Comparative Study of Intrapartum Placental and Peripheral Blood Malaria Parasitaemia in Mothers Delivering at Mbarara Regional Referral Hospital UGANDA

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Author: Achidri Job E. A, Ssendikaddiwa Bwogi.E

Comparative Study of Intrapartum

Placental and Peripheral Blood Malaria Parasitaemia in Mothers Delivering at Mbarara Regional Referral Hospital Achidri Job E.A*, Ssendikaddiwa Bwogi.E Mbarara University of Science and Technology (MUST)

Background

Malaria in pregnancy (MIP) is under estimated because surveys to assess malaria in pregnancy mostly rely on peripheral blood smear (B/S) microscopy and yet it has been observed that mature forms of Plasmodium falcipurum disappear from peripheral blood into capillaries of deeper organs hence reduction in the diagnostic sensitivity of peripheral blood microscopy.

The main objective of this study was to compare intrapartum placental and peripheral malaria parasitaemia. The specific objectives were to determine parasitaemia levels and establish relationship with obstetric and demographic parameters.

Methods

Placental and peripheral thick B/S were collected from 90 mothers who were selected by systematic random sampling among mothers who delivered at Mbarara Regional Referral Hospital in May and June-2006. The B/S were stained by Giemsa staining technique; malaria parasitaemia was determined qualitatively and quantitatively by counting malaria parasites/ěL of blood using leucocytes as a standard to estimate volume of blood. Infant birth weights and other obstetric and demographic information were also taken.

Results

Fifteen (16.7%) of the mothers had peripheral blood parasitaemia and nineteen (21%) had placental parasitaemia. Malaria parasitaemia was significantly higher in placental blood than in peripheral blood. Schizonts and haemozoins were the predominant features in placental B/S. Placental parasitaemia was significantly associated with low parity especially primigravidii and low maternal age. High placental parasitaemia was significantly associated with low infant birth weight (LBW). There was no significant difference in placental parasitaemia between the mothers who were on antenatal sulfadoxine-pyrimethamine prophylaxis and those who were not.

Conclusions

These findings suggest that placental blood microscopy is a relatively better evaluation for MIP than peripheral blood microscopy. Primigravidii and young mothers are the most susceptible to infection. It is recommended that an effective regimen of malaria prophylaxis be evaluated as the currently used sulfadoxine-pyrimethamine is apparently not so effective. *achidrijob@yahoo.com