Asymptomatic Plasmodium parasitaemia in pregnant Nigerian women: almost a decade after Roll Back Malaria

Malaria during pregnancy is a major cause of fetal and maternal morbidity and mortality. In malaria-endemic areas, the condition may remain asymptomatic but is still associated with complications. The objective of this study was to determine the prevalence of asymptomatic malaria parasitaemia and its relationship with various sociodemographic characteristics. The study was performed at three hospitals in Enugu, the centre of southeast Nigeria, during the rainy season between March 2006 and October 2007. Pregnant women attending the antenatal clinic at the index pregnancy were randomly selected and counseled, and peripheral blood samples were collected for malaria parasite and packed cell volume estimation. Age, parity, gestational age at booking, degree of anaemia and parasite density were recorded. Of 125 pregnant women tested, 73 had microscopic Plasmodium parasitaemia, giving a prevalence of 58.4%. Asymptomatic malaria parasitaemia was more common in primigravidae, in the second trimester and in the younger age group. Anaemia in pregnancy was prevalent (55.2%) and there was no significant difference in the density of parasitaemia in those with mild, moderate and severe anaemia. The prevalence of Plasmodium parasitaemia in pregnant Nigerian women is still very high nearly a decade after Roll Back Malaria. It is therefore pertinent to reappraise Roll Back Malaria strategies or to design a more effective programme for the prevention and treatment of malaria in pregnancy. © 2008 Royal Society of Tropical Medicine and Hygiene.