[Malaria prevalence at delivery in four maternity hospitals of Kinshasa City, Democratic Republic of Congo]. / Prevalence du paludisme à l'accouchement dans quatre maternités de la ville de Kinshasa, République Démocratique du Congo.

ABSTRACT

In areas with stable transmission, malaria is an alarming threat both for mothers (anemia) and fetus (abortion, premature birth, a birth ponderal deficit, death in utero). Our study aims at estimating the malaria prevalence among parturients and their newborn babies in Kinshasa, Democratic Republic of Congo, in order to conduct the national programme of control. Between September and November 2004, 196 pregnant women aged of 14 to 45 years old (average 25.8 years) were recruited consecutively from four maternity hospitals in Kinshasa; those who received antimalarial drugs 2 weeks before delivery were not selected. The socio-demographic information and clinical symptoms/signs were obtained by questionnaire. Blood smears were performed on the mother's capillary blood, by placental apposition and with the newborn baby's blood. Smears were stained with Giemsa. 42 out of the 196 parturients (21%) were infected by Plasmodium falciparum. Parasites were found both in capillary blood and placenta of the 37 parturients; in 5 cases, only the placental appositions were positive. Prevalence was higher among primiparae (26.5%) than among multiparae (18.8%) (p = 0.20). 19.7% of the parturients who received an Intermittent Preventive Treatment (IPT) with sulfadoxine-pyrimethamin (SP) were positive. 13 out of the 196 newborn babies had a positive malaria smear. Malaria at delivery is thus a reality in Kinshasa, despite the use of SP as an IPT. The weak protection conferred on the IPT could be explained by the inefficacy of the SP a failing in prenatal record andlor by the low compliance of the mothers with this strategy This is the reason why we strongly recommend a large-scale evaluation of this strategy.