Geohelminthiasis and malaria are global pandemics closely linked to high morbidityrnand mortality in Sub Saharan Africa. In Kenya geohelminthiasis and malaria arernpublic health problems especially in reproductive health. Despite theirr enormousrneffects on maternal health and birth outcomes information is scarce on the currentrnstatus of these infections to guide an intervention in the study area.
Thisrnstudy was conducted to determine the effects of geohelminths and malaria parasitesrnco-infection on maternal health and birth outcomes in Bungoma County.
Arnlongitudinal hospital based study was carried out from March 2016 to January 2017.rnSeven hundred and fifty expectant mothers aged between 18 to 45 years attendingrnantenatal clinic at the Bungoma County Referral hospital were enrolled in the studyrnand followed up to the time of delivery after obtaining ethical clearance. Prevalencernand intensity of specific geohelminths infection was determined by stool microscopyrnand Kato-Katz Technique. Malaria positivity prevalence and intensity wererndetermined by microscopic examination of Giemsa stained blood smearsrnHaemoglobin levels and eosinophil cell count was done using the Coulter CounterrnMachine. Peripheral Blood Films for red cell morphology were prepared and stainedrnusing Leshman stain then examined microscopically. The fitness of the neonates wasrnevaluated based on the Apgar scale. Socio economic risk factors were determinedrnusing a pre-structured and tested questionnaire. Data was analysed using STATArnversion 12. Point estimation of prevalence and intensity of geohelminths and malariarnparasites were calculated based on the stool and blood sample results. Thernrelationship of geohelminths and malaria co-infection and different explanatoryrnvariables was done using chi-squire Xrn2rn test and correlation co efficient. To identifyrnthe risk factors for geohelminthiasis and malaria mixed effects of logistic regressionrnmodels were fitted in bivariate analysis. Multivariate logistic regressions werernemployed for those variables that had significant association with disease outcome torndetermine the main socio economic risk factors of infection. P-value 0.05 wasrnconsidered significant. Odds ratios OR with a 95 confidence interval wasrncomputed to compare the strength of association between explanatory and outcomernvariables.
The results showed that the prevalence of geohelminths malaria parasitesrnand co infection was 24.7 21.6 and 6.8 respectively. Pregnant women withrngeohelminthiasis and malaria co infection were four times more likely to havernanaemia P-value 0.001 OR 4.137 CI2.088-8.195 compared to those infected withrngeohelminths or malaria parasites alone P-value 0.001 OR 0.505 CI 0.360-0.709rnand P-value 0.001 OR 0.274 CI 0.187-0.402 respectively. The odds of having lowrnbirth weight P-value 0.001 OR 0.186 CI 0.094-0.369 Preterm deliveries P-valuern0.006 OR 6.896 CI 1.755-27.101 still birth P-value 0.048 OR 3.701 CI 1.008-rn13.579 were greater in co infected women than in those not infected. Risk factorsrnfor co-infection included unemployment P-value 0.002 OR 9.588 CI 2.281-40.304rnrural residence P-value 0.752 OR 1.118 CI 0.559-2.235. Expectant mothers in theirrnsecond trimester of pregnancy were three times at risk of co-infection OR 2.961 CIrn0.892-10.060 compared to their counterparts in their first and third trimester ofrnpregnancy.
The study findings revealed that both geohelminths and malaria parasites arernprevalent in expectant mothers of Bungoma County.rnGeohelminths and malaria parasites co-infection were associated with low maternalrnhaemoglobin level and consequently increases the risk for anaemia in expectantrnwomen. Anaemic pregnant women co-infected with geohelminthiasis and malariarnhad microcytosis and hypochromasia indicating iron deficiency anaemia.rnGeohelminths and malaria parasites co-infection in this study were associated withrnstill birth and Preterm deliveries. On APGAR scale co-infection betweenrngeohelminths and malaria parasites was associated with low chances of neonatalrnsurvival at birth.rnRisk factors associated with geohelminths and malaria parasite co-infection amongrnpregnant women in Bungoma County were unemployment low income secondrntrimester of pregnancy age group between 18-27 rural residence staying in arnsemi-permanent house and primary level of education.
Publication Information
Focus County(s):
Bungoma County
Programme Area(s):
Infectious and Parasitic Diseases
Research Priority Area(s):
Disease Domain(s):
malaria in pregnancy
Document History:
Publication Date: 15.Nov.2018
Conference Title: