Outcomes of pregnancy in severe malaria wth emphasis on neurological manifestations in Gondar Hospital northwest Ethiopia.
BACKGROUND
Pregnant women are prone to severe malaria despite previous malaria attacks because of decreased immunity. This puts both the mother and the fetus at a greater risk.


OBJECTIVE
To assess the pattern of severe malaria among pregnant women.


METHODS
A six year retrospective, record analysis of all women of reproductive age with severe malaria was done at Gondar University hospital.


RESULTS
It was found that out of 204 reproductive age women admitted with severe malaria 57.8% were pregnant. Signs of severity occurred more frequently in the pregnant women and rural dwellers. The several neurological manifestations were most common complications for more than 70.0% of the pregnant women and in 60.0% of the non-pregnant women, namely cerebral malaria, convulsions, altelred mental state and prostration. The case fatality rate 33.1% among the pregnant women was found to he significantly higher than the non pregnant (p = 0.03, OR 2.2. 95% confidence interval 1.1-4.2). Cerebral malaria, pulmonary edema, shock and acidotic breathing were the severe manifestations statistically associated with maternal mortality in pregnant women. Again cerebral malaria and shock were significantly associated with either maternal or infant death or both (bad outcome of pregnancy).


CONCLUSIONS
It is this recommended that special attention for pregnant mothers in prevention, early detection and prompt treatment of malaria is needed.
Mengistu
Getahun
G
Department of Neurology, faculty of medicine, Addis Ababa University.
Diro
Ermias
E
Kassu
Afework
A
D000293:Adolescent; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D016779:Malaria, Cerebral / Q000453:epidemiology*; D008428:Maternal Mortality; D008875:Middle Aged; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index