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PREVALENCE, DETERMINANTS AND PATTERN OF PLACENTAL MALARIA IN HIV POSITIVE AND HIV NEGATIVE PARTURIENTS AT TERM AND NEONATAL OUTCOME

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Supervisor: DR ADETOKUNBO O. FABAMWO, DR OLUWAROTIMI I. AKINOLA
Faculty: OBSTETRICS AND GYNAECOLOGY
Year: 2015

Abstract

TITLE: Prevalence, determinants and pattern of placental malaria in HIV positive and HIV negative parturients at term and neonatal outcome. BACKGROUND: The burden of malaria is severe in Africa, affecting mainly pregnant women and their unborn children. This burden is worsened by co-infection with HIV, thus making the Millennium Development Goal 6 (MDG 6) of combating HIV/AIDS, malaria and other diseases in Africa to be off track. When combined malaria and HIV account for 9% of the total burden of diseases in sub-Saharan Africa, and a total of over 4 million deaths globally, of which more than 80% occur in tropical Africa. A recent study in Nigeria also estimated that malaria and HIV account for 27% of hospital based mortality. Despite these frightening statistics, studies on malaria and HIV/AIDS are usually separate with minimal focus on pregnant women and their new born child, both of whom happen to be the most severely affected by the two diseases. Although placenta histology is regarded as the gold standard for diagnosis of malaria in pregnancy, only few studies are available in the sub-region using this method. Moreover since the placenta is not available until delivery there is need to determine which common method of malaria diagnosis has the closest accuracy to that of placental histology. OBJECTIVE: The main objective of this study was to determine the prevalence, determinants and pattern of placental malaria in HIV positive and HIV negative parturients at term and the effect on neonatal outcome. METHODS/DESIGNS: This study was a comparative cross sectional study of 90 HIV positive and 90 HIV negative parturients at term. At delivery whole blood was collected from both mother and baby to determine malaria parasitaemia and PCV, while blood was also taken from the placental sinusoid to determine malaria parasitaemia. Full thickness biopsies of the placenta were also sent for histopathological analysis. A semi-structured researcher administered questionnaire was also used to collect data from the participants and from the case notes. The birth weight of the babies was also noted. The data obtained were processed and analyzed using Statistical Package for Social Sciences, (SPSS) version 19.

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