Prevalence and factors associated with placental malaria in Lira District, Northern Uganda: a cross-sectional study

Abstract

Abstract Introduction Malaria has stable perennial transmission across Uganda. Placental malaria is associated with adverse maternal, fetal, and neonatal outcomes. The magnitude and the factors associated with placental malaria are poorly studied in our setting. The purpose of this study was to assess the prevalence of placental malaria and to explore associated factors among parturient women in Lira District, Uganda. Methods This was a cross-sectional study among 366 pregnant women who delivered at Lira Regional Referral Hospital. An interviewer-administered questionnaire was used to collect data on socio-demographic, obstetric characteristics, and malaria preventive practices of the participants. Standard Diagnostic Bioline Rapid Diagnostic Tests were used to detect placental malaria present in the placental blood. We used microscopy to quantify the severity of placental malaria infection and multivariable Odds ratios were used to report associations between selected independent variables and placental malaria. Results The prevalence of placental malaria was 16/366 (4.4%). Microscopy revealed 13% (2/16) moderate severity and 31% (5/16) mild severity of malaria parasitaemia. Women aged less than 20 years (AOR 3.483, 95% CI 1.131–10.726), and those not taking iron supplements during pregnancy (AOR = 3.548, 95% CI = 1.022–12.315) were associated with an increased likelihood of having placental malaria parasitaemia at the time of birth. Uptake of sulfadoxine-pyrimethamine for intermittent prevention of malaria during pregnancy and low parity were not associated with placental malaria. Conclusion Nearly, one in every 22 women had placental malaria infection at the time of delivery. Placental malaria infection was associated with younger age and not taking iron supplements during pregnancy.