Preventive Aspects Of Malaria In Pregnancy In Badagry Local Government Area Of Lagos State, Nigeria

ABSTRACT

The study focused on the Preventive aspects of malaria in pregnancy in Badagry Local Government Area, one of the 20 LGAs in Lagos State in Southwestern Nigeria. The objectives of the study were to determine the knowledge, attitude and practices of the community on malaria; determine the effectiveness of Intermittent Preventive Treatment in pregnancy (IPTp) using Sulfadoxine-pyremethamine (SP) [IPTp-SP] in the prevention of malaria; and ascertain the safety of SP during pregnancy by administering SP to pregnant laboratory bred albino mice. Data were obtained using semi-structured questionnaire and focus group discussion on beliefs, knowledge and practices of community members in Ikoga ward and in pregnant women attending antenatal clinics. Microscopic diagnosis using Giemsa stain was conducted to establish the baseline parasitological prevalence of malaria amongst 3,978 participants in the community. Entomological data on the vector population was collected by Pyrethrum Spray Collection (PSC). The mosquitoes were identified morphologically and the A. gambiae complex by Polymerase Chain Reaction (PCR). IPTp-SP intervention was evaluated in 426 pregnant women who received one or two doses of SP (1500mg sulfadoxine + 75 mg pyrimethamine), depending on when they registered. Fifty seven pregnant women did not take the SP, because of reaction to SP. The pregnant women comprised 183 of primigravidae, 135 of secundigravidae and 165 of multigravidae. Parameters used to evaluate the effectiveness of the SP included parasite rate determination, parasitaemia, anaemia, clinical malaria and determination of Low Birth Weight (LBW). The safety of SP was experimentally evaluated from the histopathological examination of foetuses of SP treated pregnant mice and by sperm test assay of male mice administered SP. Analysis of the questionnaire on malaria prevention revealed malaria to be a serious health problem; 48% of community members use Raid insecticide spray; 30% take herbs while 21% use mosquito coil.