Self-reported acute febrile illness, malaria and anemia among pregnant women in communities surrounding the Lagoon of Lagos, South-west Nigeria.

Abstract

Background: Maternal febrile illness is often linked with undesirable adverse consequences of pregnancy and of fetal development. Objective: The objective of this study was to assess the prevalence of malaria parasitemia and anemia among pregnant women who gave a self-report of febrile illness within 48 hours of presentation at antenatal clinics in semi-urban Lagoon communities in Lagos, Southwest Nigeria where malaria preventive strategies have been carried out. Subjects and methods: A total of 113 pregnant women receiving antenatal care at two secondary-level health facilities in Ikorodu Local Government Area of Lagos State, were recruited into this crosssectional. Relevant information such as age, gravidity, trimester of pregnancy, febrile illness within the past 48 hours and use of malaria commodities were extracted from them. Laboratory analysis was conducted for anemia and malaria parasitemia. Results: In all, 32 (28.3%), 32 (28.3%) and 49 (43.4%) of the study subjects were pregnant for the first time, second time and many times respectively. The overall means (± sd) of age (years) and of PCV (%) were 29.9 (5.8) and 30.0 (6.3) respectively while the mean age of those in 1st 2nd and >2 pregnancies were 26.8 (5.2), 27.3 (3.7) and 33.7 (5.1) years respectively. Also, 38 (33.6%) of the 113 study subjects gave a self-report of febrile illness (SERFI) 48 hours prior to presentation at Antenatal clinic. Laboratory investigation showed that 22 (19.5%) of the study subjects were malaria parasite positive, whose mean Packed Cell Volume (26.8 ± 6.6%) was significantly lower (t=2.64, P-value=0.007) than that of the 91 (80.5%) without malaria parasitemia (30.8 ± 6.0%). The mean (± sd) PCV% of the 38 pregnant women who gave a SERFI (28.4 ± 5.2) was significantly lower (t=-2.13, P-value=0.018) than that of the 75 (66.4%) who did not (30.9 ± 6.6). Women in their first pregnancy were over 2½ times as likely to present with febrile illness than those in their second or more pregnancies (χ²=5.36, Pvalue= 0.02, OR=2.65, 995% CI: 1.15, 6.27). In all 36.8%, 27.8% and 40.0% of those in 1st, 2nd and 3rd trimester presented with febrile illness. Very few of the study subjects slept under Long-lasting Insecticide-treated nets (LLINs) night before the survey or used Sulphadoxine-pyrimethamine (SP) for Intermittent Preventive Treatment of malaria in pregnancy (IPTpp). Conclusion: The prevalence of malaria and anemia among those who gave SERFI in pregnancy was moderately high in Ikorodu Local Government Area of Lagos State, Nigeria. More penetrating stronger health education should be given to pregnant women to report within 24-48 hours of any febrile illness in pregnancy. Efforts should also be intensified to identify cause(s) of maternal febrile illness to reduce maternal and neonatal morbidity and mortality in semi-urban settings of Lagos State specifically and throughout Nigeria in general.