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Malaria Research and Treatment
Volume 2010 (2010), Article ID 913857, 10 pages
http://dx.doi.org/10.4061/2010/913857
Research Article

Malaria Burden in Pregnancy at Mulago National Referral Hospital in Kampala, Uganda

1Department of Obstetrics and Gynaecology, Mulago Hospital, Kampala, P.O. Box 7051, Uganda
2Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institute, 171 77 Stockholm, Sweden
3Department of Biochemistry, Makerere University, Kampala, P.O. Box 7072, Uganda

Received 19 May 2010; Accepted 26 August 2010

Academic Editor: Kwadwo Koram

Copyright © 2010 Fatuma Namusoke et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Pregnancy-associated malaria is a major global health concern. To assess the Plasmodium falciparum burden in pregnancy we conducted a cross-sectional study at Mulago Hospital in Kampala, Uganda. Malaria prevalence by each of three measures—peripheral smear, placental smear, and placental histology was 9% (35/391), 11.3% (44/389), and 13.9% (53/382) respectively. Together, smear and histology data yielded an infection rate of 15.5% (59/380) of active infections and 4.5% (17/380) of past infections; hence 20% had been or were infected when giving birth. A crude parity dependency was observed with main burden being concentrated in gravidae 1 through gravidae 3. Twenty-two percent were afflicted by anaemia and 12.2% delivered low birthweight babies. Active placental infection and anaemia showed strong association ( ) whereas parity and placental infection had an interactive effect on mean birthweight ( ). Primigravidae with active infection and multigravidae with past infection delivered on average lighter babies. Use of bednet protected significantly against infection ( ) whilst increased haemoglobin level protected against low birthweight ( ) irrespective of infection status. Albeit a high attendance at antenatal clinics (96.8%), there was a poor coverage of insecticide-treated nets (32%) and intermittent preventive antimalarial treatment (41.5%).