Prevalence of Malaria and Associated Control Methods Among Pregnant Mothers Attending Focused Antenatal Care at Iganga Main Hospital, Iganga District, Eastern Uganda

Table of Contents

DECLARATION................................................................................................................i

APPROVAL......................................................................................................................ii

ACKNOWLEGDEMENTS..............................................................................................iii

DEDICATION ................................................................................................................. iv

LIST OF ABBREVIATIONS .......................................................................................... vii

ABSTRACT..................................................................................................................... ix

CHAPTER ONE................................................................................................................ 1

INTRODUCTION............................................................................................................. 1

1.1 Background............................................................................................................. 1

1.2 Problem Statements................................................................................................. 2

1.3 Objective of the study ............................................................................................. 3

1.3.1 Main objective ........................................................................................................ 3

1.3.2 Specific objectives............................................................................................... 3

1.4 Research Questions................................................................................................. 3

1.5 Justification of the study ......................................................................................... 3

1.6 Scope of the study................................................................................................... 3

1.6.1 Time scope.............................................................................................................. 3

1.6.2 Content scope ......................................................................................................... 3

1.6.3 Geographical scope ................................................................................................. 3

1.7 Conceptual framework ............................................................................................ 4

CHAPTER TWO............................................................................................................... 5

LITERATURE REVIEW .................................................................................................. 5

2.1 Definition................................................................................................................ 5

2.2 Epidemiology of malaria ......................................................................................... 5

2.3 Prevalence of malaria.............................................................................................. 5

2.4 Immunity and malaria ............................................................................................. 6

2.5 Effect of Malaria on pregnant woman and unborn baby........................................... 6

2.6 Utilization of ANC services .................................................................................... 7

2.7 Malaria control methods.......................................................................................... 7

CHAPTER THREE........................................................................................................... 8

METHODOLOGY............................................................................................................ 9

3.1 Study design ........................................................................................................... 9

vi

3.2 Study area ............................................................................................................... 9

3.3 Study population ..................................................................................................... 9

3.4 Sample size ............................................................................................................. 9

3.5 Sampling method .................................................................................................. 10

3.6 Study inclusion and exclusion criteria ................................................................... 10

3.6.1 Inclusion criteria. .................................................................................................. 10

3.6.2 Exclusion criteria .................................................................................................. 10

3.7 Data collection method.......................................................................................... 10

3.8 Data quality control............................................................................................... 10

3.9 Data analysis......................................................................................................... 10

3.10 Data presentation .................................................................................................. 10

3.11 Limitations............................................................................................................ 10

3.12 Ethical Consideration............................................................................................ 11

CHAPTER FOUR ........................................................................................................... 11

RESULTS ....................................................................................................................... 12

4.1 Socio demographic characteristics of participants....................................................... 12

4.2.1: Prevalence of malaria among pregnant mothers................................................. 13

4.2.2: Methods used by the pregnant mothers to control malaria .................................. 13

CHAPTER FIVE............................................................................................................. 15

DISCUSSION, CONCLUSIONS AND RECOMMENDATION ..................................... 15

5.1 Discussion............................................................................................................. 15

5.1.1 Prevalence of malaria among participant pregnant women .................................... 15

5.1.2 Malaria control methods used by participant pregnant women............................... 15

5.2 Conclusion............................................................................................................ 16

5.3 Recommendation .................................................................................................. 16

REFERENCES................................................................................................................ 17

APPENDICES................................................................... Error! Bookmark not defined.

APPENDIX I: CONSENT FORM.................................................................................. 19

APPENDIX II: QUESTIONNAIRE................................................................................ 19

APPENDIX III: MAP OF IGANGA DISTRICT SHOWING IGANGA MUNICIPAL

CCOUNCIL WHERE IGANGA HOSPITAL IS LOCATED........................................... 22

ABSTRACT

Background: Malaria is a protozoal disease caused by Plasmodium spp parasite transmitted by an infected female mosquito as it bites the human host. It is one of the most common causes of infectious disease related deaths in the World with Africa bearing the largest proportion of the world's malaria burden because the region hosts the anopheles mosquito which is the most efficient malaria vectors, and also due to lack of the basic infrastructure and resources necessary for efficient and sustainable control of the malaria disease. Despite the wide control strategies, occurrence of malaria is on the increase with an estimated incidence rate of 37% globally and 42% in Africa. In Uganda, malaria is the leading cause of morbidity and mortality and is responsible for 40% of all outpatient visits, 25% of all hospital admission and 14%of all hospital deaths. In eastern Uganda the prevalence of malaria is 37% and this poses a health risk to the pregnant women and their unborn. Objective: To determine the prevalence of malaria and associated control methods among pregnant women attending focused antenatal care at Iganga Main Hospital, Iganga District. Methods: A descriptive cross sectional study was conducted in June 2017 at Antenatal Care Clinic, Iganga Main Hospital, and Iganga District, Uganda. Quantitative data was collected by means of questionnaires covering a study population of 126 pregnant mothers where a systematic random sampling method was used. Results : 52/126 (41.3%) were found positive to malaria parasites and majority of pregnant women were aged 20-30 years, these had highest infection rate of 44.2% (38/86),with primigravidas having the highest infection rate of 54.8%. It was also observed that according to gestational age of pregnancy, women of first trimester had the highest prevalence of 68.3% (28/41). The study showed that the most common barrier method used to prevent malaria was treated mosquito nets with 76/126 (60.3%). Conclusion and Recommendation: In general, pregnant mothers had fair knowledge about malaria control methods. Despite focused antenatal care and the awareness on malaria control methods, a malaria prevalence of 41.3% was scored. Therefore interventions aimed at social and behaviour change are necessary to address the gaps highlighted by the study.