Prevalence and Associated Risk Factors of Human Placental Malaria Parasitization in Juba_south Sudan

Abstract

Pregnant mothers are more likely to be at risk of malaria infections, which commonly present with severe adverse effects during the gestational period. This thesis aimed at determining both point and time prevalence of human Placental malaria Parasitization and its associated risk factors of maternal age, parity, insecticide sprays use, population displacement, and health system among pregnant women in Juba, South Sudan, which is characterized by stable malaria transmission. Malaria control programs and non-profit organizations in South Sudan currently face a significant knowledge gap regarding Malaria in pregnancy. Research has shown that people movement, chronic political conflict, and displacement are the main drivers of the development of placental malaria. As such, this study involved different ethnic communities rather than selected single communities and also covered malaria prevalence to cover all aspects of malaria. The prospective longitudinal cohort study was primed to determine how displaced communities can identify and manage risk factors associated with placental malaria. Building on existing work targeting the control and treatment of malaria compelled the study. The study answered questions on distributions of placental malaria among study subjects together with the response of the healthcare delivery system within South Sudan, shaping insight on ABO Blood association with placental malaria Parasitization. Furthermore, the study project has highlighted correlation linkages between placental malaria and negative peripheral blood malaria. Data accrual was through a preformed questionnaire. After meeting the study entry criteria, each participant was given the study questionnaires. This was followed by blood sample taking for analysis of the malaria parasite. A follow-up until the delivery time when second blood samples were taken from the same participant and placental and baby weights were taken to answer risk questions and determine factors for placental malaria. The results revealed that placental malaria Parasitization accounts for 29.1% 268/922 in the study population. All factors considered in the follow-up study were somewhat associated with Placenta Malaria Parasitization. Significantly associated with the Placenta Malaria Parasitization were treated bed nets (P-value=0.04), negative Malaria Parasites at recruitment in ANC reported Placenta Malaria Parasites with Relative Risk 9.5 (RR) 95% Cl (6.6__13.8). Furthermore, Negative peripheral malaria parasites during delivery were significantly associated with Placental Malaria Parasitization RR. 2.3 Cl (1.6 3.4); Plasmodium vivax is associated with Placental Malaria Parasitization RR. 1.7 95% Cl (1.56 1.99). This study noted that key independent risk factors for developing placental malaria Parasitization include maternal age below 23 years and maternal parity. On this basis, it is recommended that intermittent preventive treatment compliance and proper use of long-lasting treated beds are critical factors in reducing placental malaria Parasitization in Juba, South Sudan. Further studies are needed to describe other factors that could strengthen the effectiveness of fragile South Sudan’s health system to reduce the negative impacts of malaria in pregnancy.