Malaria is an indirect cause of infant mortality, operating through infected placentas in utero leading to low-birth weight deliveries and thus increased risks of death in the neo-natal and post-neonatal periods. Poor pregnancy outcomes, because of malaria, decrease with increasing parity. Interventions aimed at reducing the risks of malaria in pregnancy have shown improvements in birth weight outcomes among primigravid women. These findings were generated under controlled trial conditions. However, LBW in primgravid vs multigravid women might serve as a useful routine malaria metric to explain trends in malaria transmission.
Question to be addressed
Review literature on LBW and malaria
Assemble parity specific monthly data on LBW (<2500gm) deliveries at KDH maternity from 2006 to 2010 from maternity ward registers and from 2011 to 2015 from KIPMAT data already held by the programme; data to include birthweight, mother’s parity, date of delivery, mothers age, history of IPTp if available, mothers residence (location/sublocation 2006-2010) and DSS EZ 2011-2015; infant outcome if recorded prior to discharge
Analysis of seasonal variation in “Brabin Index” (Brabin et al., 1999; Annals of Tropical Medicine & Parasitology, Vol.93, Supplement No.1, S43-S57); compare with plausibility framework of changing transmission intensity (Macharia et al., 2018; Malaria Journal, 17: 340) and malaria in pregnancy prevention timeline (milestone development and possible coverage data).
Skills to be acquired by intern
Use of routine health service data, record reviews, epidemiology, malaria and pregnancy
Prefered training background of required intern
Application deadline: 11 February 2019