = 2.63, 95% CI: 1.50–4.61) and middle (AOR = 1.92, 95% CI: 1.12–3.27) anaemia knowledge tertiles were about 3 and 2 times more likely to be anaemic respectively. Similarly, women in third trimester of pregnancy were about 4 times more likely to be anaemic compared to those in first trimester at the time of interview (AOR = 3.57, 95% CI: 1.91–6.67). Conclusions There is a high prevalence of anaemia, which increases with pregnancy trimester, in pregnant women attending ANC in a tertiary referral hospital in Northern Ghana. The women’s knowledge on anaemia and pregnancy trimester at the time of interview are associated with their anaemia status. The high prevalence of anaemia in pregnancy needs urgent intervention to prevent the occurrence of adverse maternal and neonatal outcomes. Education on anaemia should be intensified at ANCs.

scholarly journals Incidence and Predictors of Pre-Eclampsia Among Pregnant Women Attending Antenatal Care at Debre Markos Referral Hospital, North West Ethiopia: Prospective Cohort Study

2020 ◽  
Vol Volume 12 ◽  
pp. 1013-1021
Author(s):  
Molla Yigzaw Birhanu ◽  
Habtamu Temesgen ◽  
Gebreselassie Demeke ◽  
Moges Agazhe Assemie ◽  
Alehegn Aderaw Alamneh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Referral Hospital ◽  
North West ◽  
North West Ethiopia ◽  
Debre Markos

scholarly journals Herbal medicine use and its associated factors among pregnant women attending antenatal care at Wollega University Referral Hospital, West Ethiopia.

2020 ◽  
Author(s):  
Busha Gamachu Labata ◽  
Getu Bayisa Wakjira ◽  
Mohammed Gebre Dedefo ◽  
Ginenus Fekadu Mekonen ◽  
Eba Abdisa Golja ◽  
...  
Keyword(s):  
Herbal Medicine ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Low Income ◽  
Unplanned Pregnancy ◽  
Multivariate Logistic Regression Analysis ◽  
Referral Hospital ◽  
Medicine Use ◽  
Factors Associated ◽  
Planned Pregnancy

Abstract Background: Herbal medications are plant-derived materials or products with therapeutic or other human health benefits, which contain either raw or processed ingredients from one or more plants. There are many different types of herbal medicine that spring from different cultures around the world. All these have the use of medicinal plants in common. Developing world general population relies on these traditional medicines for primary care. Besides, pregnant women use herbal medicines because of pregnancy related ailments and normal aliments. Therefore, the study aimed to assess prevalence and factors associated with herbal medicine use among pregnant women attending antenatal care at Wollega University Referral Hospital. Method: A facility based cross sectional study was conducted among pregnant women attending Wollega University Referral Hospital antenatal care from May to June 2018. Written informed consent was obtained from study participants prior to data collection. Univariate and Multivariate logistic regression analysis was used to determine factors associated with herbal medicine use. Association was significant when p-value is less than 0.05. Result: A total of 238 pregnant mothers were participated in the study. The respondents’ age ranges from 17 to 46 years. The prevalence of herbal medicine use among pregnant women attending antenatal care at Wollega University Referral Hospital was 66.40%. The use of herbal medicine during pregnancy was 3.885 times more likely among rural residents (AOR =3.885, 95% CI 1.121-13.47) than urban residents. Respondents who has monthly income between 1001 to 2000 Ethiopian Birr (AOR=2.585, 95% CI 1.125–5.940) were 2.585 times more likely to use Herbal medicine as compared to those who earn >3000 Ethiopian Birr. However, mothers of planned pregnancy (AOR=0.335, 95% CI 0.114-0.986) were less likely to use Herbal medicine as compared to those who had unplanned pregnancy. Conclusion: The prevalence of herbal medicine use among pregnant women attending antenatal care at Wollega University Referral hospital was 66.40%. Commonly used herbs were Garlic (24.37%) and ginger (18.07%). Rural residence and low income had significantly associated to herbal medicine use while planned pregnancy was inversely associated to herbal medicine use.

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