Risk Factors for Plasmodium Falciparum Infection in Pregnant Women in Burkina Faso: A Community-Based Malaria Cross-Sectional Survey

Abstract

Background: Malaria in pregnancy remains a public health problem in sub-Saharan Africa. Identifying risk factors for malaria in pregnancy could assist in developing interventions to reduce the risk of malaria in Burkina Faso and other countries in the region.Methodology: Two cross-sectional surveys were carried out to measure Plasmodium falciparum infection using microscopy in pregnant women in Saponé Health District, central Burkina Faso. Data were collected on individual, household and environmental variables and their association with P. falciparum infection assessed using multivariate analysis. Results: A total of 356 pregnant women were enrolled in the surveys, 174 during the dry season and 182 during the wet season. The mean number of doses of sulphadoxine pyrimethamine for Intermittent Preventive Treatment in pregnancy (IPTp-SP) was 0.4 doses during the first trimester, 1.1 doses at the second and 2.3 doses at the third. Overall prevalence of P. falciparum infection by microscopy was 15.7%; 17.8% in the dry season and 13.7% in the wet season. 88.2% of pregnant women reported sleeping under an insecticide-treated net on the previous night. P. falciparum infection risk in pregnancy was reduced in those women who reported using an ITN (Odds ratio, OR=0.31, 95% CI 0.12-0.79, p=0.02) and an increasing number of IPTp-SP doses during pregnancy, with each additional dose reducing the odds by 40% (OR=0.59, 95% CI 0.43–0.81, p<0.001). ConclusionThe prevalence of P. falciparum infection among pregnant women remains high in Burkina Faso although use of IPTp-SP and ITNs were found to reduce the odds of infection. Despite this, compliance with IPTp remains far from that recommended by the National Malaria Control Programme and World Health Organization. Behaviour change communication should be improved to encourage compliance with protective malaria control tools during pregnancy.