PREVALENCE OF MALARIA PARASITE IN CORD BLOOD

Malaria in pregnancy is an obstetric, social and medical problem requiring multidisciplinary and multidimensional solution. Pregnant women constitute the  main adult risk group for malaria  and  80%   of death due  to  malaria in Africa occur in pregnant  women and children  below  5 years of  age (Ali A,  et al,  2007).
Pregnancy increases the risk of malaria parasitaemia (Nnaji G.A et al, 2007).  There is equally an increased risk of placental blood flow and  the available oxygen to the fetus. Consequently, this may manifest as low birth weight, intra uterine growth retardation, intra uterine death, premature labour, still birth, prenatal asphyxia and neonatal asphyxia (Sullivan,  et al,  1999) 
The impact of maternal   malaria infection  on  prenatal and infant mortality is very difficult    to assess. However ,  few studies have provided insight into the problem. 
Sleketee et al   estimated that  3-8%  of  infant deaths  was  caused by pregnancy associated malaria approximately 75,000-200,000  infants  every year  (Steketee RW, et al , 2001) . The strongest risk factor of umbilical cord parasitaemia  was maternal blood   parasitaemia at delivery.
(Villamor E, et al,  2005)  provides  evidence  for policy  formulation   and  issues  in the  case of  primigravidae  and secundigravidae  who have shown to have increased susceptibility   to malaria parasitaemia (Nnaji G A, et al , 2006).
Malaria parasites are the protozoa  parasite  belonging to  subclass coccidioe, genus plasmodium (Ochei  2004) . It is  a major public health  problem and causes much suffering   and  prepremature death in poorer areas   of tropical Africa  Asia and latin  America (Cheesbrough 2005). 
Since  2000,  the World Health Organization (WHO) has recommended a package of  intervention  to prevent malaria infection during   pregnancy  and it sequelae,  these include the promotion  at insecticide treated bed nets (ITMS)  Intermitted Preventive Treatment (IPT ) and   effective case  management of malaria illness with respect  Intermittent Preventive Treatment (IPT).
WHO recommended that pregnant women in malaria endemic areas should receive at   least two dose of sulfadoxine pyrimethamin in  the  second and third trimesters of    pregnancy  (Shulman, et al, 1999) . Many countries have adopted the WHO  recommendations  but implementation has often been hampered by  constrain  within health   service delivery system  or individual perception  of Intermittent Preventive  Treatment (IPT). these factors  includes  health  services delivery system burdened  by poor drug  supply, poor health worker practices and  low  attendance or  late presentation to antenatal  clinics
 
STATEMENT OF PROBLEMS
Malaria has continued to  remain a major disease in tropical homogeneous black African  population  especially in,  pregnant women and children (Fischer  2006)  malaria infection is associated  with  great  morbidity and  mortality in pregnant  women  and children. from  my observation  many pregnant women in our environment have  reported the incidence of malaria at various   times  which may translate to increase in cord blood  parasiteamia   in their babies as well as congenital  malaria in the new borns
This  study therefore evaluates the prevalence   of malaria in cord blood of new born babies  delivered at the labour  ward of mile  4  hospital Abakaliki

AIMS AND OBJECTIVE OF THE STUDY
The aims   of this study is to investigate   the   prevalence  of malaria parasite  in  cord blood.  Evaluation  of the prevalence  of malaria  parasite  in cord  blood will afford the  opportunity  of  assessing  the  burden of  malaria .
This study also aims
·         To identify other factors that influence  the level of cord  blood malaria parasitaemia  
·         To identify   association between malaria parasitaemia in cord  and maternal blood.
To identify any association between malaria parasitaemia in the umbilical cord  blood and the birth weight  of the infant at  delivery.
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