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SEASONAL VARIATION IN THE RISK AND CAUSES OF MATERNAL DEATH IN THE GAMBIA: MALARIA APPEARS TO BE AN IMPORTANT FACTOR

An increase in maternal mortality risk during peak malaria transmission in endemic countries is thought to implicate malaria in maternal deaths. The purpose of this study was to evaluate changes in risk and causes of maternal death in relation to the malaria season at the main referral hospital in The Gambia. During the malaria season, there was a 168% increase in the maternal mortality ratio (MMR), a three-fold increase in the proportion of deaths due to anemia, and an eight-fold increase in the anemia MMR. Apart from a 5.4-fold increase in eclampsia, there was no significant change in the contribution of other causes of death. It is estimated that malaria may account for up to 93 maternal deaths per 100,000 live births.

Received January 7, 2004. Accepted for publication February 19, 2004.

Acknowledgment: I thank the Head of the Records Unit of Royal Victoria Teaching Hospital for facilitating access to some of the data presented. The American Society of Tropical Medicine and Hygiene provided assistance with publication expenses.

Author’s address: Samuel E. Anya, Reproductive Health Research Unit, Department of Obstetrics and Gynaecology, Clinical Sciences Division, Faculty of Medicine and Allied Health Sciences, University of The Gambia, PO Box 3530, Serrekunda, The Gambia, Telephone: 220-775-937, Fax: 220-395-064, E-mail: se_anya{at}yahoo.co.uk.

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