Global Journal of Medical Research, E: Gynecology and Obstetrics, Volume 21 Issue 3

IV. D iscussion Malaria in pregnancy is a major public health problem in sub-Saharan Africa. It poses a risk to both the mother and the fetus because it has a compromising effect on immunity in the latter [18]. Despite the poor implementation of malaria prevention strategies, their use has a reasonable effect on malaria and pregnancy parameters. Thus, gestational malaria is still a threat in our country. This study revealed a good knowledge of pregnant women on the causes and complications of malaria and the benefit of using preventive means such as the impregnated mosquito net, however the rate of net use was low. The prevalence of gestational malaria has been reported throughout Africa and particularly in Cameroon [16,19]. The overall prevalence of gestational malaria is 48.5% in this study. This is higher compared to the 39.2% reported in the Mount Cameroon area. This may be due to poor compliance with malaria preventive methods; specifically the low use of the mosquito net which was 47.97% in the study conducted in Mount Cameroon [20]. This prevalence is very high compared to the 7.90% and 6.60% found among pregnant women living in rural [21] and urban [22] areas of Cameroon respectively. This result may be explained by the different study areas, the type of study or the use of Intermittent Preventive Treatment with Sulphadoxine- Pyrimethanin (IPT-SP). In rural areas, a prospective longitudinal study was conducted with a predominance of multiparous women in the study population. The prevalence of malaria is higher in younger pregnant women although this is not significant. This has been similarly proven by previous studies conducted in the Littoral [16] and in South West Cameroon [19]. This is because this group of pregnant women have not yet acquired specific pregnancy- related immunity that protects them from gestational malaria. This provides a better understanding of their susceptibility to Plasmodium falciparum. Consistent with previous studies, a poorly sanitized environment would influence the risk of malaria infection [19, 23]. These authors report that proximity to fields and/or puddles increased the occurrence of malaria in pregnant women living in such environments. Radio, television, and health centers were the main sources of information for the vast majority of participants in this study about malaria and its dangers. The majority of nets were obtained during prenatal visits. This finding is consistent with that conducted in Buea [24] where the primary source of nets for pregnant women had been ANC. The most recurrent shapes and colors were rectangular shapes and white colors, respectively. Occupation significantly influenced (P=0.04) net ownership in the study population. This result is in Level of education ≤Primaire 18 6,98 0,56 0,75 Secondaire 113 43,80 Universitaire 127 49,22 18 Year 2021 Global Journal of Medical Research Volume XXI Issue III Version I ( D ) E © 2021 Global Journals Gestational Malaria and Factors Influencing Mosquito Bed Net use among Pregnant Women in Biyem-Assi, Yaounde agreement with that of Dionne-Odom reported in Cameroon. In addition, the net use rate was 47.67%. This rate is high compared to the 16.9%, 26%, and 17% observed in Cameroon [25,26], Nigeria [27] and Sub- Saharan Africa [28], respectively. A plausible explanation for this high net use could be the free net distribution campaigns by Cameroon's Ministry of Public Health (MINSANTE). In addition, the messages regularly disseminated through the various media channels always by this ministry on the use of the impregnated net as an effective means of malaria control have largely reached the populations. This is why the majority of our participants had heard about the net on television and radio. However, this rate of net use is low compared to that obtained in Buea (69.7%). Government action in easy accessibility justifies this proportion [24]. The shape of the net significantly influenced Plasmodium infection. The rectangular shape was the most used by participants in this study (268) for a malaria prevalence of 98.54% compared to 1.46% of infected participants using a conical shape net. This is because it is more spacious and fits the bed better. However, some participants preferred the conical shape because it was easier to install. Given the high prevalence of malaria, net use is insufficient to significantly reduce malaria in this study population. Cultural beliefs or prejudices are often cited as potential barriers to the adoption of innovative health behaviors and attitudes in Africa [29].. However, the results obtained in Cameroon indicate that, contrary to this idea, cultural beliefs are not the real explanatory factors for non-use of LLINs. This result is in agreement with those obtained in Niger [30]. However, education level is associated with net use. Women with at least secondary education had a high rate of net use. This result is due to the fact that those who have attained at least secondary school level are better able to read and understand messages on leaflets, radio, television. Thus, education remains an effective platform for influencing the behavior of pregnant women to reduce malaria prevalence. In addition, net use by participants was significantly reduced by personal reasons such as heat, choking, burning, itching, and laziness to use the net. These findings corroborate those of previous studies conducted in North Cameroon [31] and Ghana [32],