Malaria Prevalence and Drug Management in Pregnant Women Attending Remotely Located Daura General Hospital, North West Nigeria (Published)
Health authorities in Nigeria have for many years promoted national malaria control measures such as the use of insecticide treated bed nets (ITNs), indoor residual spray of insecticides (IRS), intermittent preventive treatment (IPTp) for pregnant women and children and the use of artemisinin combined therapy (ACT) as first line of treatment to reduce the prevalence of the disease in the country. In order to evaluate the effectiveness of these control measures, there is the need for continued disease monitoring and management across different zones of the country, especially among high risk cohorts such as children and pregnant women at remote locations. A 13 months study (July 2014 to July 2015) was carried out to establish the current prevalence of malaria among female patients attending Daura General Hospital in North West Nigeria, using standard laboratory procedures. Daura is a remotely located town that lies in the semi-arid zone of northern Nigeria at the intersection of roads from Katsina, Kano and Zinder in Niger Republic, with coordinates of 130 2’11’’ North, 80 19’4’’ East and 1,558 feet (474 meters) above sea level. Of the 8413 patients that tested positive for malaria parasite during the period, 1119 (13.30%) were children, 3721 (44.23%) were women, 2609 (30.99%) were men and 966 (11.48%) were the elderly. Among the infected women population, 2105 (56.57%) were pregnant (PGW), while 1616 (43.23%) were non-pregnant (NPW) women, indicating statistical significance in malaria prevalence between the two cohorts (p<0.05). Age related prevalence was significantly higher (p<0.05) in the 11 – 20 years group (32.68%) of the PGW and 21 – 30 years group (44.43%) of the NPW than the 25.89% recorded in the 21 – 30 years group and 21.05 and 20.38% recorded in the 31 – 40 years and 41 – 50 years groups of the PGW respectively. The highest seasonal prevalence rate was recorded during the late rainy season (LRS) months of July to September (10.86% for PGW and 8.83% for NPW) followed by the 7.73% recorded for PGW and 7.24% recorded for NPW during the early dry season (EDS) months of October to December. The lowest rates (5.67 and 5.46% for PGW and 6.50% for NPW) were recorded during the early rainy (ERS, April – June) and late dry season (LDS, January – March) months respectively. Monthly prevalence rates were highest during August (15.63%), September (15.11%) and October (11.26%) for the PGW, while corresponding prevalence figures for these months among the NPW were significantly lower (p<0.05) at 8.29, 9.22 and 7.80% respectively. Major drugs prescribed for the prevention of malaria during the second and third trimesters once foetal quickening is noticed include sulphadoxine/pyrimethamine given monthly, while for cure and treatment during all trimesters quinine SO4, arthessunate, α-β arteate and arthessunate/lumefantrim were prescribed. Analgesics, electrolytes and vitamins were also indicated. Malaria is a major cause of hospital visits pregnant women especially during the rainy season months, indicating the need to improve advocacy on intervention control measures among these groups in the study area.