Prevalence of Gestational Malaria in Kisangani, Democratic Republic of Congo

Noël, Labama Otuli; Nguma, Jean-Didier Bosenge; Mike-Antoine, Maindo Alongo; O’yandjo, Antoine Modia; Bosunga, Gédéon Katenga; Likwela, Joris Losimba; Okenge, Jean-Pascal Manga

doi:10.4236/ojog.2018.810089

Cited by 4 publications

(1 citation statement)

References 16 publications

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“…Furthermore, hypertensive disorders tend to be more prevalent among the primigravidas than multigravidas which may increase the risk of adverse perinatal outcomes in this group [30,31]. Additionally, primigravidas tend to be more prone than multigravidas to malaria which may compromise placental perfusion resulting in an increased risk of adverse perinatal outcomes such as low birth weight and stillbirth [32,33]. Given the association between primigravidity and adverse perinatal outcomes, deliberate efforts should be made to improve care for primigravidas, including promoting awareness of the importance of antenatal care, facilitating early and regular antenatal visits, and addressing delays in detecting pregnancy complications in this population.…”

Section: Discussionmentioning

confidence: 99%

Maternal near miss as a predictor of adverse perinatal outcomes: findings from a prospective cohort study in southwestern Uganda

Jjuuko,

Lugobe,

Migisha

et al. 2023

Preprint

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Background Despite efforts, Uganda has not met the World Health Organization target of < 12 newborn deaths per 1,000 live births. Severe maternal morbidity or ‘near miss’ is a major contributor to adverse perinatal outcomes, particularly in low-resource settings. However, the specific impact of maternal near miss on perinatal outcomes in Uganda remains insufficiently investigated. We examined the association between maternal near miss and adverse perinatal outcomes at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda. Methods We conducted a prospective cohort study among women admitted for delivery at MRRH’s maternity ward from April 2022 to August 2022. We included mothers at ≥ 28 weeks of gestation with singleton pregnancies, while intrauterine fetal death cases were excluded. For the near-miss group, we consecutively included mothers with any one of the following: antepartum hemorrhage with shock, uterine rupture, hypertensive disorders, coma, and cardiac arrest; those without these complications constituted the non-near-miss group. We followed the mothers until delivery, and their infants until seven days postpartum or death. Adverse perinatal outcomes considered were low birth weight (< 2,500 g), low Apgar score (< 7 at five minutes), fresh stillbirths, early neonatal death, or admission to neonatal intensive care unit. Multivariable log-binomial regression was used to determine predictors of adverse perinatal outcomes. Results We enrolled 220 participants (55 maternal near misses and 165 non-near misses) with a mean age of 27 ± 5.8 years. Most of the near-misses were pregnancies with hypertensive disorders (49%). Maternal near misses had a four-fold (adjusted risk ratio [aRR] = 4.02, 95% CI: 2.32–6.98) increased risk of adverse perinatal outcomes compared to non-near misses. Other predictors of adverse perinatal outcomes were primigravidity (aRR = 1.53, 95%CI: 1.01–2.31), and gestational age < 34 weeks (aRR = 1.81, 95%CI: 1.19–2.77). Conclusion Maternal near misses, primigravidity, and preterm pregnancies were independent predictors of adverse perinatal outcomes in this study. We recommend implementing maternal near-miss surveillance as an integral component of comprehensive perinatal care protocols, to improve perinatal outcomes in Uganda and similar low-resource settings. Targeted interventions, including specialized care for women with maternal near misses, particularly primigravidas and those with preterm pregnancies, could mitigate the burden of adverse perinatal outcomes.

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Section: Discussionmentioning

confidence: 99%

Maternal near miss as a predictor of adverse perinatal outcomes: findings from a prospective cohort study in southwestern Uganda

Jjuuko,

Lugobe,

Migisha

et al. 2023

Preprint

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Efficacy and safety of malarial prophylaxis with mefloquine during pregnancy in Kisangani, Democratic Republic of Congo: A randomized clinical trial

Noël

Djang'Eing'A

Likwela

et al. 2021

Brit J Clinical Pharma

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Kisangani is an area with intense malaria transmission and sulfadoxinepyrimethamine resistance. Alternative antimalaria prophylaxis medication and protocols are needed, particularly with pregnant individuals. In this study, we compare the tolerance and effectiveness of mefloquine regimen as a split dose with a meal vs.sulfadoxine-pyrimethamine for the intermittent preventive treatment in pregnant individuals in Kisangani.Methods: This study was conducted from 15 May to 30 November 2019 as a singleblind, randomized clinical trial comparing 2 regimens of intermittent preventive treatment during pregnancy. The first regimen consisted of 4 doses of sulfadoxinepyrimethamine, and the second of 2 doses of mefloquine taken as a split dose with meal.

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Prevalence of Congenital Malaria in Kisangani, A Stable Malaria Transmission Area in Democratic Republic of the Congo

Noël

Jean-Didier

Mike-Antoine

et al. 2020

Infectious Diseases in Obstetrics and Gynecology

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Background. Gestational malaria is a major public health problem. It produces fetal complications such as low birth weight, perinatal mortality, and congenital malaria. The present study is aimed at determining the prevalence of congenital malaria and its neonatal complications in the city of Kisangani. Methods. We conducted a cross-sectional study in Kisangani from 1 January to 30 September 2018. Our study population was composed of 1248 newborns born in our study sites, during the period of our study. Just after their birth, we performed the thick drop smear in the placental print and in umbilical blood smear. Results. The prevalence of congenital malaria was 13.98%; 69.23% of newborns who contracted congenital malaria were from 18- to 34-year-old mothers, 53.85% from primiparous mothers, 92.31% from mothers who took intermittent preventive treatment in pregnancy with Sulfadoxine-Pyrimethamine, all (100%) from mothers using the insecticide-treated mosquito nets and 7.69% from HIV-positive mothers. Low birth weight and perinatal mortality were recorded in 76.92% and 7.69% of congenital malaria cases, respectively. Intermittent preventive treatment in pregnancy with Sulfadoxine-Pyrimethamine had no effect on congenital malaria (FE=0.5218; OR: 0.8, 95% CI: 0.1651-3.8769) and on low birth weight (FE=0.3675; OR: 1.2308, 95% CI: 0.0037-0.1464); however, it seemed to have protective effect against perinatal mortality (FE=0.0001; OR: 0.0233, 95% CI: 0.0037-0.1464). Conclusion. Congenital malaria remains a major problem in stable malaria transmission area like Kisangani, and it is grafted by major perinatal complications, particularly low birth weight and perinatal mortality. We recommend an extended study to clarify the relationship between the outcome of pregnancy and the intermittent preventive treatment in pregnancy with Sulfadoxine-Pyrimethamine.

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Prevalence of Gestational Malaria in Kisangani, Democratic Republic of Congo

Cited by 4 publications

References 16 publications

Maternal near miss as a predictor of adverse perinatal outcomes: findings from a prospective cohort study in southwestern Uganda

Maternal near miss as a predictor of adverse perinatal outcomes: findings from a prospective cohort study in southwestern Uganda

Efficacy and safety of malarial prophylaxis with mefloquine during pregnancy in Kisangani, Democratic Republic of Congo: A randomized clinical trial

Prevalence of Congenital Malaria in Kisangani, A Stable Malaria Transmission Area in Democratic Republic of the Congo

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