Abstract
BackgroundAlthough infectious diseases still account for a high burden of morbidity and mortality in sub-Saharan Africa, simultaneous investigations on multiple infections affecting maternal and child health are missing.MethodsWe conducted a cross-sectional, single-centre pilot study in a rural area of Ghana to assess the infectiological profile during pregnancy. Screening of 180 expectant mothers was done by vaginal swabs and serology to detect the most common pregnancy-relevant infections. They were also interviewed for potential risk factors, outcome of previous pregnancies, and socio-economic aspects.ResultsWe found a high prevalence of infections caused by hepatitis B virus (16.7% HBs antigen positive). In contrast, infections caused by hepatitis C virus (1.1% anti-HCV) and HIV (0.6%) were rare. Maternal malaria was frequent (10.6%), despite increasing acceptance of intermittent preventive treatment during pregnancy (IPTp). Group B streptococci were present in 10.6% of all pregnant women. Absence of antibodies against varicella zoster virus in 43.2%, Toxoplasma gondii in 26.8%, parvovirus B19 in 20.0%, and rubella virus in 15.7% makes a significant proportion of pregnant women susceptible for acquiring primary infections. Whereas all study participants had specific IgG antibodies against human cytomegalovirus, infections with Listeria, Brucella, or Neisseria gonorrhoeae as well as active syphilis were absent.ConclusionsOur pilot study in a rural community in Ghana indicates an urgent need for action in dealing at least with high-prevalent pregnancy-relevant infections, such as hepatitis B, malaria and those caused by group B streptococci. In addition, the resulting prevalence rates of various other infections may offer guidance for health officials to prioritize possible future intervention schemes.
Highlights
Infectious diseases still account for a high burden of morbidity and mortality in sub-Saharan Africa, simultaneous investigations on multiple infections affecting maternal and child health are missing
Plasmodium and Human immunodeficiency virus (HIV) infections are often in the focus of research [5]. Based on this limitation in knowledge, the aim of our pilot study was to determine the prevalence rates of pregnancy-relevant infections which might have an impact on newborn health
Hepatitis B played the most important role as pregnancy-relevant infection, we found regional differences in Hepatitis B surface antigen (HBsAg)-carrier rates; a possible explanation for the high prevalence rate in subgroup 1 (21.8%) as compared to subgroup 2 (11.5%) may be its more remote location with less access to the public transport system and lower risk of exposure
Summary
Infectious diseases still account for a high burden of morbidity and mortality in sub-Saharan Africa, simultaneous investigations on multiple infections affecting maternal and child health are missing. Between 1990 and 2015 the maternal mortality ratio in sub-Saharan Africa decreased from 987 maternal deaths per 100,000 live births to 546, but is still significantly higher than in high-income countries with only twelve deaths per 100,000 live births [1, 2]. The main medical causes for maternal death are hemorrhage, hypertensive disorders and infections which are accompanied by high mortality rates in low-income countries [3]. Based on this limitation in knowledge, the aim of our pilot study was to determine the prevalence rates of pregnancy-relevant infections which might have an impact on newborn health. We aimed to evaluate the influence of socio-economic factors, such as access to medical services, age, origin and education on the prevalence of certain infectious diseases.
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