Prevalence and Risk Factors for Placental Malaria in Nnewi, South East Nigeria

Abstract

Background: Placental malaria is one of the complications of malaria in pregnancy and is associated with poor pregnancy outcome. Demonstration of its prevalence and risk factors will help in modifying the measures in the prevention of malaria in pregnancy and strengthens the effective pre-existing preventive measures in our community. More so, there is paucity of studies of placental malaria in our environment using histology which is the gold standard. Aim: To determine the prevalence and the risk factors for placental malaria. Study Design and Setting: This is a cross sectional study carried out at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, South East, Nigeria between 1st August, 2012 and 31st January, 2013. Materials and Methods: A cross section of pregnant women who delivered in the labour ward was recruited for the study. The following data were obtained from those who met the inclusion criteria: age, parity, gestational age, the booking status, educational level and husband’s occupation. The history of Intermittent preventive therapy (IPT), Insecticide treated net (ITN), HIV status, Blood group and Haemoglobin genotype were also obtained. Descriptive analysis of the results was done using the statistical package for social sciences (SPSS) version 16. Univariate analysis and logistic regression were used and the results expressed in Odd ratios (OR) and Confidence interval (C.I). P-value <0.05 was taken as significant level. Result: Out of 200 placentae analyzed, 141 were positive for malaria, giving a prevalence of 70.5%. The commonest form of parasitisation was chronic infection (68.09%) followed by past infection (19.14%) and acute infection (12.77%). Using univariate analysis, the potential risk factors were young age, primigrividity, unbooked status and non use of IPT, non use of ITN, low social class, HIV positivity and haemoglobin genotype AA. However when these were subjected to logistic regression, the independent risk factors identified were young age, primigrividity, unbooked status, non use of IPT and non use of ITN. Conclusion: This study highlighted high prevalence of placental malaria in our environment. The independent risk factors noted were young age, primigrividity, unbooked status, non use of IPT and non use of ITN.