Abstract

Asymptomatic malaria and anemia during pregnancy increase the risk of negative birth outcomes. This cross-sectional study investigated the prevalence and correlates of asymptomatic malaria and anemia during first antenatal care (ANC) visit among pregnant women in a rural district, Tanzania. HIV-uninfected pregnant women without symptoms of malaria (n = 819) attending their first ANC at Kibiti Health Centre were enrolled from February 2017 to February 2018. Asymptomatic malaria was detected by malaria rapid-diagnostic tests (mRDT) and real-time PCR. Hemoglobin concentration was determined by HemoCue Hemoglobin 201+. The study outcomes were the prevalence of asymptomatic malaria and anemia (Hemoglobin level <11 g/dL). The overall prevalence of asymptomatic malaria was 36.4% (95% CI: 33.1, 39.8). The monthly prevalence of asymptomatic malaria remained >25% throughout the year, and the highest prevalence (40%) was recorded during the rainy season. Asymptomatic malaria was significantly associated with primigravida, younger maternal age, and anemia. The prevalence of anemia was 68.5% (95% CI: 65.2, 71.6). Asymptomatic malaria, primigravida, younger maternal age and low Body Mass Index were significant predictors of low hemoglobin concentration. We report high prevalence of asymptomatic malaria and anemia among pregnant women on the first ANC visit. Screening of malaria and anemia during the first ANC visit is recommended for targeted interventions.

Highlights

  • Malaria and anaemia in pregnancy are significant maternal health problems causing an increased risk for maternal death, stillbirth, spontaneous abortion, and low birth weight [1,2]

  • The prevalence of asymptomatic malaria (36.4%) at first antenatal care (ANC) before initiating IPTp-SP found among pregnant women in the study area is higher than the prevalence of asymptomatic malaria at first ANC reported from Kenya (35%) [28], but lower than that reported in Uganda (50%) [29] and Malawi (54.2%) [30]

  • We report delayed presentation in seeking ANC, and a high prevalence of asymptomatic malaria and anemia among pregnant women at first ANC visit

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Summary

Introduction

Malaria and anaemia in pregnancy are significant maternal health problems causing an increased risk for maternal death, stillbirth, spontaneous abortion, and low birth weight [1,2]. Health Organization (WHO) recommends antenatal care (ANC) involving intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) and folic acid supplementation for prevention of malaria and anemia respectively in all pregnant women living in endemic countries. In most cases, pregnant women begin attending ANC after the first trimester has passed, and do not fully benefit from the service [3,4]. Evaluating the efficiency of existing interventions for prevention of malaria and anemia provides valuable information for better planning and implementation of public health programs. Res. Public Health 2020, 17, 3123; doi:10.3390/ijerph17093123 www.mdpi.com/journal/ijerph

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