1.0 Introduction
1.1 Background of Study
Malaria has long been recognized as a major health problem in Nigeria and other tropical countries, with its roots tracing back centuries. The disease was first described in ancient texts, but it wasn't until the late 19th century that scientists confirmed that malaria was caused by Plasmodium parasites and transmitted by Anopheles mosquitoes (Cox, 2010). With Nigeria located in a malaria-endemic zone, the country has continuously faced enormous challenges in controlling the disease. Malaria transmission occurs all year round in most parts of Nigeria, with increased prevalence during the rainy season due to favorable breeding conditions for mosquitoes.
Historically, malaria has disproportionately affected vulnerable populations, including pregnant women. Recognition of this heightened vulnerability led to the development of specialized malaria control strategies focusing on maternal health. The World Health Organization (WHO) began advocating for intermittent preventive treatment in pregnancy and the distribution of insecticide-treated nets (ITNs) as early as the 1990s (WHO, 2004). The Imo State Specialist Hospital in Owerri has been one of the key health institutions involved in providing maternal healthcare services. Over the past two decades, the hospital has seen varying trends in malaria-related admissions among pregnant women. However, despite national and state-level efforts to address malaria through programs like the Roll Back Malaria initiative and the National Malaria Elimination Programme, malaria remains a recurring cause of hospitalization among pregnant women in the state (Federal Ministry of Health [FMoH], 2021).
Malaria remains one of the most significant public health challenges in sub-Saharan Africa, where it causes substantial morbidity and mortality, particularly among vulnerable groups such as pregnant women and young children. It is a parasitic disease transmitted through the bite of an infected Anopheles mosquito, caused primarily by Plasmodium falciparum, which is responsible for the most severe cases and deaths in Africa (World Health Organization [WHO], 2023). Nigeria bears the highest burden of malaria globally, accounting for nearly 27% of the world's malaria cases and 32% of deaths, a significant proportion of which occur among pregnant women (WHO, 2023).
According to Guyatt & Snow (2004), pregnancy significantly increases the susceptibility of women to malaria due to changes in immunity and the presence of the placenta, which provides a favorable environment for parasite sequestration. Malaria in pregnancy (MiP) poses serious risks, including maternal anemia, spontaneous abortion, intrauterine growth restriction, low birth weight, premature delivery, and perinatal mortality (Guyatt & Snow, 2004). Malaria is a life-threatening disease caused by Plasmodium parasites, which are transmitted to humans through the bites of infected female Anopheles mosquitoes (World Health Organization, 2023). It remains one of the most serious public health problems in sub-Saharan Africa, particularly affecting vulnerable populations such as children under five and pregnant women. Pregnant women are especially susceptible to malaria due to the physiological and immunological changes that occur during pregnancy, which can reduce resistance to infections (Desai et al., 2007). This study, therefore, aims to assess the prevalence of malaria among pregnant women on admission at the Imo State Specialist Hospital, Owerri.
1.2 Statement of Problems
Investigation revealed that malaria remains one of the leading causes of illness and death among pregnant women in sub-Saharan Africa, and Nigeria carries one of the highest burdens globally (World Health Organization [WHO], 2023). Also, the disease continues to thrive, especially among vulnerable groups such as pregnant women. This is deeply concerning because malaria during pregnancy is not just a health threat to the mother it also places the unborn child at risk of complications such as low birth weight, preterm delivery, and even stillbirth (Guyatt & Snow, 2004).
Furthermore, the persistence of malaria among pregnant women in the region is undermining maternal health outcomes despite the availability of preventive measures such as insecticide-treated nets (ITNs) and intermittent preventive treatment in pregnancy (Federal Ministry of Health, 2021). It is against the backdrop that this study is therefore necessary to assess the prevalence of malaria among pregnant women on admission in the Imo State Specialist Hospital, Owerri.
1.3 Aim and Objectives of Study
The aim of this study is to investigate the prevalence of malaria among pregnant women admitted to the Imo State Specialist Hospital Owerri.
The specific objectives of the study are as follows:
- To determine the prevalence rate of malaria among pregnant women on admission in the Imo State Specialist Hospital Owerri.
- To identify the demographic and clinical characteristics of pregnant women diagnosed with malaria upon admission.
- To examine the level of awareness and utilization of malaria prevention measures such as insecticide-treated nets (ITNs) and intermittent preventive treatment (IPTp) among the pregnant women.
- To evaluate the association between malaria infection and pregnancy-related complications in admitted patients.
- To provide evidence-based recommendations for enhancing malaria prevention and treatment strategies targeted at pregnant women in the hospital.
1.4 Research Questions
Based on the objectives of the study, the following research questions have been formulated:
- What is the prevalence rate of malaria among pregnant women on admission in the Imo State Specialist Hospital Owerri?
- What are the demographic and clinical characteristics of pregnant women diagnosed with malaria upon admission?
- What is the level of awareness and utilization of malaria prevention measures such as insecticide-treated nets (ITNs) and intermittent preventive treatment (IPTp) among pregnant women?
- What is the relationship between malaria infection and pregnancy-related complications among the admitted women?
- What strategies can be recommended to improve the prevention and management of malaria among pregnant women in the hospital?
1.5 Significance of Study
The outcome of this research will help public health officials and malaria control programs evaluate the effectiveness of current preventive measures and design more impactful community-based campaigns. Also, pregnant women and caregivers will benefit from increased awareness and education on the risks of malaria during pregnancy and the importance of timely prevention and treatment.
Furthermore, the results will serve as a useful reference for future researchers, students, and public health scholars who are interested in maternal health and infectious disease control.
Lastly, this study will support evidence-based decision-making that will lead to improved maternal and neonatal outcomes in Imo State and potentially in other parts of Nigeria with similar malaria transmission patterns.
1.6 Scope of Study
This study focuses on assessing the prevalence of malaria among pregnant women admitted to the Imo State Specialist Hospital located in Owerri, Imo State, Nigeria. The research will cover pregnant women at various stages of pregnancy who seek medical care and are admitted to the hospital during the study period.
1.7 Limitations of the Study
This study was limited to pregnant women admitted only to the Imo State Specialist Hospital Owerri, which may not represent the prevalence of malaria among all pregnant women in Imo State or other healthcare facilities.
Furthermore, the study period was restricted and did not cover all seasons, so variations in malaria transmission throughout the year were not fully captured.
Additionally, limited resources and time constraints were challenges that influenced the sample size and scope of data collection.
1.8 Definition of Terms
Malaria:
Malaria is a life-threatening disease caused by parasites of the genus Plasmodium, transmitted to humans through the bites of infected female Anopheles mosquitoes (World Health Organization [WHO], 2023). It is characterized by symptoms such as fever, chills, headache, and vomiting. Malaria remains a significant public health issue, particularly in tropical regions like Nigeria, where it affects millions of people annually.
Prevalence:
Prevalence refers to the proportion of individuals in a population who have a particular disease or condition at a specific time (Babbie, 2013). In this study, it relates to the percentage of pregnant women admitted to the hospital who are diagnosed with malaria during the study period.
Pregnant Women:
This term refers to women who are carrying one or more embryos or fetuses within their uterus (Cunningham et al., 2018). Pregnancy is a critical period during which women are more susceptible to infections like malaria, which can pose risks to both the mother and the unborn child.
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