Placental Malaria and Lack of Prenatal Care in an Area of Unstable Malaria Transmission in Eastern Sudan

Abstract

A cross-sectional study was conducted in Gadarif Hospital in eastern Sudan to determine the prevalence, and evaluate the risk factors, of placental malaria. Two hundred and thirty-six delivering women were enrolled in the study. Socio-demographic characteristics were gathered through questionnaires. Maternal hemoglobin was measured, ABO blood groups were determined, and placental histological examinations for malaria were performed. The birth weight of the newborn was also recorded. The mean (SD) maternal age was 25.5 (6.0) yr and the mean (SD) hemoglobin was 9.8 (0.9) g/dl. Placental histology showed acute malaria infections in 13 (5.5%) and chronic infections in 5 (2.1%) women; 28 (11.9%) of the placentas revealed past infection and 190 (80.5%) indicated no infection. Lack of prenatal care was significantly associated with placental infections (OR = 12.0, 95% CI = 2.3-16.2; P = 0.003). There was no significant association between placental malaria infections and maternal age, parity, and blood group. Thirty-two (13.5%) of these pregnancy outcomes resulted in low birthweight babies. There was, however, no significant association between placental malaria and low birth weight (OR = 2.0, 95% CI = 0.4-4.1; P = 0.1). Thus, placental malaria infections affect pregnant women in this area of eastern Sudan regardless of their age or parity. Prenatal care should be encouraged to reduce malaria in the area. Much more research regarding malaria and pregnancy is needed.

Leptin, insulin like growth factor-I levels and histology-diagnosed placental malaria in an area characterized by unstable malaria transmission in central Sudan

“…Many other studies also observed that the mother's age and parity are risk factors for placental malaria (Falade et al, 2010;Ndeserua et al, 2015;Ojurongbe et al, 2010;Tako et al, 2005;Walker et al, 2013), which is in contrast with our previously published results (Adam et al, 2005a;Adam et al, 2005b;Adam et al, 2007;Adam et al, 2009;Adam et al, 2011;Albiti et al, 2010).…”

Polymerase chain reaction and histology in diagnosis of placental malaria in an area of unstable malaria transmission in Central Sudan

“…Recently, two studies in the Eastern Sudan have shown that, the prevalence of placental P. falciparum was 1.7% (5/293) and 3% (7/237) by microscopy examinations and the prevalence was 32.0% and 19.5% by the histology [5,23]. Interestingly, 40 (32%) of the 125 smear-negative pregnant women in the Eastern Sudan had submicroscopic P. falciparum (PCR) infections [15].…”

Malaria and stillbirth in Omdurman Maternity Hospital, Sudan

“…In Sudan, malaria during pregnancy is a considerable burden [17]; pregnant women are more susceptible to malaria regardless of their age and parity [8], and even severe cases of malaria have been reported among pregnant women in central and eastern Sudan [18,19]. In neighboring Ethiopia, a 7-fold increase in the risk of stillbirth was found in mothers who were newly infected with malaria [20].…”

“…Blood films for malaria may underestimate malaria in pregnant women. Because of funding constraints, blood film was the diagnostic tool for malaria that was used in the current study; placental histology, the gold standard, which was used in the previous study yielded a high prevalence of placental malaria in eastern Sudan [17]. Secondly, other infections, such as syphilis, HIV, and bacterial and viral infections (parvovirus and Coxsackie virus) were not investigated in the current study.…”