A perspective of the epidemiology of malaria and anaemia and their impact on maternal and perinatal outcomes in Sudan

Abstract

Introduction: Both malaria and anaemia have adverse effects on maternal and perinatal outcomes. Thus there is an urgent need to investigate the co-epidemiology of malaria and anaemia and their combined impact on maternal and perinatal outcomes in the different regions of Sudan Methodology: Various cross-sectional and case control studies conducted during the years 2003-2010 to investigate the epidemiology of malaria and anaemia and their impact on maternal and perinatal outcomes in different regions of Sudan were compared. Results: While 13.7% of antenatal attendants in New Halfa had peripheral microscopically detected Plasmodium falciparum malaria, placental malaria (using histological examinations) was prevalent in 32.0-40% and 19.5% of parturient women in New Halfa and Gadarif Hospitals, respectively. Malaria was a risk factor for anaemia in New Halfa and for stillbirths in Omdurman Maternity Hospital. Anaemia was present in 52.5%, 62.6% and 80.2% of pregnant women in Medani, New Halfa, and Gadarif Hospitals, respectively. In Gadarif, 57.3% of pregnant women had a folate deficiency, while 1% had a vitamin B12, deficiency. In Medani, zinc and copper deficiencies were detected in 45.0% and 4% of pregnant women, respectively. Anaemia was a risk factor for low birth weight in Al-Fashir, for fetal anaemia in New Halfa, and for stillbirth in Kassala Hospital. Conclusion: More care should be taken to ensure proper nutrition and malaria prevention such as bed nets and intermittent preventive treatments to avoid these diseases and their effects on maternal and perinatal outcomes.

Plasmodium falciparum genotypes in matched peripheral, placental and umbilical cord blood in an area characterised by unstable malaria transmission in eastern Sudan

“…Malaria, especially plasmodium falciparum infection during pregnancy, is a major public health problem in sub-Saharan Africa, where it is the major cause of perinatal and infant deaths (Desai et al, 2007; Bader et al, 2010; Adam et al, 2011). The sequestration of parasite-infected red blood cells in the placenta is the pathognomonic of malaria during pregnancy.…”

“…Malaria during pregnancy is one of the main causes of maternal perinatal morbidity and mortality in Sudan (Adam et al, 2005b; Adam et al, 2011; Mohammed et al, 2013). There is no published data on P. falciparum genotypes in matched peripheral, placental and umbilical cord blood in Sudan.…”

Antenatal iron and folic acid supplementation use by pregnant women in Khartoum, Sudan

“…Anaemia during pregnancy (haemoglobin level less than 11 g/dl) can lead to adverse maternal and perinatal outcomes, including maternal and perinatal mortality [3-8]. …”

“…Anaemia during pregnancy is a major health problem in Sudan affecting around half of women in some areas; it is a risk factor for maternal and perinatal morbidity and mortality [3,8]. Pregnant women are at risk of anaemia regardless of their age or parity [8,17].…”

“…Pregnant women are at risk of anaemia regardless of their age or parity [8,17]. However, no published data exist on the use of iron-folic acid supplements in pregnant women in Sudan.…”