SUMMARY

Malaria infection during pregnancy is a major health problem with substantial risks for the

mother, fetus and the neonate. In Nigeria, malaria contributes to an estimated 11% of maternal

mortality. An estimated 65% of Nigeria’s population lives in poverty and poverty is a major

factor affecting malaria prevention and treatment as it affects the accessibility to and

affordability of the limited interventions. One of the effective strategies that reduce maternal

mortality is the prevention of malaria in pregnancy. The World Health Organization (WHO)

formulated a strategic framework for the prevention and control of malaria during pregnancy by

recommending a three pronged approach using the Intermittent Preventive Treatment during

pregnancy (IPTp), Vector control including using of Insecticide Treated mosquito Nets (ITNs),

and Case management of malaria illness and anemia.

A cross-sectional study was conducted to measure the association between the use of preventive

strategies during pregnancy from antenatal records and the risk of malaria and other adverse

outcome among parturients in FMC Nguru, Yobe State between July and November 2014.

Interviewer-administered questionnaires were used to obtain data from one hundred and eighty-

four parturients who satisfied the inclusion criteria. Both venous and cord blood samples were

collected and tested for malaria and anemia.

Seventy four parturients tested positive for malaria giving a prevalence rate of 40%. Age group

<25years accounted for the highest proportion of the positive mothers. The presence of malaria

infection at ANC enrollment, dosage of IPTP received during pregnancy, and method used to

administer the IPTp drugs showed significant effect on the presence of the infection at delivery

respectively (OR: 6.6 CI 1.5-6.7; OR:3.08 CI 1.5-6.7; OR 4.6 CI2.2-9.5). The prevalence of

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maternal anaemia (PCV<30%) was 41% and malaria positive mothers were mostly affected

(58%).

The prevalence of malaria parasitaemia and maternal anaemia at delivery were found to be 40%

and 41% respectively. There was generally low uptake and adherence to the standard regimen of

the IPTp. Recommendations include education and social mobilization activities on the

importance and adherence to malaria prevention practices to women during pregnancy, Prompt

procurement of IPTp drugs and ITNs with monitoring the process of administration at the facility

level and ensuring the implementation of DOTS in the IPTp policy to enable effective prevention

of malaria in pregnancy and its adverse effects on pregnancy outcomes.

Key words: Malaria, Parasitaemia, Parturients, Yobe state Nigeria

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CHAPTER ONE

INTRODUCTION

1.1    Background Information

Malaria affects 3.3 billion people or half of the world’s population in 106 countries and

territories.1 WHO estimates that 216 million cases of malaria occurred in 2010, of which

81%occurred in the African region. WHO estimates that there were 655,000 malaria deaths in

2010, 91% of which occurred in the African region, and 86% were in children under 5 years of

age. Malaria is the third leading cause of death for children under five years worldwide, after

pneumonia and diarrheal disease.2

Thirty countries in sub-Saharan Africa account for 90% of global malaria deaths. Nigeria,

Democratic Republic of Congo (DRC), Ethiopia, and Uganda account for nearly 50% of the

global malaria deaths. Malaria is the second leading cause of death from infectious diseases in

Africa, after HIV/AIDS. Almost 1 out of 5 deaths of children under 5 in Africa is due to

malaria.2

Malaria causes anemia which may necessitate blood transfusions, a procedure that increases the

risk for HIV infection where universal blood screening is yet to be achieved. People living with

HIV/AIDS (PLWHA) are at an increased risk of clinical malaria, severe illness, hospitalization,

and death. Malaria contributes to a temporary increase in viral load among HIV-infected people

which may worsen the clinical disease, increase mother-to child transmission, and augment

transmission in adults .2

Malaria is a major public health problem in Nigeria where it accounts for more cases and deaths

than any other country in the world. Ninety seven percent of Nigerian population is at risk of

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malaria. The remaining 3% of the population live