Association Between Maternal Malaria Prevention and the Occurrence of Malaria Parasites Among Mothers and Their Newborns at the University of Medical Sciences Teaching Hospital, Akure

Abstract

Background: Malaria in pregnancy is a public health problem in tropical countries like Nigeria where it is associated with adverse pregnancy outcomes. Several strategies have been put in place to control its occurrence in pregnancy but despite all these the prevalence has persistently remained high in the tropics. Aims & Objectives: This study is aimed at assessing the occurrence of malaria parasites in the mothers and the newborns when established preventive measures such as insecticide treated nets, residual indoor spraying and intermittent preventive treatment are used. Methodology: The study utilized cross-sectional descriptive survey design to recruit 108 mothers and 108 neonates who booked and delivered at the University of Medical Sciences Teaching Hospital, Akure. Their blood samples were collected and assessed for the presence and density of malaria parasites using their thick films by trained research assistants and certified laboratory scientists. Information about the participants socio-demographic characteristics, use of malaria prevention methods, Obstetrics and clinical characteristics of the mothers and their newborns were also obtained from their clinical records. Data obtained was analyzed using SPSS Windows 25. Frequency tables were obtained from relevant variables, Chi Square test was used to obtain the association between maternal prevention and the presence of parasites in the mothers and the newborns and a Multi-variable logistic regression was used to predict the main method of prevention with lower risk of the occurrence of malaria parasites. Significant value was set at P<0.05. Results: The participants were mostly primigravidae who had more than four antenatal visits and also had good knowledge of the use of the long- lasting insecticide treated nets. However, only 42 (38.9%) actually slept under the nets. Many had the opportunity of having intermittent preventive treatment during pregnancy, 97 (89.8%). Among the women, 50 (46.3%) had malaria parasites while 86 (79.8%) of the newborns had malaria parasites. Out of the 50 mothers who had malaria parasites, 30 (60.0%) did not sleep under an insecticide treated net, this was statistically significant [X2=0.826, P=0.048]. Similarly, 53 (61.6%) of the newborns with malaria parasites were delivered by mothers who did not sleep under the insecticide treated nets, this was also statistically significant [X2=0.828, P=0.047]. Out of these 50 mothers, 22 (44.0%) did not apply indoor residual spraying which was found to be statistically significant in contributing to the presence of the parasites [X2= 0.925, P=0.009]. Also 37(43.0%) of these neonates were delivered by the mothers who did not apply indoor residual spraying which was also statistically significant [ X2=0.838, P=0,042]. The use of intermittent preventive treatment was found to significantly reduce the presence of malaria parasites in the mothers [X2=0.563, P=0.036] and the newborns [X2=0.847, P=0.037]. Conclusion: This study showed that the use of insecticide treated nets, residual spraying or the use of intermittent preventive treatment during pregnancy can significantly reduce the presence and the density of malaria parasites in the mother and the neonates though some still had the parasites. Therefore, possible combination of these methods of prevention may be useful to achieve complete absence of malaria parasites in the mothers and their newborns.