Гинекология и акушерство

Гинекология и акушерство
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ISSN: 2161-0932


Epidemiological Aspects and Foeto-Maternal Complications of Malaria at NDjamena Mother and Child Hospital (Chad)

Foumsou Lhagadang, Damthéou Sadjoli, Gabkika Bray Madoue, Hinfiéné Aimé and Mahamat Pierre

Background: Malaria contributes very significantly to maternal and fetal mortality. The severity of malaria in pregnancy is thought to be due to general impaired immunity plus a diminution of acquired immunity to malaria in endemic areas. Chad since 2008 imposed the politics of exemption from payment of emergencies cares fees and the distribution of malaria preventing drugs for pregnant women and child. Few prior studies focused on fetal and maternal complications of malaria in this country.

Objective: increase combat both malaria and foeto-maternal complications, improve maternal and perinatal health and curb the spread of this preventable infectious disease.

Material and method: This was a prospective and descriptive survey of six months (from April 15th 2014 to October 15th 2014) about epidemiological aspects and foeto-maternal complications of malaria at N’Djamena mother and child hospital. All women pregnant women admitted for symptomatic or asymptomatic malaria during this survey period were included. Malaria diagnosis had involved identifying malaria parasites or antigens/ products in patient blood. Data were analyzed using SPSS17.0. Chi-square (X2) test (p<0.05) was used to compare variables.

Results: We recorded 155 patients admitted for malaria among 1065 patients, giving and incidence of 14.55%. The majority of pregnant women, 65% (101/155) hadn’t attended ante natal consultation. Three quarters (¾) of patients didn’t receive malaria ‘preventive treatment during pregnancy (khi²=103; p=001). Seventyeight patients (50.3%) declared using insecticide-treated bed nets. Rapid diagnostic test was use first and the conventional microscopic diagnosis by staining thin and thick peripheral blood smears later. The majority (141/155 i.e. 90.97%) had had positive malaria rapid test. The microscopic examination of stained blood films using Giemsa showed Plasmodium falciparum malaria diagnosis in 80.64%. Quinine and artesunate were used for curative treatment. More than ¾ of patients (n=120/155 i.e. 77.4%) received quinine. Eighteen per cent 18% (n=28/155) of patients presented anaemia, the outcome of malaria infection was fatal for one patient giving a death rate of 0.65%. Among fetal complications, we registered 15.48 %( n=24/155) of low birth weight and 10.3 %( n=16/155) premature delivery.

Conclusion: Malaria remains a frequent infectious disease during pregnancy. Sensitizations for antenatal consultations are useful to improve malaria ‘management.