Pregnancy-Associated Malaria in Sudan: Prevalence and Possible Risk Factors

Abstract

This study aimed to investigate the malaria infection prevalence and predisposing risk factors among some pregnant women in Greater Khartoum area, Sudan. Following informed consent, eight hundred thirty six pregnant women were interviewed and thick blood films were prepared and examined for malaria parasites. Parasite densities were determined by counting parasites against 200 leukocytes assuming a white blood cells count of 6,000/µl. PCR was performed using outer and nested primers to enhance detection of parasitemia below the microscopy threshold, after DNA extraction by chelex method. Microscopy and species-specific PCR results showed that 26.2% and 56.5% of women were positive respectively. Low parity and young-aged pregnant women were significantly associated with parasitemia (p=0.001, 0.004). Second trimester pregnancy (adjusted odd ratio (aOR), 3.2 (95% CI, 2.9-5.8,)) and season of antenatal visit ((aOR), 1.7 (95% CI, (0.9-1.1)) constituted a significant risk factor for contracting malaria. In a multivariate analysis, mothers <20 years ((aOR), 2.4 (95% CI, 1.3-3.0)), first and second pregnancies ((aOR), 2.0 (95% CI, 1.1-1.9)), poverty- related factors (low-income, illiteracy) were independent predictors for P. falciparum infection. Pregnancy-associated P. falciparum malaria is prevalent among Sudanese pregnant women with evidence of close correlation to low parity, young age and socioeconomic status.