Between 80-90% of the world’s malaria cases occur in sub Sahara Africa and approximately 19 -24 million
pregnant women are at risk for malaria and its adverse consequences. The major impact of Malaria in pregnancy
has severe negative effects on maternal health and birth outcomes including maternal anaemia, high incidence of
miscarriages and low birth weight. Primigravidae and secundigravidae are most at risk. Due to increased and
spreading malaria parasite resistance to first line antimalarials like chloroquine and sulphadoxine–Pyrimethamine
in sub-Saharan Africa, the available tools for malaria control in pregnancy are now very limited. One of the most
commonly used tool for preventing malaria in pregnancy is insecticide treated bed nets (ITNs), which have been
shown to reduce the number of infective mosquito bites by 70-90% in a variety of ecologic settings. In Nigeria, the
current use of ITNs among pregnant women and children under 5 years, is just 1%, according to the Nigeria
Demographic and Health Survey (NDHS).
This study aimed at examining the effects of the use of ITNs on episodes of uncomplicated malaria, frequencies of
malaria parasitaemia and anaemia among two hundred and eight primigravidae. The design was an analytical case
control. One hundred and four subjects received ITNs between August 2003 and January 2004 and the other 104
subjects acted as controls. Data were obtained using the new World Health Organization antenatal care classifying
form and the basic component checklist, and a structured interviewer-administered, 30-item questionnaire.
Laboratory tests were done to obtain data on episodes of malaria, levels of malaria parasitaemia, mean
haemoglobin concentration and anaemia.
The results in test group showed 28.9% and 20% reduction in episodes of uncomplicated malaria and in frequency
of malaria parasitaemia at 38 weeks gestation, respectively. However, there was no difference in mean
haemoglobin concentration and in frequency anaemia between the test and control groups. The use of ITNs by
primigravidae in this peri-urban settlement in south eastern Nigeria, showed significant reductions in episodes of
uncomplicated malaria and malarial parasitaemia.