scholarly journals Epidemiology of Malaria in Pregnancy and Associated Risk Factors in Nigeria: a Review

2021 ◽  
pp. 59-72
Author(s):  
Chibuzo Christian Uba ◽  
Moses Nkechukwu Ikegbunam ◽  
Emmanuel Chigozie Udegbunam ◽  
Chioma Abana ◽  
Stephen Nnaemeka Ezekwueche ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Preventive Treatment ◽  
Malaria In Pregnancy ◽  
Sub Saharan Africa ◽  
Drug Misuse ◽  
Care Services ◽  
Sub Saharan ◽  
Associated Risk Factors ◽  
In Pregnancy

Each year, an estimated number of 300–500 million people are infected with malaria parasite, with an undesirable effect of over one million deaths. Pregnant women as well as young children, non-immune travellers visiting malaria-endemic zones are at the highest risk of suffering or experiencing life - threatening malaria infection. Maternal immunity, parasite density, parity, inadequate antenatal care services, drug misuse and abuse as well intermitted preventive treatment drug failure cum resistance are the most associated risk factors of malaria in pregnancy obtainable in endemic regions of sub-Saharan Africa. Identification and understanding of these factors will play a major role in reducing the burden as well as eliminating malaria disease among pregnant women living in endemic regions.

scholarly journals Intermittent screening and treatment with dihydroartemisinin-piperaquine for the prevention of malaria in pregnancy: implementation feasibility in a routine healthcare system setting in western Kenya

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Jenny Hill ◽  
Peter Ouma ◽  
Seth Oluoch ◽  
Jane Bruce ◽  
Simon Kariuki ◽  
...  
Keyword(s):  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Standard Of Care ◽  
Health Facilities ◽  
Malaria In Pregnancy ◽  
Sub Saharan Africa ◽  
Directly Observed Therapy ◽  
Western Kenya ◽  
Sub Saharan ◽  
In Pregnancy

Abstract Background Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is recommended for preventing malaria in pregnancy in areas of moderate-to-high transmission in sub-Saharan Africa. However, due to increasing parasite resistance to SP, research on alternative strategies is a priority. The study assessed the implementation feasibility of intermittent screening and treatment (ISTp) in the second and third trimester at antenatal care (ANC) with malaria rapid diagnostic tests (RDTs) and treatment of positive cases with dihydroartemisinin-piperaquine (DP) compared to IPTp-SP in western Kenya. Methods A 10-month implementation study was conducted in 12 government health facilities in four sub-counties. Six health facilities were assigned to either ISTp-DP or IPTp-SP. Evaluation comprised of facility audits, ANC observations, and exit interviews. Intermediate and cumulative effectiveness analyses were performed on all processes involved in delivery of ISTp-DP including RDT proficiency and IPTp-SP ± directly observed therapy (DOT, standard of care). Logistic regression was used to identify predictors of receiving each intervention. Results A total of 388 and 389 women were recruited in the ISTp-DP and IPTp-SP arms, respectively. For ISTp-DP, 90% (289/320) of eligible women received an RDT. Of 11% (32/289) who tested positive, 71% received the correct dose of DP and 31% the first dose by DOT, and only 6% were counselled on subsequent doses. Women making a sick visit and being tested in a facility with a resident microscopist were more likely to receive ISTp-DP (AOR 1.78, 95% CI 1.31, 2.41; and AOR 3.75, 95% CI 1.31, 2.40, respectively). For IPTp-SP, only 57% received a dose of SP by DOT. Payment for a laboratory test was independently associated with receipt of SP by DOT (AOR 6.43, 95% CI 2.07, 19.98). Conclusions The findings indicate that the systems effectiveness of ANC clinics to deliver ISTp-DP under routine conditions was poor in comparison to IPTp-SP. Several challenges to integration of ISTp with ANC were identified that may need to be considered by countries that have introduced screening at first ANC visit and, potentially, for future adoption of ISTp with more sensitive RDTs. Understanding the effectiveness of ISTp-DP will require additional research on pregnant women’s adherence to ACT.

scholarly journals A case study of the first pregnant women with COVID-19 in Bukavu, Eastern DR Congo.

2020 ◽  
Author(s):  
Etienne KAJIBWAMI BIRINDWA ◽  
Guy MULINGANYA MULUMEODERHWA ◽  
Olivier NYAKIO ◽  
Guy-Quesney MATESO MBALE ◽  
Serge ZIGABE MUSHAMUKA ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Microscopic Examination ◽  
Sub Saharan Africa ◽  
Dr Congo ◽  
Case Presentation ◽  
History Of ◽  
Sub Saharan ◽  
In Pregnancy

Abstract Introduction: Vertical transmission of covid-19 is possible; its risk factors are worth researching. The placental changes found in pregnant women have a definite impact on the foetus.Case presentation: We report a case of a 25-year-old woman, gravida 3, para 2 (2 alive children), with a history of two caesarean deliveries, who was infected by the SARS-Cov-2 during the last term of her pregnancy. She gave birth by caesarean after 34 weeks of gestation to a new-born baby also infected with SARS-Cov-2. The per-operative observations noted several eruptive lesions in the pelvis, bleeding on contact. Microscopic examination of the foetal appendages revealed thrombotic vasculopathy in the placenta and in the umbilical cord vessels.Conclusion: This case is one of the first documented cases of COVID-19 in pregnancy in sub-Saharan Africa. We strongly suggest obstetricians to carefully examine the aspect of the peritoneum, viscera and foetal appendages in affected pregnant women.

scholarly journals Managing intermittent preventive treatment of malaria in pregnancy challenges: an ethnographic study of two Ghanaian administrative regions

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Matilda Aberese-Ako ◽  
Pascal Magnussen ◽  
Margaret Gyapong ◽  
Gifty D. Ampofo ◽  
Harry Tagbor
Keyword(s):  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Ethnographic Study ◽  
Health Facilities ◽  
Malaria In Pregnancy ◽  
Sub Saharan Africa ◽  
Bed Nets ◽  
Maternal Healthcare ◽  
Sub Saharan ◽  
In Pregnancy

Abstract Background Malaria in pregnancy (MiP) is an important public health problem across sub-Saharan Africa. The package of measures for its control in Ghana in the last 20 years include regular use of long-lasting insecticide-treated bed nets (LLINs), directly-observed administration (DOT) of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) and prompt and effective case management of MiP. Unfortunately, Ghana like other sub-Saharan African countries did not achieve the reset Abuja targets of 100% of pregnant women having access to IPTp and 100% using LLINs by 2015. Methods This ethnographic study explored how healthcare managers dealt with existing MiP policy implementation challenges and the consequences on IPTp-SP uptake and access to maternal healthcare. The study collected date using non-participant observations, conversations, in-depth interviews and case studies in eight health facilities and 12 communities for 12 months in two Administrative regions in Ghana. Results Healthcare managers addressed frequent stock-outs of malaria programme drugs and supplies from the National Malaria Control Programme and delayed reimbursement from the NHIS, by instituting co-payment, rationing and prescribing drugs for women to buy from private pharmacies. This ensured that facilities had funds to pay creditors, purchase drugs and supplies for health service delivery. However, it affected their ability to enforce DOT and to monitor adherence to treatment. Women who could afford maternal healthcare and MiP services and those who had previously benefitted from such services were happy to access uninterrupted services. Women who could not maternal healthcare services resorted to visiting other sources of health care, delaying ANC and skipping scheduled ANC visits. Consequently, some clients did not receive the recommended 5 + doses of SP, others did not obtain LLINs early and some did not obtain treatment for MiP. Healthcare providers felt frustrated whenever they could not provide comprehensive care to women who could not afford comprehensive maternal and MiP care. Conclusion For Ghana to achieve her goal of controlling MiP, the Ministry of Health and other supporting institutions need to ensure prompt reimbursement of funds, regular supply of programme drugs and medical supplies to public, faith-based and private health facilities.

scholarly journals A case study of the first pregnant women with COVID-19 in Bukavu, Eastern DR Congo

2020 ◽  
Author(s):  
ETIENNE KAJIBWAMI BIRINDWA ◽  
Guy MULINGANYA MULUMEODERHWA ◽  
Olivier NYAKIO ◽  
Guy Quesney MATESO MBALE ◽  
Serge ZIGABE MUSHAMUKA ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Microscopic Examination ◽  
Sub Saharan Africa ◽  
Dr Congo ◽  
Case Presentation ◽  
History Of ◽  
Sub Saharan ◽  
In Pregnancy

Abstract Introduction: Vertical transmission of covid-19 is possible; its risk factors are worth researching. The placental changes found in pregnant women have a definite impact on the foetus.Case presentation: We report a case of a 25-year-old woman, gravida 3, para 2 (2 alive children), with a history of two caesarean deliveries, who was infected by the SARS-Cov-2 during the last term of her pregnancy. She gave birth by caesarean after 34 weeks of gestation to a new-born baby also infected with SARS-Cov-2. The per-operative observations noted several eruptive lesions in the pelvis, bleeding on contact. Microscopic examination of the foetal appendages revealed thrombotic vasculopathy in the placenta and in the umbilical cord vessels.Conclusion: This case is one of the first documented cases of COVID-19 in pregnancy in sub-Saharan Africa. We strongly suggest obstetricians to carefully examine the aspect of the peritoneum, viscera and foetal appendages in affected pregnant women.

scholarly journals A case study of the first pregnant woman with COVID-19 in Bukavu, eastern Democratic Republic of the Congo

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Etienne Kajibwami Birindwa ◽  
Guy Mulinganya Mulumeoderhwa ◽  
Olivier Nyakio ◽  
Guy-Quesney Mateso Mbale ◽  
Serge Zigabe Mushamuka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Democratic Republic ◽  
Sub Saharan Africa ◽  
Case Presentation ◽  
Republic Of The Congo ◽  
History Of ◽  
Sub Saharan ◽  
In Pregnancy

Abstract Introduction Vertical transmission of covid-19 is possible; its risk factors are worth researching. The placental changes found in pregnant women have a definite impact on the foetus. Case presentation We report a case of a 25-year-old woman, gravida 3, para 2 (2 alive children), with a history of two caesarean deliveries, who was infected by the SARS-CoV-2 during the last term of her pregnancy. She gave birth by caesarean at 34 weeks of gestation to a newborn baby also infected with SARS-CoV-2. The peri-operative observations noted several eruptive lesions in the pelvis, bleeding on contact. Microscopic examination of the foetal appendages revealed thrombotic vasculopathy in the placenta and in the umbilical cord vessels. Conclusion This case is one of the first documented cases of COVID-19 in pregnancy in sub-Saharan Africa. We strongly suggest obstetricians to carefully examine the aspect of the peritoneum, viscera and foetal appendages in affected pregnant women.

scholarly journals Anaemia, Body Mass Index and Risk Factors Association with Malarious Pregnant Women in Ebonyi State, Nigeria

2020 ◽  
pp. 32-38
Author(s):  
C. A. Imakwu ◽  
J. C. Ozougwu ◽  
O. P. Okeke ◽  
G. U. Amana ◽  
S. C. Eziuzor
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Pregnant Women ◽  
Body Mass ◽  
Primary Education ◽  
Rainy Season ◽  
Malaria Infection ◽  
Malaria In Pregnancy ◽  
Sub Saharan Africa ◽  
In Pregnancy

Aims: Malaria in pregnancy is a weighty health problem in sub-Saharan Africa where 90% of the global malaria burden occurs, therefore there is urgent need for more researches on malaria in pregnancy to reduce its mortality and morbidity. Anaemia, body mass index and risk factors association with malarious pregnant women in Ebonyi State was investigated in this study. Study Design: A cross-sectional study on malaria infection among pregnant women in Ebonyi State, Nigeria was carried out from April 2011 to March 2012 from two selected hospitals. Methodology: Venous blood samples were collected for thick and thin films blood smears for microscopic examinations. Presence or absence of anaemia was determined by measuring haemoglobin concentration spectrophotometrically using the cyanmethemoglobin method. Chi-square (χ2) was used to analyse the data collected. Statistical significance was set at P < 0.05. Results: The result showed that out of 360 pregnant women sampled with average age of (26.54 ± 4.61), infection rate of 150 (41.7%) was observed. The prevalence of anaemia was 202(56.1%) and it was highly associated with malaria, infection was higher among pregnant women who were anaemic than those who were not. Also, body mass index is associated with malaria as it showed its highest prevalence amongst overweight pregnant women. The risk factors associated with malaria in this study were rainy season, primigravidae and primary education. Conclusion: Increased awareness about anaemia, body mass index and risk factors such as rainy season, primigravidae and primary education association with malaria as established in this study could help in the reduction of the burden of malaria among pregnant women.

scholarly journals Sub-optimal Intermittent Preventive Treatment in pregnancy (IPTp) is associated with an increased risk of submicroscopic P. falciparum infection in pregnant women: a prospective cohort study in Benin

2020 ◽  
Author(s):  
Cornélia P A Hounkonnou ◽  
Nicaise Tuikue Ndam ◽  
Nadine Fievet ◽  
Manfred Accrombessi ◽  
Emmanuel Yovo ◽  
...  
Keyword(s):  
Gestational Age ◽  
Negative Binomial ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Malaria In Pregnancy ◽  
Sub Saharan Africa ◽  
Increased Risk ◽  
Sub Saharan ◽  
The Impact ◽  
In Pregnancy

Abstract Background Harmful maternal and neonatal health outcomes result from malaria in pregnancy, the prevention of which primarily relies on intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP). WHO recommends IPTp-SP in sub-Saharan Africa, but implementation is highly heterogeneous and often sub-optimal in terms of the number of doses and their timing. In this study, we assessed the impact of this heterogeneity on malaria in pregnancy, mainly with respect to submicroscopic Plasmodium falciparum infections. Methods We used data from 273 Beninese women followed throughout pregnancy. Screening for P. falciparum infections, using both microscopy- and polymerase chain reaction (PCR) -based methods, was performed monthly, and information on IPTp-SP dose was collected. Gestational age was estimated by repeated ultrasound scans. Using a negative binomial model, we investigated the effect of IPTp-SP doses and timing, after 17 weeks of gestation, on the number of P. falciparum infections, focusing on submicroscopic infections detectable only by PCR. Results At least two IPTp-SP doses were taken by 77.3% of the women. The median gestational age at first IPTp-SP dose was 22 weeks. A late first IPTp-SP dose (&gt;21.2 weeks) was marginally associated with an increased number of P. falciparum infections (adjusted incidence rate ratio [aIRR] =1.3; p=0.098). The number of IPTp-SP doses was not associated with the number of submicroscopic infections (aIRR=1.2, p=0.543). Conclusion A late first IPTp-SP dose fail to provide optimal protection against P. falciparum, especially submicroscopic infections. This highlights the need for a new antimalarial drug for IPTp that could be taken early in pregnancy.

scholarly journals Assessment of Malaria Intermittent Preventive Treatment (Ipt) Uptake among Pregnant Women attending Antenatal Care at Kasanje Health Center III, Wakiso District

2021 ◽  
Author(s):  
◽  
Doreen Kabatongole
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Health Center ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Malaria In Pregnancy ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Major Public Health Problem ◽  
In Pregnancy

Background: Malaria in pregnancy is a major public health problem with substantial risks for both the mother and unborn child. Malaria is responsible for 10,000 maternal deaths globally, 20% of stillbirths, and 11% of newborn deaths in sub-Saharan Africa. The study intends to explore the extent of intermittent preventive treatment IPTp uptake among pregnant women attending ANC. Methodology A Cross-sectional survey was carried out among pregnant women attending antenatal care at Kasanje Health Center III to explore the extent of intermittent preventive treatment (IPTp) uptake among pregnant women attending ANC. Data on their socio-demographic characteristics and antenatal service utilization were collected using a questionnaire and review of antenatal care (ANC) cards. In-depth interviews were conducted and data on ANC service delivery collected and analyzed. Univariate, Bivariate and multiple logistic regression analyses were done to determine factors associated with uptake of IPTp. Results: A total of 75 pregnant women were interviewed, all in reproductive age 15-48 years, with an average age of 25.6years. All the respondents (100%) had attended antenatal care at least once. 58% of the participants wherein their third trimester. Many, 31% were on their second visit, 24% on their 3rd visit while only 10% were on their first visit. The majority of the participants (88%) had their ANC started in the first trimester. It was also noted that the number of IPTp varied significantly with the number of ANC visits (chi2=33.8, p<0.001). The majority (62.67) of the participants knew IPTp and the majority of the respondents (99%) knew how malaria is transmitted. Abortion was mentioned as the major outcome of malaria in pregnancy (95%) followed by Stillbirths (72%). Conclusion and recommendations: An increased number of ANC visits, providing IPTp information to pregnant women, and the gestational age of pregnancy resulted in increased uptake of IPTp.

scholarly journals Managing intermittent preventive treatment of malaria in pregnancy challenges: an ethnographic study of two Ghanaian administrative regions

2020 ◽  
Author(s):  
Matilda Aberese-Ako ◽  
Pascal Magnussen ◽  
Margaret Gyapong ◽  
Gifty Dufie Ampofo ◽  
Harry Tagbor
Keyword(s):  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Ethnographic Study ◽  
Health Facilities ◽  
Malaria In Pregnancy ◽  
Sub Saharan Africa ◽  
Bed Nets ◽  
Maternal Healthcare ◽  
Sub Saharan ◽  
In Pregnancy

Abstract Background: Malaria in pregnancy (MiP) is an important public health problem across sub-Saharan Africa. The package of measures for its control in Ghana in the last 20 years include regular use of long-lasting insecticide-treated bed nets (LLINs), directly observed administration (DOT) of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) and prompt and effective case management of MiP. Unfortunately, Ghana like other sub-Saharan African countries did not achieve the reset Abuja targets of 100% of pregnant women having access to IPTp and 100% using LLINs by 2015.Methods: This ethnographic study explored how healthcare managers dealt with existing MiP policy implementation challenges and the consequences on IPTp-SP uptake and access to maternal healthcare. The study collected date using non-participant observations, conversations, in-depth interviews and case studies in eight health facilities and twelve communities for twelve months in two Administrative regions in Ghana. Results: Healthcare managers addressed frequent stock-outs of malaria programme drugs and supplies from the National Malaria Control Programme and delayed reimbursement from the NHIS, by instituting co-payment, rationing and prescribing drugs for women to buy from private pharmacies. This ensured that facilities had funds to pay creditors, purchase drugs and supplies for health service delivery. However, it affected their ability to enforce DOT and to monitor adherence to treatment. Women who could afford maternal healthcare and MiP services and those who had previously benefitted from such services were happy to access uninterrupted services. Women who could not maternal healthcare services resorted to visiting other sources of health care, delaying ANC and skipping scheduled ANC visits. Consequently, some clients did not receive the recommended 5+ doses of SP, others did not obtain LLINs early and some did not obtain treatment for MiP. Healthcare providers felt frustrated whenever they could not provide comprehensive care to women who could not afford comprehensive maternal and MiP care.Conclusion: For Ghana to achieve her goal of controlling MiP, the Ministry of Health and other supporting institutions need to ensure prompt reimbursement of funds, regular supply of programme drugs and medical supplies to public, faith-based and private health facilities.

Sign in / Sign up

Export Citation Format

Share Document