Malaria risk factors in women on intermittent preventive treatment at delivery and their effects on pregnancy outcome in Sanaga-Maritime, Cameroon

• Published in: PloS one Vol. 8; no. 6; p. e65876
• Main Authors: Tonga, Calvin, Kimbi, Helen Kuokuo, Anchang-Kimbi, Judith Kuoh, Nyabeyeu, Hervé Nyabeyeu, Bissemou, Zacharie Bissemou, Lehman, Léopold G
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 06-06-2013; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Antimalarial agents; Antimalarials - therapeutic use; Aquatic insects; Biology; Birth weight; Blood; Blood levels; Cameroon - epidemiology; Cord blood; Drug Combinations; Female; Fetus; Fetuses; Health risks; Hemoglobin; Hemoglobins; HIV; HIV infections; Hospitals; Human immunodeficiency virus; Humans; Infant, Newborn; Infections; Insecticides; Malaria; Malaria, Falciparum - diagnosis; Malaria, Falciparum - epidemiology; Malaria, Falciparum - parasitology; Malaria, Falciparum - prevention & control; Medical research; Medicine; Middle Aged; Morbidity; Mortality; Mosquito Nets; Neonates; Newborn babies; Newborn infants; Parasites; Parasitic diseases; Peripheral blood; Physiology; Placenta; Placenta - parasitology; Plasmodium falciparum; Plasmodium falciparum - growth & development; Pregnancy; Pregnancy Complications, Parasitic - prevention & control; Pregnancy Outcome; Pregnant women; Prevalence; Preventive medicine; Public health; Pyrimethamine; Pyrimethamine - therapeutic use; Risk analysis; Risk Factors; Social Class; Sulfadoxine; Sulfadoxine - therapeutic use; Thick films; Thin films; Vector-borne diseases; Womens health; Zoology; Cameroon
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0065876

Malaria is known to have a negative impact on pregnant women and their foetuses. The efficacy of Sulfadoxine-Pyrimethamine (SP) used for intermittent preventive treatment (IPT) is being threatened by increasing levels of resistance. This study assessed malaria risk factors in women on intermittent preventive treatment with SP (IPTp-SP) at delivery and their effects on pregnancy outcome in Sanaga-Maritime Division, Cameroon. Socio-economic and obstetrical data of mothers and neonate birth weights were documented. Peripheral blood from 201 mothers and newborns as well as placental and cord blood were used to prepare thick and thin blood films. Maternal haemoglobin concentration was measured. The overall malaria parasite prevalence was 22.9% and 6.0% in mothers and newborns respectively. Monthly income lower than 28000 FCFA and young age were significantly associated with higher prevalence of placental malaria infection (p = 0.0048 and p = 0.019 respectively). Maternal infection significantly increased the risk of infection in newborns (OR = 48.4; p<0.0001). Haemoglobin concentration and birth weight were lower in infected mothers, although not significant. HIV infection was recorded in 6.0% of mothers and increased by 5-folds the risk of malaria parasite infection (OR = 5.38, p = 0.007). Attendance at antenatal clinic and level of education significantly influenced the utilisation of IPTp-SP (p<0.0001 and p = 0.018 respectively). Use of SP and mosquito net resulted in improved pregnancy outcome especially in primiparous, though the difference was not significant. Malaria infection in pregnancy is common and increases the risk of neonatal malaria infection. Preventive strategies are poorly implemented and their utilization has overall reasonable effect on malaria infection and pregnancy outcome.