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Relatively Low Prevalence of Peripheral and Placental Plasmodium Infection at Delivery in Bangui, Central African Republic

DOI: 10.1155/2011/434816

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Abstract:

Introduction. The aim of this study was to estimate the prevalence of malaria among women giving birth in Bangui. Association between sociodemographic characteristics of those women and malaria, as well as prevention compliance (use of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTsp) and insecticide-treated bed nets (ITNs)), was analyzed. Methods. During September 2009, a survey was conducted on 328 women who gave birth at two main maternities of Bangui. Information was obtained by standardized questionnaire about sociodemographic criteria, IPTsp, other antimalarial treatment, and use of bet nets. Smears prepared from peripheral and placental blood were analysed for malaria parasites. Findings and Discussion. Positive results were found in 2.8% of thick peripheral blood smears and in 4.0% of placental slides. A proportion of 30.5% of the women had received at least two doses of IPTsp during the current pregnancy. Only a proportion of 42.4% of this study population had ITNs. Multigravid women were less likely to use IPTsp and ITNs. However, use of IPTsp was associated with personal income and secondary or university educational status. Hence, although this relatively prevalence was observed, more efforts are needed to implement IPTsp and ITNs, taking into account sociodemographic criteria. 1. Introduction Every year, it is estimated that tens of thousands of pregnant women in malaria-endemic areas are infected with Plasmodium falciparum [1]. Frequently, placental infection occurs, owing to the accumulation of P. falciparum-infected erythrocytes in the intervillous space, despite the absence of parasites in peripheral blood [2]. The complications of malaria during pregnancy are maternal anaemia, preterm delivery, and low birth weight of newborns, which increase perinatal morbidity [1, 3, 4]. The World Health Organization (WHO) recommends intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTsp) during pregnancy, with at least two doses after quickening (18–20 weeks) not more frequently than monthly, use of insecticide-treated bed nets (ITNs) and prompt treatment of clinical malaria [5]. Intermittent preventive treatment consists of delivering a curative treatment dose of an antimalarial at predefined intervals, regardless of the parasitological status of the woman, and the efficacy of this protocol has been demonstrated in a number of malaria-endemic countries [5–8]. Placental Plasmodium screening in the Central African Republic (CAR) in 1990 showed a rate of 37.1% in women who had been given chemoprophylaxis with

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