INCIDENCE AND RISK FACTORS OF MALARIA AMONG PREGNANT

WOMEN ATTENDING ANTI-NATAL CARE AT AISHA MUHAMMAD

BUHARI GENERAL HOSPITAL, JEGA

BY

IBRAHIM GARBA ALJANNARE

1910208070

A RESERACH PROJECT SUBMITTED TO THE DEPARTMENT OF

MICROBIOLOGY, FACULTY OF SCIENCE, FEDERAL UNIVERSITY
BIRNIN KEBBI
IN PARTIAL FULFILLMENT OF THE REQUIREMENTSFOR THE
AWARD OF BACHELOR OF SCIENCE DEGREE IN (BSc Hons.)
MICROBIOLOGY

UNDER SUPERVISION OF
DR. ZAHARADDIN MUHAMMAD KALGO

NOVEMBER, 2024

i
 DECLARATION
I hereby declare that the content of this project title “Incidence and Risk Factors
of Malaria Among Pregnant Women Attending Anti-Natal Care At Aisha
Muhammad Buhari General Hospital, Jega” written by me are purely a record
of my research work. It has not been presented before in any previous application
for degree. All quotation and literature cited from other sources have been duly
acknowledged.

......................................... .............................................
Name Sign / Date

ii
 CERTIFICATION
This project title “Incidence and Risk Factors of Malaria Among Pregnant
Women Attending Anti-Natal Care At Aisha Muhammad Buhari General
Hospital, Jega” carried out by Ibrahim Garba Aljannare with admission
Number 1910208070 has meet the regulation governing the award of the degree of
Bachelor of Science in the Department of Microbiology in Federal University
Birnin Kebbi and its approved for its contribution to knowledge and literary
presentation.

...................................... ............................................
Dr. Zaharaddin Muhammad Kalgo Date
Project Supervisor

...................................... ............................................
Mal. Abdulnasir Bello Date
Project Coordinator

...................................... ............................................
Dr. Muhammad Bashar Dalami Date
(Head of Department)

...................................... ............................................
(External Examiner) Date
Prof. A.H Kawo

iii
 DEDICATION

My profound gratitude goes to Almighty Allah, for the support and strength given
to me. I dedicated this work to my beloved parent for their love and support.

iv
 ACKNOWLEDGEMENTS

Fast and foremost, I give all thanks and glory to Allah Almighty. the Creator of the
heavens and the earth, for His infinite mercy, grace, and guidance throughout this
Journey unweaving support, divine wisdom and constant protection have made this
achievement possible I am truly grateful for His blessings and the strength He has
given me to overcome challenges along the way

I would like to express my deepest appreciation to my esteemed supervisor. Dr.

Zaharaddin Muhammad Kalgo for his exceptional guidance, encouragement, and
support His profound knowledge, insightful suggestions, and constant
encouragement throughout the course of my research have been invaluable. His
patience in reviewing my work, offering constructive criticism, and pushing me to
achieve the highest standard of academic excellence have shaped this research and
helped me develop both academically and personally. I am forever indebted to him
for his mentorship; I also appreciate the effort of Dr Muhammad Bashar Dan lami
the Head of the Department, and the entire lecturers and staff of Microbiology
Department Federal University Benin Kebbi. I am also thankful to the lab
technologists, Mal lawal Adamu Tsafe, Mal Abdullahi Mohammed and Mal
Yakubu. Ladan Dabai, for supporting me through my studies and making me the
best of myself.

My sincere thanks also go to my wonderful parents, whose love, sacrifices and

unweaving faith in me have been my foundation. Their continuous prayers,
encouragement, and support have kept me motivated during difficult times. i
cannot express how much I appreciate the sacrifices they have made to ensure that
t have the opportunity to pursue my dreams To my siblings, thank you for your
constant love, understanding, and for being my pillars of support

v
I also wish to extend my gratitude to my friends and classmates for their
companionship, collaboration and emotional support throughout this academic
journey the shared experiences, discussions, and collective learning moments
we've had together have enriched my tone at the university. Your constant
encouragement constructive feedback and kindness have made this journey not
only academically rewarding but also personally fulfilling. I am grateful for the
bonds we have formed, and I know they will last well beyond this academic
endeavor.

vi
 TABLE OF CONTENT
Title page……………………………………………………………… i
Certification page……………………………………………………... ii
Approval page…………………………………………………………. iii
Dedication……………………………………………………………... iv
Acknowledgement……………………………………………………... v
CHAPTER ONE………………………………………….…….……...1
INTRODUCTION…………………………………………..…………1
1.1 Background of the study…………………………………………….2
1.2 Statement of Research Problem…………………………………… .2
1.3 Justification for the study……………………………………………3
1.4 Aim and Objectives……………………………………………….....3
1.5 Objectives of the study……………………………………………... 3
CHAPTER TWO………………………………..……………………..4
LITERATURE REVIEW………………..…………………………….4
2.1 Review of previews literature……………………………………….6
2.2 Effects of Malaria in Pregnancy…………………………………….6
2.3 Malaria in Pregnancy: the Nigerian Experience…………………….6
2.4 Increased Risk for Malaria During Pregnancy………………………6
2.5 Laboratory Diagnosis: the key to proper case management…………7
2.6 Global malaria control strategy……………………………………...7
2.7 International collaboration towards eradication and control of malaria in
Nigeria…………………………………………………………………..7
2.8 Incidence of Malaria in Pregnancy………………………………….9
CHAPTER THREE…………………………………………………...10
MATERIALSAND METHODS………………………………………10
3.1 Study Area………………………………………………..………....10

vii
3.2 Study Population…………………………………………………….10
3.3 Exclusion Criteria…………………………………………………....10
3.4 Ethical Consideration………………………………………………...10
3.5 Collection of Samples………………………………………………..10
3.6 Procedure for Rapid Diagnostic Test…………………………………11
3.7 Assessment of Risk Factors………………………………………… .11
3.8 Data Analysis ………………………………………………………...11
CHAPTER FOUR…………………………………………………..…..13
4.0 Result………………………………………………………………17
CHAPTER FIVE………………………………………………….…….28
5.0 Discussion, Conclusion and Recommendation……………………….28
5.1 Discussion……………………………………………………….…….28
5.2 Conclusion………………………………………………………….....30
5.3 Recommendation……………………………………………….……..31
Reference…………………………………………………………….……33
Appendix…………………………………………………………….…….36

viii
 LIST OF TABLE
Table 4.1: Risk factors associated with the occurrence malaria among the pregnant women in

relation to slapping in LLIN, Stagnant water around household, bushes around household and the

malaria types of test................................................................................................................16

Table 4.2: Incidence of malaria among the pregnant women in relation to

trimester…………………………………………………......................................................17

Table 4.3: Incidence of malaria among the pregnant women in relation to the

Age ................................................................................................................................................18

ix
 LIST OF FIGURE

Figure 4.1: Incidence of malaria test, show positive and negative malaria test were responds

respectively………………………….…………………………………………………………15

x
 Abstract

Malaria, a parasitic disease transmitted by infected Anopheles mosquitoes, remains a significant

global health burden, particularly in tropical and subtropical regions. Pregnant women are
disproportionately affected by malaria due to their physiological changes and weakened immune
system. Despite the availability of effective malaria prevention and treatment strategies, malaria
remains a prevalent health issue among pregnant women in many regions. The incidence of
malaria in pregnancy varies widely depending on factors such as geographical location,
socioeconomic conditions, and access to healthcare services. Understanding the incidence of
malaria among pregnant women attending ANC is essential for developing effective prevention
and control measures. specific objectives as determine the incidence of malaria among pregnant
women attending Anti-natal Care at Aisha Muhammadu Buhari General Hospital Jega, Identify
the risk factors associated with the malaria infection in pregnant women. Based on the findings
in this study, the following recommendations were made: Health workers should carry out an
intensive community mobilization on healthy pregnancy. Effective education and counseling of
women on the importance of antenatal care: emphasizing that it is cheap. Government should
ensure that antenatal care services are affordable, especially at the grass root.

xi
 CHAPTER ONE
INTRODUCTION
1.1 Background of the study

Malaria, a parasitic disease transmitted by infected Anopheles mosquitoes, remains a significant

global health burden, particularly in tropical and subtropical regions. Pregnant women are

disproportionately affected by malaria due to their physiological changes and weakened immune

system. Malaria infection during pregnancy poses serious risks to both mother and fetus,

including maternal anemia, low birth weight, preterm delivery, and even maternal and fetal

mortality (Ghosh, 2023).

Antenatal care (ANC) is a crucial component of maternal and child health services, providing

essential preventive and curative interventions. By attending ANC, pregnant women have access

to malaria screening, diagnosis, and treatment, which can significantly reduce the transmission

and impact of malaria in pregnancy. Malaria is a life threatening disease, despite considerable

research and control effort devoted since from time immemorial, the disease remains the most

prevalent from a public health stand point ;the most common devastating parasitic disease in the

tropical and sub-tropical regions (Juma et al., 2022).Malaria is a serious fatal parasitic disease

characterize by paroxysm include fever with temperature of up to 40-41% at regular intervals

every 48 or 72 hours (tertian or quartan) alternating with good periods of no fever, chills and

anemia and have a fatal consequence leading to death and is caused by a Plasmodium species

(Ghosh, 2023).

The parasites are transmitted from the blood of an infected host to the blood of an uninfected

person through bite (inoculative method) by female Anopheles mosquito. There are five species

1
of Plasmodium that can infect human there are; Plasmodium malaria, Plasmodium falciparum,

Plasmodium vivax, Plasmodium ovale, and Plasmodium Knowlesi (Juma et al., 2022).

. In a research conducted to determine the spatial variability in the complex it of the vector

situation, (Ghosh, 2023). Reported that in Africa An. gambiae, An .Arabiensis and An. Funestus

are primary dominant vector species, while An. moucheti, An. nili, An.melas are secondary

dominant across much of the continent, where as in Asian-Pacific region there is a highly

complex situation with multi-species co-existence and variable species dominance.

The burden of malaria infection during pregnancy is caused mainly by Plasmodium falciparum

the most common species in Africa (Lankala et al., 2023). Malaria infection in pregnancy is a

health problem requiring multi disciplinary and multidimensional solution. Pregnant women

constitute the main adult risk group of malaria and 80% of death due to malaria in Africa occurs

in pregnant women and children below 5 years (Kaseje, 2022). (Kwan et al., 2023) pointed out

that the effect of malaria in pregnancy include; morbidity, anemia, fever illness, hypoglycemia,

puerperal sepsis, more severe infection such as cerebral malaria and hemorrhage. The problems

in the new born include low birth weight, premature birth, congenital malaria and mortality. The

pathological effect of malaria in pregnancy is greatly due to altered immunity. Thenonimmune,

primigravidae are usually the most affected than the multigravidae (Lankala et al., 2023).

1.2 Statement of the Research Problem

Despite the availability of effective malaria prevention and treatment strategies, malaria remains

a prevalent health issue among pregnant women in many regions. The incidence of malaria in

pregnancy varies widely depending on factors such as geographical location, socioeconomic

conditions, and access to healthcare services. Understanding the incidence of malaria among

2
pregnant women attending ANC is essential for developing effective prevention and control

measures.

1.3 Justification of the study

There paucity of data on the incidence and risk factors associated with malaria in the study area.

The risk of death from malaria is considerably higher in Africa than other parts of the world. It

remains a major impediment to health in Africa, South of the Sahara. Each year there are more

than 247million cases of malaria killing between one and three million people, majority of who

are young children in sub-Saharan Africa (Kaseje, 2022).. Nigeria contributes a quarter of

malaria burden in Africa where over 90 % of the population of are at risk. 50 % of the population

would have at least one attack per year. It is responsible for about 67% of all clinic attendance

and is the commonest cause of absenteeism from offices, farms, markets, schools etc. Malaria

accounts for 30 % childhood mortality, 11 % maternal mortality and reduces by1% Nigeria’s

GDP annually (Kwan et al., 2023).

1.3 Aim and Objectives

This study was aimed to investigate the incidence of malaria among pregnant women attending

Anti-natal Care at Aisha Muhammadu Buhari General Hospital Jega with specific objectives as

follows:

i. Determine the incidence of malaria among pregnant women attending Anti-natal Care at

Aisha Muhammadu Buhari General Hospital Jega

ii. Identify the risk factors associated with the malaria infection in pregnant women

3
 CHAPTER TWO

LITERATURE REVIEW

2.1 Review of previews literature

Malaria remains a significant public health challenge, particularly in malaria-endemic regions.

Pregnant women are especially vulnerable to malaria due to physiological changes during

pregnancy that increase susceptibility to infection (Abebe et al., 2023). This chapter reviews

existing literature on the incidence of malaria among pregnant women attending antenatal care

(ANC) and the associated factors. Malaria remains a significant public health challenge,

particularly in malaria-endemic regions. Pregnant women are especially vulnerable to malaria

due to physiological changes during pregnancy that increase susceptibility to infection (Akpan

et. al., 2023).

Malaria is caused by the parasite plasmodium which can be spread to humans through the bite of

an infected mosque to. Of the five types of plasmodium, the plasmodium falciparium is the

deadliest and affects the lives of almost 40 per cent of the world’s population with pregnant

women and children under-five years of age being the most affected (Abebe et al., 2023). This

mini-review involved the collation of findings from recent studies in regards to the incidence of

malaria infection among pregnant women and infants (Akpan et. al., 2023). A systematic

analysis of recent literature on the incidence of malaria in pregnancy from many authors was

carried out and the facts synthesized to make an easy read. From the analysis of literature, Ten

Thousand women and 200,000 babies were reported to body in annually from complications of

malaria in pregnancy which recorded a incidence of 85 percent in sub-Saharan Africa

(Chukwumaet al., 2022). More so, Fifty percent of pregnant women were discovered to be

4
carrying plasmodium falciparium in their placenta without even experiencing malaria signs

symptoms, and this development was reported to have been responsible for Twenty per cent of

stillbirths and 11 per cent of all maternal deaths. Malaria infection is considered a major threat to

the lives and well-being of pregnant women and infants (Fadimu, et. al.,2023). Therefore,

stakeholders should ensure that every clinical diagnosis of malaria in pregnancy is confirmed

with a laboratory plasmodium falciparium-based diagnosis before the administration of anti-

malarial drugs. Furthermore there should be as tepping –up on the distribution of insecticide

treated nets alongside enlightenment of pregnant women on ways of preventing mosquito bite.

Instituting the aforementioned approaches is key to improving the health-seeking behavior of

pregnant women in particular and the wider population in general thus enabling them to stay

malaria free throughout the period of pregnancy and infancy (Chukwuma et al.,2022).

Malaria affects the lives of almost 40 per cent of the world’s population, and the high risk group

being pregnant women and young children (under 5-years of age) and about 10,000 women and

200,000 babies die annually because of malaria in pregnancy. Furthermore, 85 per cent of

malaria cases in the world occur in sub- Saharan Africa, as there were 214 million malaria cases

and 438,000 malaria deaths globally in 2015 (Fadimu, et. al.,2023). Also, in sub-Saharan Africa

20 per cent of pregnant women attending ante natal clinic tested positive for the malaria parasite

(Plasmodium Falciparum) as 72 per cent of pregnant women had at some point during their

pregnancy suffered malaria infection, because 50 per cent of pregnant women carry the malaria

parasite in the placenta without noticing it, which makes them three (3) times more likely to

suffer from other severe diseases (Chukwuma et al., 2022).

5
2.2 Effects of Malaria in Pregnancy

Malaria is responsible for 20 per cent of stillbirths and 11 percent of all maternal deaths by way

of spontaneous abortion, maternal anemia, placental pathologies, infant mortality and morbidity,

intrauterine growth retardation and low birth weight. Other effects include: threatened abortion,

miscarriage, premature delivery and low birth weight which all have serious public health

implications for the mother, the fetus and newborn (Lemoine et al.,2023).

2.3 Malaria in Pregnancy the Nigerian Experience

In Nigeria, overall malaria incidence stood at 79.5 % , in Lagos and Enugu States the incidence

during pregnancy was reported to be 52 and 99 per cent respectively, and having devastating

effects on pregnant women, the fetus and the new born (Mwamburi, 2022).

2.4 increased risk for malaria during pregnancy

Mosquito (the vector that transmits the malaria parasite) has affinity for pregnant women because

pregnancy causes women to release a greater than normal amount of Carbon Dioxide (CO 2)

which adds to the odoriferous secretions during pregnancy, which attracts mosquitoes, coupled

with the increased body surface and increased blood flow in the skin, exposing the pregnant

woman to mosquito bite. Also, the accumulation of parasitized red blood cells in the placental

vessels triggers an inflammatory process which has been known to cause an immune activation

in the placental tissue which would not have occurred in a non-pregnant woman Oka et al.,

(2023).

6
2.5 Laboratory diagnosis: the key to proper case management

Clinical diagnosis is not a reliable malaria diagnostic technique especially in sub-Saharan Africa

due to inadequate local epidemiological data on malaria and the presence of other febrile

ailments which have similar signs and symptoms with malaria. Therefore all suspected malaria

cases (clinical diagnosis) should be confirmed with a laboratory test as a concurrence World

Health Organization’s policy that all clinical diagnosis must be confirmed by a laboratory

parasite- based diagnosis before the administration of anti-malarial to prevent malaria is

diagnosis and drug resistance (Fofana, 2023).

2.6 Global malaria control strategy

World Health Organization report shows a decline in malaria cases by 25 percent globally and 33

per cent in Africa between 2000 and 2015, with a decrease in both the incidence and death rates

by 37and 60 per cent respectively, a development associated with increased malaria prevention

mechanisms and health seeking behaviour in reducing the burden of malaria in pregnancy.

Further efforts include the use of insecticide treated net (ITN) and effective case management of

malaria and anaemia in pregnant women. In Nigeria, a national programme to eliminate malaria

was launched in 2015, meanwhile, in 2004 Nigeria adopted World Health Organization’s three

(3) pronged strategy for combating malaria in pregnancy (MiP),which are:(1) inter mitten

preventive treatment in pregnancy (IPTp) through the directly observed therapy with

Sulphadoxine- Pyrimethamine (SP), (2) distribution and use of insecticide treated net (ITN), and

(3) case management of MiP (Oluwaseun et al., 2023).

7
2.7 International collaboration towards eradication and control of malaria in nigeria

Nigeria became the 17th Presidential Malaria Initiative (PMI) country in 2010 although, pre-PMI

malaria funding in Nigeria was $18 million and rose to $43.6 million in Fiscal Year (FY) 2011,

and was projected at $43.2 million in FY 2012. Furthermore, Malaria Action Programme for

States (MAPS) a PMI-funded integrated malaria project which was to cover the period 2010 to

2015 was implemented in six(6) states in Nigeria, among them were: Benue, Cross River,

Ebonyi, Nasarawa, Oyo and Zamfara. Furthermore, before the support from USAID / PMI,

Nigeria received a total of $280 million from World Bank for the Malaria Booster Programme

which supported seven (7) states and some national level activities up until 2009. Also, U.K.

Department for International Development (DFID) supported Nigeria with a $100 million five-

year programme under the Support for Nigeria malaria programme (SuNMaP) in 2008. Lastly,

Global Fund also provided $500 Million Round 8 Malaria Grant that began in 2009and expired

in 2014. Malaria infection is a major threat to the lives and well- being of pregnant women and

young children (under- five years of age). Stakeholders should ensure that clinical diagnosis

must be confirmed by a laboratory parasite-based diagnosis before the administration of anti-

malarial, and the distribution of insecticide treated nets alongside health education to improve

health–seeking behavior with the aim of preventing malaria infection among pregnant women

and young children (Sang et al., 2023).

2.8 Incidence of Malaria in Pregnancy

Studies have shown varying incidence rates of malaria among pregnant women in different

regions. For instance, a study conducted in Sherkole district, West Ethiopia, reported a incidence

rate of 20.8% among symptomatic pregnant women. Several factors contribute to the incidence

of malaria among pregnant women attending ANC. These include geographical location,

8
socioeconomic status, use of preventive measures, and healthcare access. Lower socioeconomic

status is often associated with higher malaria incidence due to limited access to preventive

measures and healthcare services. The World Health Organization (WHO) recommends at least

eight antenatal contacts during pregnancy to ensure comprehensive care, including malaria

prevention. Interventions such as IPTp, ITNs, and prompt diagnosis and treatment of malaria

cases are essential for reducing malaria incidence among pregnant women.

The literature highlights the significant burden of malaria among pregnant women attending

ANC and the need for effective interventions to reduce its incidence. Further research is needed

to identify additional factors and develop innovative strategies to combat malaria in pregnancy.

9
 CHAPTER THREE

MATERIALSAND METHODS

Study Area

The study was conducted at the Aisha Muhammad Buhari General Hospital Jega, Kebbi State,

Nigeria the study area is located between latitude 9 0 50’ and 100 05’ N and longitude 80 45’ and 90

01’ E. Kebbi State shares borders with Sokoto State to the north, ,Niger State to the south. It is

situated in the North western part of Nigeria.

3.2 Study Population of Pregnant

One hundred (100) pregnant women who attended their antenatal routine check up at the were

enrolled for the study.

3.3 Sample Size Determination

A number of model shave been developed to estimate sample size. Bartlett, et al (2001)

developed a model for determining the minimum returned sample size for any given population

size for continuous and categorical data. The model simplified lengthy calculation exemplified in

Cochran’s (1977) model and may be used if margin of error is appropriate for are search study

and that sample size would need to be calculated if the error ate are not appropriate. Bartlett et, al

(2001) based on margins of error of 0.03 for continuous and 0.05 for categorical data with

consideration of appropriate study population, sample size, and alpha value.

Using the solving formula of:

SS=N/(1+N/2)

Where SS = sampling size

10
N=Population sample (the questionnaire is 100)

e= Error term (using 8% of the standard level, that is 95% level of significant)

N=75

0=5\%=0.05

SS=N / (1+NeR)

SS=75(1+60(0.05x*0.05)

SS=75 / (1+0.5)

SS=75 / (1.5)

SS=50.1

SS=50 (Approximate Instrument sampling Technique)

The sampling was obtained using accidental sampling method; the study is to allow for selection

of respondents with a view to maintain risk error from sample in formation. The sample for this

study will consist of about 75 respondents by which 50 will be selected through accidental

sampling technique.

3.4 Exclusion Criteria

The non-pregnant women and those that did not consent for the study or not willing to participate

were excluded.

11
3.5 Ethical Consideration

Ethical clearance was obtained from the Aisha Muhammad Buhari General Hospital Jega. The

approval was granted on the understanding that all information about each patient will be treated

with utmost confidentiality.

3.6 Collection of Samples

This was carried out according to the method adopted from the literature review. Before

commencement of sample collections from the individual patient, the patient were enlighten on

malaria transmission, prevention and control and the effects of malaria on both the mother and

the fetus. Afterwards, oral informed consents were obtained from individual patient after a clear

explanation of the objectives, potentials benefit of the study and information such as age,

occupation, genotype, trimester, use of insecticide treated nets (ITNs) /long lasting insecticide

nets (LLINs) were obtained from each patient using pre– tested questionnaire. The sample

collection was twice a week and carried during the antenatal visits. 2mls of the blood samples of

each patient was collected intravenously/ vein puncture using sterile 5ml syringe after carefully

swabbing the surface with cotton wool soaked/ dipped in ethylated spirit. The blood wastrels

ferred in to a sterile EDT Atubes. This anticoagulant (EDTA) is used for hematological test. The

chemical therein, prevent blood from clotting by removing calcium. Each container has a number

corresponding to that written on the questionnaire given to each individual to avoid mixing of

results. After each day’s collection, the blood samples were taken to the Faith Alive Foundation

laboratory for examination.

12
3.7 Procedure for Rapid Diagnostic Test

Malaria rapid diagnostic test (RDTs) detects specific antigens (protein) produced by malaria

parasites that are present in blood of infected or recently infected individuals. Some RDTs can

detect only one species (Plasmodium falciparum), some also detect other species of the parasite

(Plasmodium vivax, Plasmodium malariae, Plasmodium ovale).The RDTs were used in the study

according to the manufacturer’s instruction. RDTs are lateral flow immune-chromatographic

antigen detection tests, which rely on the capture of dye-labeled antibodies to produce a visible

band on a stripe of nitro cellulose. With malaria RDTs, the dye- labeled antibody first bind to a

parasite antigen, and the resultant complex is captured on the strip by a band of bound antibody

forming a visible line (tests line). A control line gives information on the integrity of the

antibody-dye conjugate, but does not confine the ability to detect parasite antigen. The test is

limited to detection of antigens to malaria P. falciparum though the test is very accurate in

detecting histidine rich protein (HRP2).

The blood was transferred from the EDTA bottle to the sample window on the test kit and then

two drops of buffer was then added to the buffer well window on the cartridge. Each test kit was

read between15-30 minutes. Malaria was detected by the present of two colour bands T test line

and C control line within the result window. The control band became visible as sufficient label

antibody accumulates on the line.

3.8 Assessment of Risk Factors

The risk factors associated with the occurrence of the infection were determined using structured

questionnaire.

13
3.9 Data Analysis

This chapter presents and interprets data analyzed after successful administration of research

instrument where 100 questionnaires were administered, 100 were retrieved and analyzed with

descriptive statistical approach.

14
 CHAPTER FOUR

4.0 Result

The figure 4.1 show that the incidence of malaria test. Which illustrate in the pie-chart were the

positive test of pregnant women is 62% and also the Negative test of pregnant women’s are 38%

respond respectively.

Malaria Test
Positive Negative

38%

62%

Figure 4.1 above shows that Incidence of Malaria test, show positive 62%and malaria test

negative 38% respond respectively.

15
Table 4.1: Incidence of malaria among pregnant women in relation to trimester

The table 4.4 show that the Incidence of malaria among pregnant women in relation to trimester

were the 30 pregnant women’s are in 1 st trimester with the percentage of 26(7.8%) and also the

50 pregnant women’s are in 2nd trimester with the percentage of 37(18.5%) and 20 pregnant

women’s are in 3rd trimester with the percentage of 37(7.4%). Furthermore the negative of 1 st

trimester are 74(22.2%), 2nd trimester 63(31.5%) and 3rd trimester is 63(7.2%) respond

respectively.

GESTATION PERIOD TOTAL NO. NO. OF POSITIVE NO. OF NEGATIVE

CASE (%) CASE (%)
1st 30 26(7.8%) 74(22.2%)

2nd 50 37(18.5%) 63(31.5%)

3rd 20 37(7.4%) 63(7.2%)

16
Table 4.2: Incidence of malaria among pregnant women in relation to Age

The table 4.2 show that the majority 33(66%) of the respondents are within the age range of 20-

30 years, 17(34%) are 31-40 years while 0(0%) are 41-50 years and 50-60 years respectively.

AGE FREQUENCY PERCENT (%)

20 – 30 33 66%

31 – 40 17 34%

41 – 50 - -

50 – 60 - -

TOTAL 50 100

17
 Table 4.3: Risk Factors associated with the occurrence of malaria among pregnant women in
relation to Sleeping in LLIN, Stagnant water around household, Bushes around household and
Malaria type of test
The table 4.3 are show that Risk Factors associated with the occurrence of malaria among
pregnant women in relation to Sleeping in LLIN the percentage of positive test 57(32.49%),
negative test 43(22.36%) and the percentage No is 43(18.49%), negative test 57(24.51%) the
stagnant water around household the percentage of positive test are 56(31.36%), negative test
44(42.64%) and the percentage of Negative test are 44(19.36%), 56(24.64%) while the Bushes
around household the percentage of positive test are 48(23.4%), the Negative test are 52(24.96%)
and the percentage of positive test 52(27.4%), and the percentage of negative test 48(24.96%) are
according to questionnaire respond respectively.
S/N PARAMETER TOTAL NO. NO. OF POSITIVE NO. OF NEGATIVE
CASE (%) CASE (%)
iii. Sleeping in LLIN
Yes 57 57(32.49%) 43(22.36%)
No 43 43(18.49%) 57(24.51%)
iv. Stagnant water around

household

Yes 56 56(31.36%) 44(24.64%)

No 44 44(19.36%) 56(24.64%)

v. ` Bushes around household

Yes 48 48(23.4%) 52(24.96%)

No 52 52(27.4%) 48(24.96%)

vi. Malaria type of Test

RDT 100 (100%) 100(100%)

Microscopy 0 0% 0%

18
 CHAPTER FIVE
5.0 Discussion, Conclusion and recommendation
5.1 Discussion
Malaria in pregnancy is a public health challenge that continues to put pregnant women and their

unborn babies at risk. Our study found that asymptomatic carriage of P. falciparum infections not

detected by RDT were common in pregnant women during the malaria transmission season in

southern Senegal. Low-density infections can make an important contribution to malaria

transmission16 pregnant women represent an important potential reservoir in southern Senegal,

and our findings indicate that the use of RDTs is not effective in detecting these infections as part

of malaria elimination strategies. There is conflicting evidence as to whether low-density

infections (submicroscopic or undetectable by RDT) are associated with adverse pregnancy

outcomes, with some studies showing an association with anemia17,18 and low birth

weight19,20 but others showing no evidence. The high incidence of such infections in Senegal

warrants further investigation of their clinical consequences. Our study shows that among

asymptomatic women, RDTs had very low sensitivity. This contrasts with the study of Williams

et al., (2022) which found that a combination RDT (detecting HRPs and Plasmodium lactate

dehydrogenase [pLDH]) had much higher sensitivity for detecting PCR-positive infections at the

first antenatal visit in The Gambia, Burkina Faso, Mali, and Ghana. This study showed that

RDTs were effective for malaria diagnosis in symptomatic patients, with a sensitivity of 98% and

83% for women with fever during unscheduled visits and scheduled visits, respectively. We were

not able to investigate reasons for low RDT sensitivity in asymptomatic women, but this might

be explained by low parasite densities and/or pfHRP2 gene deletion.

The present study showed that almost half of pregnant women attending antenatal clinics were

infected with P. falciparum. This high incidence reflects the high level of malaria transmission in

19
these areas during the rainy season. High incidences have been reported in other studies. Our

study confirmed the uneven distribution of malaria in southern Senegal, with a high incidence in

three regions Kolda, Tambacounda, and Kedougou compared with that in Kaffrine and Ndoffane.

There has been a marked reduction in the number of reported cases of confirmed malaria in the

north and central regions of Senegal over the last 15 years, associated with scaling up of control

measures, but transmission remains high in the southern regions. Rainfall in Senegal follows an

increasing north-south gradient, from 300 mm in the north to 1,200 mm in the south, with

variations from 1 year to another. Consequently, conditions in the south of Senegal remain very

favorable for the development of breeding sites for the vectors responsible for malaria

transmission. The humidity following the rainfall also favors the longevity of the vector.

Women who had received SP were less likely to be PCR positive, with a 46% reduction in

incidence in women who had received three or more SP doses compared with women who had

not received SP, in the adjusted model. Intake of SP was associated with marked reductions in

incidence consistent with effectiveness of IPTp in other studies. However, a study undertaken by

the NMCP in Senegal indicates that these benefits may be poorly understood by women and by

the heads of households, as women who reported having received IPTp-SP were unaware of the

benefits. Better communication of the benefits of IPTp could lead to improved demand and

uptake.

5.2 Conclusion

Based on the major findings, there searchers concluded that; Majority of the respondents

(pregnant women) used for the study were between the ages of 20-30 years of age. Most of the

respondents are house wives while majority are civil servants. From the findings, it can be

deduced that most of the respondents experienced fever, malaria, excessive fatigue, vomiting,

20
backache, swelling of the face and feet, as their health problems during pregnancy while some

experienced malnutrition, anemia, diarrhea, abnormal discharge, blurred vision and abnormal

cramps as their health problems. A greater number of the respondents opined that the causes of

these problems are pregnancy related. It was found that them a jor factors influencing the health

seeking behavior of the respondents are their husbands, followed by finance. Majority of the

respondents utilize primary health care centers as a place to seek for healthcare, few utilize

hospital sand traditional birth attendants, while others utilize herbalist. Greater number of the

respondents chose where to seek for healthcare because they feel the services / care rendered

there are effective and cheap. Also, it is noted that teenage pregnancy was on a high side

5.3 Recommendation

Based on the findings in this study, the following recommendations were made:

 Health workers should carryout an intensive community mobilization on healthy

pregnancy

 Effective education and counseling of women on the importance of antenatal care:

emphasizing that it is cheap.

 Government should ensure that antenatal care services are affordable, especially at

the grass root.

 Government should grant a policy on women empowerment to enable them take

decision of their health problem especially in pregnancy.

 Public health campaign on the importance of healthy pregnancy, problems in

pregnancy and where to get care.

21
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