The present study was designed to determine the prevalence of placental malaria infection and risk factor among delivering women at the main hospitals in Ouagadougou, Burkina Faso. The prevalence observed in our study 7,53% was lower compared to the prevalence previously reported elsewhere ,19, 40% and 19,50% in Angola [12] and Burkina Faso [13] respectively. The factors responsible for such variations in the placental malaria prevalence were reported to be acquired immunity related to the malaria transmission in the various setting [14]. This difference may be explained by the fact that parturients in our study received intermittent preventive treatment with Sulfadoxine/Pyrimethamine. Moreover, this prevalence is higher than the previous recorded in a study in Ghana [15] which value was.
The risk of the malaria infection was higher in pregnant women aged between 18 and 25 years. This is confirmed by Bianor [12] who found that the age was also identified as a risk factor for placental infection,
In addition, women unemployed and who lived around the city of Ouagadougou, performing their prenatal consultation in a health and social promotion centre and by midwife. Therefore, the young age, precarious living condition and lack of financial support would be constituting a risk factors increasing malaria infection.
The prevalence of placental malarial was found higher in paucigestates, and who started their intermittent preventive treatment in the second trimester of their pregnancy. Probably due to the late start of the intermittent preventive treatment with Sulfadoxine/ Pyriméthamine different from World Health Organization’s recommendation of the start of the intermittent preventive treatment (IPT) at the end of the 28 weeks of pregnancy.
Indeed, malaria prevalence is higher in the first and second trimesters of pregnancy and decreases in third trimester to reach the rate before childbirth. This would explain the high placental malaria infection prevalence in pregnant women starting their intermittent preventive treatment in the second trimester. Essiben et al. reported the same results in Cameroun.
Sulfadoxine/Pyrimethamine administration was not supervised and more than 50% of the women slept regularly under untreated mosquito net [16].
Placenta malaria prevalence was higher in pregnant women who were not talking intermittent preventive treatment unattended by a health professional and those who had no side effects after taking intermittent preventive treatment. The difference was not statically significant (P = 0,2198). Mosquito net impregnated with repellents reduces noctural mosquito bites, thus limiting Plasmodium infestation. According to WHO, women should be encouraged to use insecticide-treatment mosquito nets throughout their pregnancy because Sulfadoxine/Pyrimethamine intermittent preventive treatment would not replace LLINs.
The management strategies adopted for malaria preventive in pregnancy are the use of the Impregnated Long-Action Mosquito Net (LLIN), Sulfadoxine/Pyrimethamine intermittent preventive treatment (IPTp-SP) and adequate cases management thanks to rapid malaria treatment in pregnant women. The value of this work lies in the identification of factors that may have an influence on placental malaria infection.