Abstract
AimIn 2005, the Ghana Health Service mandated malaria and helminths chemoprophylaxis during antenatal care visits. The aim of this study was to investigate the prevalence of malaria and helminth infections and their relationship with adverse birth outcomes (low birth weight, stillbirth, and preterm) following the implementation of these treatments.Study DesignA quantitative cross-sectional study.MethodThe study was conducted on 630 women presenting for delivery in the Komfo Anokye Teaching Hospital and the Manhyia District Hospital from July to November 2011. Socio-demographic information and medical and obstetric history were collected. Laboratory analyses for the presence of malaria and helminths were performed. Association of malaria and helminths with birth outcomes was assessed using logistic regression to obtain odds ratios (ORs) and 95% confidence intervals.ResultsThe prevalence of malaria, helminths and adverse birth outcomes was 9.0%, 5.0% and 22.2%, respectively. Compared with women who received malaria prophylaxis, women without malaria prophylaxis were two times more likely to have malaria infection (aOR = 2.1; 95% CI = 1.06-4.17). Women who were not screened for helminths were twice as likely to be infected with helminths (aOR = 2.4; 95% CI = 1.15-5.12) than women who were screened for helminths. For women infected with hookworm or Schistosoma mansoni, the odds of having an adverse birth outcome (aOR = 3.9; 95% CI = 1.09-14.20) and stillbirth (aOR = 7.7; 95% CI = 1.21-36.38) were greater than for women who were not infected.ConclusionThe prevalence of malaria, helminths and adverse birth outcomes was lower than previously reported 9.0% vs. 36.3, 5.0% vs. 25.7 and 22.2% vs. 44.6, respectively. Helminth but not malaria infection was found to be significantly associated with adverse birth outcomes.
Highlights
Malaria and helminths are endemic in most sub-Saharan African countries
Compared with women who received malaria prophylaxis, women without malaria prophylaxis were two times more likely to have malaria infection
Women who were not screened for helminths were twice as likely to be infected with helminths than women who were screened for helminths
Summary
Malaria and helminths are endemic in most sub-Saharan African countries. A study in Nigeria demonstrated that over 45% of Plasmodium infected near-term mothers had intestinal helminths [1]. These infections have been associated with low haemoglobin (Hb) levels and iron/folate deficiency anemia especially in primigravid women [1]. Fifty percent of pregnant women in developing countries are often at a high risk of experiencing adverse birth outcomes due to iron/folate deficiency [1,2]. Moderate to severe anemia is associated with an increased risk of low birth weight and preterm delivery [4]
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