Placental Malaria and Hypertensive Disorders of Pregnancy: A Case-Control Study in a Teaching Hospital, Ghana
Samira Daud
Department of Haematology, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana.
Charles Nkansah
*
Department of Haematology, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana and Department of Medical Laboratory Sciences, Faculty of Health Science and Technology, Ebonyi State University, Abakaliki, Nigeria.
Yaw Amo Wiafe
Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Nafiu Amidu
Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana.
Eliezer Togbe
Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Ruth Duku-Takyi
Department of Medical Laboratory Technology, Accra Technical University, Accra, Kumasi, Ghana.
Ganiwu Abdul
Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Lawrence Duah Agyemang
Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Max Efui Annani-Akollor
Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Eddie-Williams Owiredu
Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Constance Adu-Gyamfi
Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Charles Gyasi
Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Alexander Yaw Debrah
Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
William K. B. A. Owiredu
Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Kofi Mensah
Department of Haematology, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana and Department of Medical Laboratory Sciences, Faculty of Health Science and Technology, Ebonyi State University, Abakaliki, Nigeria.
Samuel K. Appiah
Department of Haematology, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana and Department of Medical Laboratory Sciences, Faculty of Health Science and Technology, Ebonyi State University, Abakaliki, Nigeria.
Gabriel Abbam
Department of Haematology, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana.
Otchere Addai-Mensah
Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
*Author to whom correspondence should be addressed.
Abstract
Aim: To determine the prevalence of placental malaria among women with HDP in Ghana, and its effect on fetal and pregnancy outcomes.
Study Design: Case-control study.
Place and Duration of Study: Obstetrics and Gynaecology unit of Tamale Teaching Hospital, Tamale, Ghana from 1st September, 2019 to 31st January, 2020.
Methods: The study involved one hundred and twenty (120) parturient women (80 cases vs 40 controls). Cases were parturient women with HDP admitted at the labour ward, whereas controls were normotensive parturient women admitted for normal delivery at the labour ward. Maternal blood was taken for peripheral malaria diagnosis. Placental Malaria (PM) was diagnosed by placenta tissue examination. Data were analysed using GraphPad Prism version 8.0, and p<.05 was considered significant.
Results: The overall prevalence rate of PM was 38% (15% in control versus 53% in cases). The proportion of the malaria (placental) positive participants were different from those without PM who delivered via spontaneous vaginal delivery (64% vs 0%, p=.01) and tested positive for malaria during the pregnancy (19% vs 42%, p=.046). Higher age, being self-employed, preterm delivery complication and non-central cord insertion significantly increased the risk of developing HDP.
Conclusion: There is an increased prevalence of PM among women with HDP, with resultant increased adverse outcomes such as stillbirth. The observed influence of PMI on expectant mothers and their neonates inform the need to intensify the preventive measures against malaria in pregnancy.
Keywords: Placental malaria, hypertensive disorders, pregnancy