Manifestations of falciparum malaria in pregnant women of Eastern Sudan

OBJECTIVE: This study was conducted to investigate the morbidity pattern of malaria during pregnancy in New Halfa Teaching Hospital, Eastern Sudan, where malaria transmission is unstable.

METHODS: Pregnant (or in the puerperium) women presented with symptoms of falciparum malaria to the hospital during the period of November 2002 to March 2003 were enrolled to the study. Their socio-demographic characters, physical examinations, especially manifestations of severe falciparum malaria were performed and data were recorded. Blood films for malaria, urine, hemoglobin and blood glucose were tested.

RESULTS: Fifty-nine pregnant (or in the puerperium) women with falciparum malaria were presented in this study. The mean +/- SD gravidity was 3.3 +/- 2.1. Fourteen (23.7%) out of 59 patients presented with one or more manifestations of severe malaria according to the World Health Organization criteria. Severe anemia (5), pulmonary edema (4), jaundice (3), hypoglycemia (3) and hypotension (1) were the manifestations of the severe illness. In comparison to non-severe group, patients with severe illness have significantly higher temperature and significantly lower hemoglobin level. The other parameters were not significantly different between the 2 groups of patients. In the severe cases, one patient was presented with missed second trimester abortion and the 6/59 (10.2%) patients delivered prematurely 4 were in the severe form. There were 4 perinatal deaths all in the severe group and there was one maternal death due to pulmonary edema.

CONCLUSION: In this locality not only primigravidae but all parities were infected with falciparum malaria and different manifestations of severity were detected. Higher perinatal mortalities were documented.