# Knowledge and misconception of malaria among pregnant Women attending antenatal care

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#### Abstract

Background. In Uganda Malaria continues to be a major public health problem accounting for about 30–50% of all outpatient consultations and 35% of hospital admissions and a leading cause of mortality and morbidity. Pregnant women and their unborn children are vulnerable to malaria. Methods. A cross-sectional survey was conducted in rural area, selected randomly as clusters. 769 pregnant women were interviewed. Results. The majority of the respondents 85% have ever heard about malaria. Most (80%) 571 respondent attributed malaria to be transmitted by mosquito bites, 15 said cold weather, 53 said dirt, and 35 said not sleeping under net. Most (91%) 683 respondents mentioned that malaria was caused by mosquito, 28 mentioned cold food, 3 mentioned playing in the rain, 19 mentioned cold weather, and 6 mentioned eating mangos. Conclusion. Most pregnant women in in rural areas have relatively high knowledge about malaria transmission, signs, symptoms, and consequences during pregnancy. However, majority of respondents had misconception about the cause of malaria while a few had misconception about the mode of malaria transmission.

INTRODUCTION

Malaria is a life threatening parasite disease spread by female Anopheles mosquitoes. More than 40 percent of the total population lives in malarious environments (WHO, 2010). (WHO, 2010). It is projected that the number of cases of malaria climbed from 233 million in 2000 to 244 million in 2005 but declined to 225 million in 2009 (WHO, 2010). (WHO, 2010). The number of fatalities attributable to malaria is predicted to have dropped from 985 000 in 2000 to 781 000 in 2009 (WHO, 2010). (WHO, 2010). Malaria is the most most frequent tropical illness with substantial morbidity and mortality, and with high economic and social effect (WHO, 2010). (WHO, 2010). Over 90 percent of all deaths caused by malaria occur in sub – Saharan Africa and around 85 percent of deaths globally were in children under 5 years of age (WHO, 2010). (WHO, 2010). In addition, pregnant women are at tremendous risk of malaria due to normal immunological suppression in pregnancy (Fievet et al., 2007). (Fievet et al., 2007). About 25 percent of all estimated malaria cases in the World Health Organisation African Region occur in Nigeria (WHO, 2010). (WHO, 2010).
Malaria infection during pregnancy is a major public health hazard in tropical and subtropical locations throughout the world (WHO, 2010). (WHO, 2010). The burden of malaria infection during pregnancy is produced mostly by Plasmodium falciparum, the most common malaria species in Africa (WHO, 2010). (WHO, 2010). Each year at least 3 million pregnancies occur among women in malarious parts of Africa, most of who reside in areas of relatively constant malaria transmission

(Brabin, 2000). The symptoms and problems of malaria during pregnancy differ with the severity of malaria transmission and hence with the level of immunity the pregnant woman has developed (Perlmann and Troye-Blomberg (2000). (2000). Pregnant women and the unborn children are particularly sensitive to malaria, which is a primary cause of prenatal mortality, low birth weight, and maternal anaemia (Greenwood et al., 2007). (Greenwood et al., 2007).

Beyond the impact of malaria on infants and pregnant women, it impacts the whole community. 100 percent of the total population of Nigeria is at risk of malaria and at least 50 percent of the total population suffers from at least one episode of malaria each year (WHO, 2010). (WHO, 2010). About 51 percent of malaria infections and deaths in Nigeria occur in rural areas away from efficient diagnostic or treatment facilities (WHO, 2010). (WHO, 2010). Malaria incidence and deaths have been increasing in the country, mostly due to injudicious use of antimalarial medications, delayed health seeking, and reliance on the clinical judgment without laboratory confirmation in most of the peripheral health facilities (Vander et al., 2005). (Vander et al., 2005). Despite evidence of the cost- effectiveness of improving treatment access and compliance (Goodman et al., 1999), most victims of malaria still die because of a lack of health care close to their homes or because their condition is not diagnosed by health workers (WHO, 2000; Armstrong- Schellenberg et al., 1994). (WHO, 2000; Armstrong- Schellenberg et al., 1994). Early diagnosis and fast effective treatment of malaria disease has been a cornerstone of malaria control (Vander et al., 2005). (Vander et al., 2005). Diagnosis based on symptoms alone has inherent challenges (Vander et al., 2005), but volunteer

health professionals in rural regions have practised it with some effectiveness (Pagnoni, 1997; Okanurak and Ruebush, 1996). (Pagnoni, 1997; Okanurak and Ruebush, 1996). The decrease of morbidity and the prevention of parasite transmission by means of community-based antimalarial treatment necessitate an accurate, quick and practical technique of detection. The delivery of treatment in rural locations in Nigeria is hindered by the centralized character of microscopy services (Alaba and Alaba, 2008). (Alaba and Alaba, 2008). Over the past few years, improvements in quick field diagnostic procedures based on the demonstration of parasite antigens have created new opportunities for enhanced rural malaria diagnosis that is independent of centralized diagnostic services (Bojang, 1999; Singh et al., 1997). (Bojang, 1999; Singh et al., 1997).

There have been a great number of reports about knowledge, attitudes, and practices relating to malaria and its control from diverse parts of Africa. These reports indicated that misunderstandings surrounding malaria still exist and that practices for the prevention of malaria have been poor (Deressa et al., 2008). (Deressa et al., 2008). However, epidemiological patterns of malaria are widely varied from one region to another (Himeiden et al., 2005). (Himeiden et al., 2005). Specific data of a place obtained can help in the formulation of a design of improved programme for strategic malaria control for a particular site. There are available effective low-cost strategies for the treatment of malaria, but any attempt to control a disease such as malaria in an area or locality should first of all be preceded by an extensive evaluation of the magnitude of the prevailing situation; a complete description of the health problems of the community

providing an account not only of the prevalence, but also of the community’s assessment of its own problems and its usage of existing health services. Ascertaining the factors that influence community and provider acceptance of and adherence to the new treatment regime will be vital to improving the effectiveness of this intervention and reducing the risk of development of drug resistance, and thus reduction in prevalence, towards elimination and subsequent eradication. Part of the rationale for examining malaria prevalence in pregnancy is to compare present with past situations especially with current attempts at limiting malaria during pregnancy.

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