Malaria and Intestinal Helminths Coinfections and Anemia Severity among Pregnant Women Attending Antenatal Clinic in Bungoma County, Kenya
Omanyo, Peter Wanyama
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Malaria and intestinal helminths infections are the most prevalent parasitic infections in developing countries, especially in Sub-Saharan Africa (SSA) affecting children under five years and pregnant women. These infections during pregnancy may lead to anemia which may often cause maternal and perinatal complications. The coinfections of malaria and intestinal helminths may cause considerable health effects leading to more severe clinical symptoms and pathology than in mono-infection situations. Kanduyi Sub-County in Bungoma County Kenya is the malaria-endemic zone where these parasites are also prevalent. A hospital-based descriptive cross-sectional study targeting the pregnant women attending antenatal clinic at government health facilities in Kanduyi Sub-County was conducted between September and November 2019. This study was aimed at determining the prevalence of anemia, malaria, and intestinal helminths coinfections and factors associated with the severity of anemia among pregnant women. Data was collected using both quantitative methods. A multi-stage sampling approach was used to get a quantitative sample. Data were analyzed using SPSS version 22.0 and descriptive data were presented using tables and bar graphs. Chi-square statistics were used to test the association between the variables. Logistic regression was used to determine the association between malaria and intestinal helminths coinfections and anemia severity. The prevalence of anemia was 56.3% while malaria, intestinal helminths, and coinfection were 35.5%, 23.6%, and 9.9% respectively. Age (p=0.012), marital status (p=0.014), use of insect treated mosquito nets or repellents (p=0.033) and malaria chemoprophylaxis (p=0.0001) were significantly associated with malaria infection. Hand washing before meals (p=0.041) was significantly associated with intestinal helminths infection. Age (p=0.019), education level (p=0.017), hand washing before meals (p=0.031) and malaria chemoprophylaxis (p=0.0001) were significantly associated with coinfection. Malaria infection (p=0.015), intestinal helminths (p=0.039), and their coinfections (p=0.022) were significantly associated with anemia severity. In conclusion, the prevalence of anemia was high among pregnant women. The prevalence of malaria, intestinal helminths infection, and their coinfections was low. Malaria chemoprophylaxis, use of insect treated mosquito nets, and hand washing before meals was associated with malaria, intestinal helminth, and their coinfection. Malaria, intestinal helminths infection, and their coinfection was found to be associated with anemia severity. The study recommended that pregnant women should be advised on early initiation of antenatal clinic attendance, get iron supplements and dietary counseling to prevent anemia. Provision of malaria chemoprophylaxis and insect treated mosquito nets should be issued to all pregnant women to protect them from malaria infection. All pregnant women attending antenatal clinics should be screened for intestinal helminths infection through routine stool tests and anti-helminths therapy should be provided to prevent intestinal helminths infection. Offer health educate pregnant women on risk factors associated with malaria and intestinal helminth infection. Prompt treatment of pregnant women who have malaria and intestinal helminths infection.