Asymptomatic malaria infection impact on maternal anemia in Delta State, Nigeria

Authors

  • Obi Sadiatu Sally (Ph.D, MS) Walden University, College of Health Professionals; Delta State Ministry of Health (Nigerian Institute of Medical Research), Asaba, Delta State Nigeria
  • W Sumner Davies (Ph.D, MPH, MHA, MScs, MS, MSHE, M.T.S, M.Div, CAS, CAS, ASTMH) Walden University, College of Health Professionals
  • Garrett-Cherry, Tiana (Ph.D, MPH) Walden University, College of Health Professionals
  • Adebe Gabriel Aondofa (Ph.D, MPH) Walden University, College of Health Professionals
  • Adjekuko Collins Ohwonigho (FWAPCMLS, Ph.D, MS, BMLS). Delta State Ministry of Health, Asaba, Nigeria
  • Nze Francis Ikechukwu (MS) St. Joseph Catholic Hospital, Asaba, Delta State, Nigeria
  • Odili-Igba Ann (BS) Delta State Ministry of Health, Asaba, Nigeria
  • Ogirisen Felix (PGD, BS) Delta State Ministry of Environment, Asaba, Nigeria
  • Ajani Dele (PGD, HND, NCE) Federal College of Education (Technical) Asaba, Delta State, Nigeria

DOI:

https://doi.org/10.47941/ijhmnp.915

Keywords:

malaria, Plasmodium, peripheral malaria, placenta malaria, parasite-resistance, pregnancy outcome, maternal anemia, mosquito

Abstract

Background and Purpose: Pregnant women are vulnerable due to the pregnancy-induced suppressed immunity in malaria-endemic areas. Asymptomatic malaria in pregnancy (MiP) threatens both the mother, fetus, and neonate via chronic placental malaria which impacts maternal-neonatal exchange. Some studies reported that MiP risk factors vary across locations, however, there are few studies on MiP and maternal anemia in Nigeria. The purpose of this study was to investigate the association between asymptomatic placental malaria infection and maternal anemia among parturients in Asaba, Delta State, Nigeria.

Method: This study was developed with a quantitative methodology that utilized primary and secondary healthcare data from 483 subjects aged 18-49 years from four healthcare facilities between May and July 2021. The Socio-Ecological Model (SEM) framework was used to explain how parturients can achieve improved pregnancy outcome via the mobilization of multi-levels supports to enhance the compliance of parturients to malaria interventions. The research question and hypothesis were tested with the binomial logistic regression test.

Result:  The findings showed a statistically significant association between placental malaria parasitemia by microscopy (PMPM), intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine, use of complementary and alternative medicine (CAM), and  maternal anemia in the study population. Also, the study revealed that positive PMPM, use of  CAM, insecticides treated net (ITN) ownership, ITN frequent use, and antenatal care (ANC) attendance were the risk factors of maternal anemia among the study population.

Conclusion: The findings of this study could inform malaria control policymaking in Asaba and Delta State on tracking and treating asymptomatic placenta malaria among underserved parturient accessing antenatal services.

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References

Abbott Point of Care Inc., (2016) Hematocrit/HCT and calculated Hemoglobin/Hb. Art: 74178.00Q. https://www.abaxis.com/sites/default/files/resource-

Achu, C., Nwaorgu, O., Egbuche, C., Ezeagwuna, D., Ajibaye, O., Aribodor, D. (2020) frequency of Merozoite Surface Protein 2 (MSP2) Allelic Families and Sulphadoxine-Pyrimethamine (SP) Resistance Markers Among Pregnant Women in Delta State, Nigeria. American Journal of BioScience, 8 (1), pp. 6-14.

http://dx.doi.org/10.11648/j.ajbio.20200801.12

Aguzie, ION. (2018) pregnancy-associated Malaria, Challenges and Prospects in Sub- Saharan Africa. Clinics Mother Child Health 15: 282. https://dx.doi.org/10.4172/2090-7214.1000282

Aikins, A. (2005) healer shopping in Africa: new evidence from rural-urban qualitative study of Ghanaian diabetes experiences. BMJ. 331 (7519):737. hppts:// doi-org.ezp.waldenulibrary.org/10.1136/bmj.331.7519.737

Amoakoh-Coleman, M., Arhinful, D., Klipstein-Grobusch, K., Ansah, E. and Koram, K. (2020) Coverage of intermittent preventive treatment of malaria in pregnancy (IPTp) influences delivery outcomes among women with obstetric referrals at the district level in Ghana. Malaria Journal 19, 222.

https://doi.org/10.1186/s12936-020-03288-4

Anorue, C.O., Ukaga, C.N., Ogbonna, C.U., Chiamah, O.C. & Ezenwa, C.M. (2020) prevalence of placental malaria in pregnant women. A case study of Asaba, Delta State Nigeria. Scholarly Journal of Biological science, 9 (1) pp. 8-13. https://scholarly-journals.com/SJBS.

Awuah, R. B., Asante, P. Y., Sakyi, L., Biney, A., Kushitor, M. K., Agyei, F., & de-Graft Aikins, A. (2018) Factors associated with treatment-seeking for malaria in urban poor communities in Accra, Ghana. Malaria journal, 17(1), 168. https://doi.org/10.1186/s12936-018-2311-8.

Balami, A.D., Said, S.M., Zulkefli, N.A.M., Norsa'adah, B. and Audu, B. (2021). Improving malaria preventive practices and pregnancy outcomes through a health education intervention: A randomized controlled trial. Malaria Journal (20)55. https://doi.org/10.1186/s12936-021-03586-5

Bardají, A., Martínez-Espinosa, F. E., Arvalo-Herrera, M., Padilla, N., Kochar, S., Ome- Kaius, M., Bôtto-Menezes, C., Castellanos, M. E., Kochar, D. K., Kochar, S. K., Betuela, I., Mueller, I., Rogerson, S., Chitnis, C., Hans, D., Menegon, M., Severini, C., Del Portillo, H., Dobaño, C., Mayor, A., "¦ PregVax Study Group (2017) burden and impact of Plasmodium vivax in pregnancy: A multi-centre prospective observational study. PLoS ONE neglected tropical diseases, 11 (6). https://doi.org/10.1371/journal.pntd.0005606

Berzosa, P., de Lucio, A., Romay-Barja, M., Herrador, Z., González, V., García, L., Fernández-Martínez, A., Santana-Morales, M., Ncogo, P., Valladares, B., Riloha, M., & Benito, A. (2018). Comparison of three diagnostic methods (microscopy, RDT, and PCR) for the detection of malaria parasites in representative samples from Equatorial Guinea. Malaria journal, 17(1), 333. https://doi.org/10.1186/s12936-018-2481-4

Buh A., Kota K., Bishwajit, G. and Yaya, S. (2019) Prevalence and Associated Factors of Taking Intermittent Preventive Treatment in Pregnancy in Sierra Leone. Tropical Medical Infectious Disease. 4 (1):32. https://doi.org/10.3390/tropicalmed4010032

Carmona-Fonseca J, Arango E. (2017) asymptomatic plasmodial infection in pregnant women: A global scenario. Journal of Vector borne diseases, 54(3), 201-206. https://doi.org/10.4103/0972-9062.217610.

CDC, (2020) DPDX- laboratory identification of parasites of public health concern: malaria.

CDC, (1998) Recommendations to prevent and control iron deficiency in the United States. MMWR Recommendation. Rep. 47(RR-3), 1-36.

CDC, (2015) The Social-Ecological Model: A Framework for Prevention. https://www.cdc.gov/violenceprevention/about/social-ecologicalmodel.html

Chuma J, Okungu V, Molyneux C. (2010) Barriers to prompt and effective malaria treatment among the poorest population in Kenya. Malaria Journal 9(144). https://doi.org/10.1186/1475-2875-9-144

City population (n. d) Oshimili south (Local Government Area), Nigeria with population statistics, charts, maps, and location. https://www.citypopulation.de

Creswell, J. & Creswell, J. (2018) research design: qualitative, quantitative, and mixed methods (5th ed.). Thousand Oaks, CA: Sage.

Cochran, W.G. (1977), Sampling Techniques, 3rd ed., John Wiley & Sons.

Desai, M., ter Kuile, F. O., Nosten, F., McGready, R., Asamoa, K., Brabin, B., Newman, R.D. (2007). Epidemiology and burden of malaria in pregnancy. Lancet Infectious Diseases, 7(2), 93-104. http://www.ncbi.nlm.nih.gov/pubmed/17251080

Frankfort-Nachmias, C., & Nachmias, D. (2015). Research Methods in the Social Sciences (8th ed.). New York: Worth.

Haider, BA., Olofin, I., Wang, M., Spiegelman, D., Ezzati, M., Fawzi, WW. (2013) Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. BMJ. 346. https://doi.org/10.1136/bmj.f3443

Katrak, S., Nayebare, P., Rek, J. Arinaitwe, E., Nankabirwa,J., Kamya,M., Dorsey,G., Rosenthal, P. and Greenhouse, B. (2018) Clinical consequences of submicroscopic malaria parasitemia in Uganda. Malaria Journal 17(67). https://doi.org/10.1186/s12936-018-2221-9.

Kapisi, J., Kakuru, A., Jagannathan, P., Muhindo, M., Natureeba P., Awori, P., Nakalembe, M., Ssekitoleko, R., Olwoch, P., Ategeka, J., Nayebare, P., Clark,T., Rizzuto, G., Muehlenbachs, A., Havlir, D., Kamya, M., Dorsey G. & Gaw, S. (2017) Relationships between infection with Plasmodium falciparum during pregnancy, measures of placental malaria, and adverse birth outcomes. Malaria Journal 16(400). https://doi.org/10.1186/s12936-017-2040-4

Kumar, S., Quinn, S., Kim, K., Musa, D, Hilyard, K. and, Freimuth V. (2012) The social ecological model as a framework for determinants of 2009 H1N1 influenza vaccine uptake in the US. Health Education Behavior 39. 229-243.

https://doi.org/10.1177/1090198111415105

Koperska, M. (2018) Hematocrit/Hemoglobin Ratio calculator. Omni calculator.

Lufele E, Umbers A, Ordi J, Ome-Kaius M, Wangnapi R, Unger H, Tarongka N, Siba P, Mueller I, Robinson L, Rogerson S. (2017) Risk factors and pregnancy outcomes associated with placental malaria in a prospective cohort of Papua New Guinean women. Malaria Journal 16 (1) 427.

https://doi.org/10.1186/s12936-017-2077-4

Mfuh, K.O., Achonduh-Atijegbe, O.A., Bekindaka, O.N. Esemu, L., Mbakop, C., Gandhi, K., Leke, R., Taylor, D. and Nerurkar, V. (2019) A comparison of thick-film microscopy, rapid diagnostic test, and polymerase chain reaction for accurate diagnosis of Plasmodium falciparum malaria. Malaria Journal 18(73). https://doi.org/10.1186/s12936-019- 2711-4.

National Population Commission & National Bureau of Statistics, (n. d) National Population Estimates. https://www. nigerianstat.gov.ng.

National Population Commission (n. d) Population by sex and Local Government Area: Delta state government. Pdf. https://www. deltastategov.ng.

https://ethnobiomed.biomedcentral.com/articles/10.1186/s130 02-015-0057-8.

Nigeria Demographic and Health Survey (NDHS) 2018 (2019) Nigeria 2018 Demographic and Health Survey: Malaria Situation. Malariamatter.org.

National Population Commission (NPC) [Nigeria] and ICF (2019) Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF. https://www. dhsprogram.com/pubs/pdf/FR359/FR359.pdf.

National Malaria Elimination Program (NMEP), National Population Commission (NPopC), National Bureau of Statistics (NBS), and ICF International (2016) Nigeria Malaria Indicator Survey 2015. Abuja, Nigeria, and Rockville, Maryland, USA: NMEP, NPopC, and ICF International. https://www. dhsprogram.com/pubs/pdf/MIS20/MIS20.pdf.

Negard, C. S., Than Ho, T., Diallo, D., Ballo, N., Paulsen, B. S., & Nordeng, H. (2015) Attitudes and use of medicinal plants during pregnancy among women at health care centers in three regions of Mali. West-Africa. Journal of Ethnobiology and Ethnomedicine, 11(73). https://doi.org/10.1186/s13002-015-0057-8

https://ethnobiomed.biomedcentral.com/articles/10.1186/s130 02-015-0057-8.

Odorizzi P. M. and Feeney M. E. (2016) Impact of utero exposure to malaria on fetal T cell immunity. Trends Molecular Medicine 22, 877-88. https://doi.org/10.1016/j.molmed.2016.08.005.

Ogbonnaya, C., Duru, A., Ingwu, J., Arinze, J., Chikeme, P., Kotoye, C. (2019). Use of traditional medicines in treatment of malaria among pregnant women in two urban slums in Enugu State, Nigeria. Journal of public health and diseases 2(2), 24- 31. https://dx.doi.org/10.31248/JPHD2019.032

Olukosi A, and Afolabi B. (2018) malaria and anemia among pregnant women living in communities along the coast of Lagos Lagoon, South-west Nigeria. International Journal of Pregnancy and Childbirth 4 (6),175-182. https://doi/10.15406/ipcb.2018.04.00122

Omer, S., Franco-Jarava, C., Noureldien, A., Omer, M., Abdelrahim, M., Molina, I., and Adam, I. (2021) Impact of placental malaria on maternal, placental, and fetal cord responses and its role in pregnancy outcomes in women from Blue Nile State, Sudan. Malaria Journal 20(35). https://doi.org/10.1186/s12936-021-03580-x

Omer, S., Idress, H., Adam, I., Abdelrahim, M., Noureldein, A. Abdelrazig, A., Elhassan, M. and Sulaiman, S. (2017) research placental malaria and its effect on pregnancy outcomes in Sudanese women from Blue Nile State. Malaria Journal 16.

https://doi.org/10.1186/s12936-017-2028-0

Ononge S, Campbell O, Mirembe F. (2014) Haemoglobin status and predictors of anaemia among pregnant women in Mpigi, Uganda. BMC Research Notes.7:712. https://dx.doi.org/10.1186/1756-0500-7-712

Onyemaechi, N. and Malann, Y. (2020) Malaria Prevalence Investigation among Pregnant Women in Relation to their Social Well Being: A Case Study of Lugbe and Gosa, Abuja, Nigeria. International Journal of Pathogen Research 4 (2), 7-15. https://doi.org.10.9734/ijpr/2020/v4i230107

Oudraogo, A., Tiono, A., Diarra,A., Bougouma,E., Konat, I., Sodiomon B. Sirima, S. (2012) Transplacental Transmission of Plasmodium falciparum in a Highly Malaria Endemic Area of Burkina Faso. Journal of Tropical Medicine, vol.109705,7 pages. https://doi.org/10.1155/2012/109705

Quakyi, I., Tornyigah, B., Houze, P., Kusi, K., Coleman, N., Laar, A., Cot, M., Asare, G., Deloron, P., Anang, A., Cottrell, G., Ofori, M. and Ndam, N. (2019) High uptake of Intermittent Preventive Treatment of malaria in pregnancy is associated with improved birth weight among pregnant women in Ghana. Scientific reports, 9 (1), 19034. https://doi-org.ezp.waldenulibrary.org/10.1038/s41598-019-55046- 5.

Pallant, J. (2016) Factor Analysis. In SPSS survival manual (6th ed.).Two Penn Plaza, New York, NY: McGraw Hill. https://www.routledge.com/SPSS-Survival-Manual- A- step-by-step-guide-to-data-analysis-using-IBM- SPSS/Pallant/p/book/9781760875534.

Renzo G., Spano F., Giardina I., Brillo E., Clerici G., Roura L. (2015) Iron deficiency anemia in pregnancy. Womens Health (London). 11(6), 891-900.

https://doi.org/10.2217/whe.15.35

Revenson, T., Schiaffino, K., Majerovitz, S. and Gibofsky, A. (1991) Social support as a double-edged sword: the relation of positive and problematic support to depression among rheumatoid arthritis patients. Social Science Medicine. 33, 807-813. https://doi.org/10.1016/0277-9536(91)90385-p .

Roman, E., Andreiko, K., Henry, M., Youll, S. Florey, L., Ferenchick, E. and Gutman, J.

(2019) Determinants of uptake of intermittent preventive treatment during pregnancy: a review. Malaria Journal 18, 372. https://doi.org/10.1186/s12936- 019-3004-7.

Rouamba, T., Samadoulougou, S., Oudraogo, M., Hiren, H., Tinto, H. and Kirakoya- Samadoulougou, F. (2021) Asymptomatic malaria and anaemia among pregnant women during high and low malaria transmission seasons in Burkina Faso: household-based cross-sectional surveys in Burkina Faso, 2013 and 2017. Malaria Journal 20(211). https://doi.org/10.1186/s12936-021-03703-4.

Rudestam, K. E., Newton, R. R. (2014). Surviving Your Dissertation: A Comprehensive Guide to Content and Process, 4th Edition.

Tabachnick, B.G., & Fidell, L.S. (2012). Using multivariate statistics (6th ed.). Boston: Pearson Education.

United Nation International Children's Emergency Fund [UNICEF] (2018) UNICEF- Kyrgyzstan; Routine Immunization Communication Strategy and Action Plan 2018- 2020. Bishkek, Kyrgyzstan. https://www. unicef.org/

U.S. Centers for Disease Control and Prevention (2020) Malaria biology. Available at http://www.cdc.gov/malaria/about/biology/.

U.S Center for Disease Control and Prevention, (2020). The Social Ecological Model Framework. https://www.cdc.gov/violenceprevention/overview/socialecologicalmodel.html.

White, N. (2018) Anemia and malaria. Malaria Journal 17, 371. https://doi.org/10.1186/s12936-018-2509-9

World Health Organization, (2010) Basic Malaria Microscopy: Tutor's guide. Geneva, World Health Organization. http://apps.who.int/iris/bitstream/handle/10665/44208/9789241547918_eng.pdf;j sessionid=030BA52E6423A778E5B3EC78B5A.

World Health Organization, (2011) Hemoglobin concentrations for the diagnosis of anemia and assessment of severity. Vitamin and Mineral Nutrition Information System. Geneva, World Health Organization.

http://www.who.int/vmnis/indicators/haemoglobin.

World Health Organization, (2016). World Malaria Report 2016. Geneva. https://apps.who.int/iris/bitstream/handle/10665/252038/9789241511711- eng.pdf?ua=1?sequence=1.

World Health Organization, (2017) intermittent screening and treatment in pregnancy and the safety of ACTs in the first trimester. Recommendations of WHO Global Malaria Program. WHO, Geneva. https://www.who.int/malaria/publications/atoz/istp-and- act- in-pregnancy.pdf?ua=1.

World Health Organization, (2017) Malaria in Pregnant Women?

http://www.org/who.int/malaria/areas/high-risk groups/pregnancy/en/.

World Health Organization, (2018) World malaria report 2018: Geneva, Switzerland. http://www.org/apps.who.int/iris/bitstream/handle/10665/275867/9789241565653 - eng.pdf

World Health Organization, (2018) Intermittent Preventive Treatment in Pregnancy (IPTp). http://www.who.int/ malaria/areas/preventive-therapies/pregnancy/en/.

World Health Organization (2018) malaria. https://who.int.com/malaria.

World Health Organization (2019) the World Malaria Report 2019; at a Glance. https://www.org/who.int/newsroom/feature-stories/detail/world-malaria-report

World Health Organization (2020) malaria. https://who.int.com/malaria.

World Health Organization (2020) malaria; diagnostic testing.

https://www.org/who.int.com/malaria/ares/diagnosis.

World Health Organization, (2020) Malaria. https://www.org/who.int/news-room/factors- sheets.

World Health Organization & UNICEF/UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases. ("Ž2015)"Ž. Microscopy for the detection, identification, and quantification of malaria parasites on stained thick and thin bloodfilmsinresearchsettings(version1.0)procedure:methodsmanual.

https://apps.who.int/iris/handle/10665/163782

Wright K. (2016) Social networks, interpersonal social support, and health outcomes: a health communication perspective. Front Communication1(10).

https://www.org/doi.org/10.3389/fcomm.2016.00010.

Yaya, S., Uthman, O. A., Amouzou, A., & Bishwajit, G. (2018). Use of Intermittent Preventive Treatment among Pregnant Women in Sub-Saharan Africa: Evidence from Malaria Indicator Surveys. Tropical medicine and infectious disease, 3 (1), 18. https://doi-org.ezp.waldenulibrary.org/10.3390/tropicalmed3010018.

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Published

2022-07-08

How to Cite

Obi , S. S. ., W Sumner, D. ., Garrett-Cherry, T., Adebe , G. A., Adjekuko , C. O., Nze , F. I., … Ajani, D. . (2022). Asymptomatic malaria infection impact on maternal anemia in Delta State, Nigeria. International Journal of Health, Medicine and Nursing Practice, 4(1). https://doi.org/10.47941/ijhmnp.915

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