Malaria Burden in Pregnancy at Mulago National Referral Hospital in Kampala, Uganda

Abstract

Pregnancy-associated malaria is a major global health concern. To assess the Plasmodium falciparum burden in pregnancy we conducted a cross-sectional study at Mulago Hospital in Kampala, Uganda. Malaria prevalence by each of three measures—peripheral smear, placental smear, and placental histology was 9% (35/391), 11.3% (44/389), and 13.9% (53/382) respectively. Together, smear and histology data yielded an infection rate of 15.5% (59/380) of active infections and 4.5% (17/380) of past infections; hence 20% had been or were infected when giving birth. A crude parity dependency was observed with main burden being concentrated in gravidae 1 through gravidae 3. Twenty-two percent were afflicted by anaemia and 12.2% delivered low birthweight babies. Active placental infection and anaemia showed strong association (OR = 2.8) whereas parity and placental infection had an interactive effect on mean birthweight (P = .036). Primigravidae with active infection and multigravidae with past infection delivered on average lighter babies. Use of bednet protected significantly against infection (OR = 0.56) whilst increased haemoglobin level protected against low birthweight (OR = 0.83) irrespective of infection status. Albeit a high attendance at antenatal clinics (96.8%), there was a poor coverage of insecticide-treated nets (32%) and intermittent preventive antimalarial treatment (41.5%).

The aetiology of anaemia during pregnancy: a study to evaluate the contribution of iron deficiency and common infections in pregnant Ugandan women

“…The prevalence of anaemia was 29·1 % which is comparable to 31 % reported in the Uganda Demographic and Health Survey 2011 (3) and is consistent with data from other studies in Uganda (36)(37)(38)(39) . However, IDA represented only a small proportion of all anaemia, about 5-10 % depending on the biomarker used and cut-off level applied.…”

Burden of Placental Malaria among Pregnant Women Who Use or Do Not Use Intermittent Preventive Treatment at Mulago Hospital, Kampala

“…Histopathological data collected ten years earlier showed prevalence of 64%, 4%, and 32% for active, chronic, and past infection, respectively [10]. The trend in these proportions is comparable to that observed among SP nonusers in this study, that is, 50%, 12.5%, and 37.5% for active, chronic, and past infections, respectively.…”

“…This is a robust and the most sensitive measure for MIP when compared with others such as peripheral, placental, or cord smear microscopy [10, 46]. In addition, placental histology provides a temporal history of malaria over more than half of the gestational period [35].…”

“…In Kampala district, an area of moderate malaria transmission, data from Mulago Hospital collected ten years earlier showed that 14% of deliveries had evidence of malaria infection [10]. The country has since witnessed a sustained malaria control campaign implemented by the government in collaboration with development partners.…”

Factors influencing the usage of different types of malaria prevention methods during pregnancy in Kenya

“…14 The highly protective effect of ITNs against malaria was established in Uganda as well. 15 Despite these malaria prevention benefits, only 50.0% of the women in sub-Saharan Africa use ITNs and 44.0% have received IPTp. 11,12 Aligned to the Abuja target, Kenya's national malaria strategy plan of 2001-2010 aimed to ensure that 80% of pregnant women in the country received ITNs and IPTp by 2010.…”