Prevalence of Clinical Malaria and Relationship with Preventive Measures Among Pregnant Women Living in Libreville Gabon

Background: Pregnant women in malaria endemic areas are at high risk of P.falciparum infection and its complications. This study investigated for the first time in Libreville, the prevalence and factors associated with clinical malaria, among febrile pregnant women. Methods: We conducted a cross-sectional study from May to November 2019 at the obstetric ward of the Hopital Instruction des Armees Omar Bongo Ondimba (HIABO) of Libreville. Voluntary pregnant women who consulted for fever were approached. After obtaining their informed consent, the socio-demographic, obstetrical and clinical data, the history of fever treated with an antimalarial drug, the use of IPTp-SP and/or bednet were recorded. Peripheral blood was collected for P.falciparum detection by thick and thin blood smears. The associations between the studied variables and malaria were analyzed using a logistic regression analysis. Results: During the study period, a total of 179 pregnant women were included. Their median age was 29 [25-33] years and 56.4% (n=101) were under IPTp-SP. The prevalence of P.falciparum malaria was 31.8%. The bivariate analysis identified the following factors associated with P.falciparum clinical malaria: age <20 years (p=0.06), high education level (p<0.01), not working (p<0.01), being single (p<0.01), and fever history (p<0.01). The multivariate analysis confirmed that age below 20 years (p=0.01), higher education level (p<0.01), not working (p<0.01), absence of IPTp-SP use (p<0.01), fever history (p<0.01) remained independent risk factor for clinical malaria in pregnant women. Conclusion: The frequency of clinical malaria is high in this population of febrile pregnant women. It is associated with an infrequent use of preventive measures.