Plasmodium falciparum parasitaemia and malaria among pregnant women at first clinic visit in the mount Cameroon Area.
BACKGROUND
Pregnant women in malaria endemic areas are at high risk of P. falciparum infection and its complications. This study investigated the prevalence and risk factors for P. falciparum infection and malaria among pregnant women reporting for first antenatal care (ANC) clinic visit in the mount Cameroon area.


METHODS
Venous blood samples from consented pregnant women were screened for malaria parasitaemia by light microscopy. Haemoglobin levels, white blood cell (WBC) counts, lymphocyte counts and percentage were determined using an automated haematology analyser. Socio-demographic/economic data, environmental factors and use of malaria control measures were documented. Univariate and multivariate statistical analyses were used.


RESULTS
Sixty-eight (22.4%; N = 303) of the women enrolled were positive for P. falciparum parasitaemia. Malaria parasitaemia was significantly (P < 0.001) associated with febrile illness. The overall prevalence of malaria and asymptomatic infection was 16.0% (95% CI = 11-20%) and 10.5% (95% CI = 7.3-15%) respectively. A greater proportion of the malaria cases (61%) reported at the clinic during unscheduled days meanwhile women with asymptomatic parasitaemia mostly (92.8%) seek for ANC during scheduled clinic days. Lower lymphocyte percentage was significantly associated with increase parasite density (r = - 0.34; P = 0.011) and febrile status (MU = 2.46; P = 0.014). While age and gravidity were significant factors associated with P. falciparum infection and/or malaria, the presence of bush and/or standing water around human residence was an independent risk factor of P. falciparum parasitaemia (OR = 3.3: 95% CI = 1.6-7.0; P = 0.002) and malaria (OR = 5.2: 95% CI = 2.0-14; P = 0.001). Being unmarried was significantly associated with increase risk (OR = 2.6:95% CI = 1.1-6.0; P = 0.032) of P. falciparum parasitaemia. Similarly, single women (938) had a significantly higher (t = 2.70; P = 0.009) geometric mean parasite density (GMPD) compared with married women (338).


CONCLUSIONS
Marital status and human residence in areas with bushes and/or standing water modify risk of P. falciparum infection and malaria. Education on early ANC attendance and environmental sanitation are important public health targets for malaria control in pregnancy in this setting.
Department of Zoology and Animal Physiology, University of Buea, Buea, 63, Cameroon. kuoh2000@yahoo.fr.
Judith K
JK
Anchang-Kimbi
Department of Zoology and Animal Physiology, University of Buea, Buea, 63, Cameroon. vepretty89@yahoo.com.
Vera Ngenwie
VN
Nkweti
Department of Biological Sciences, University of Bamenda, Bamenda, Cameroon. ngumnto@yahoo.com.
Helen Ngum
HN
Ntonifor
Department of Biochemistry and Molecular Biology, University of Buea, Buea, 63, Cameroon. apinjohtoby@yahoo.co.uk.
Tobias O
TO
Apinjoh
Department of Molecular Parasitology, University of Buea, Buea, 63, Cameroon. rollandbantar@yahoo.com.
Rolland Bantar
RB
Tata
Department of Molecular Parasitology, University of Buea, Buea, 63, Cameroon. hanesh_chi@yahoo.com.
Hanesh Fru
HF
Chi
Department of Biochemistry and Molecular Biology, University of Buea, Buea, 63, Cameroon. achidi_e@yahoo.com.
Eric Akum
EA
Achidi
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D002163:Cameroon / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology*; D018512:Parasitemia / Q000453:epidemiology; D010963:Plasmodium falciparum / Q000472:pathogenicity; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology* / Q000469:parasitology; D011295:Prenatal Care; D012307:Risk Factors; D055815:Young Adult