Effect of Malaria and Geohelminth Infection on Birth Outcomes in Kumasi, Ghana

Abstract

Aim In 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 Design A quantitative cross-sectional study. Method The 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. Results The 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. Conclusion The 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.

Malaria and Geohelminthiasis Coinfections in Expectant Women: Effect on Maternal Health and Birth Outcomes in a Malaria Endemic Region in Kenya

“…Compared to those infected with either geohelminths or malaria parasites, expectant mothers coinfected with geohelminths and malaria parasites were twice likely to give birth to low birth weight babies, 3.7 times likely to have still births, 6.8 times likely to have preterm deliveries, and 5 times likely to have newborn babies with low chances of survival. These findings are comparable to a related study where coinfected expectant women with malaria parasites and geohelminths were 3.0-fold and 2.6-fold at risk of low birth weight and preterm deliveries, respectively, compared with uninfected women [21]. The possible explanation is that adult intestinal worms compete with the host for food and interfere with the absorptive surface.…”

The Effectiveness of the Revised Intermittent Preventive Treatment with Sulphadoxine Pyrimethamine (IPTp-SP) in the Prevention of Malaria among Pregnant Women in Northern Ghana

“…The authors reported 13% depreciation of the national usage of IPT services after policy change [ 23 ]. Moreover, a 2014 study by Asundep et al reported that taking a single IPTp-SP dose protected pregnant women better than multiple dosing in Kumasi, Ghana [ 24 ]. In a study conducted in Navorongo of Northern Ghana, the authors reported that higher SP doses were not able to protect pregnant women against episodes of malaria [ 25 ].…”

Characteristics of asymptomatic Plasmodium spp. parasitaemia in Kwahu-Mpraeso, a malaria endemic mountainous district in Ghana, West Africa

“…It seems that a blanket approach of interventions by the Ministry of Health and the Ghana Malaria Control Programme, such as roll-out of LLIN, indoor residual spraying (IRS), change of first-line treatment to artemisinin-based combination therapy (ACT), shift from presumptive treatment to diagnostic + treatment and availability of WHO pre-qualified malaria rapid diagnostic test kits (RDT), has worked in Ghana to reduce malaria cases and deaths [ 4 ]. Currently, studies are focusing on elements that are essential in formulating tailor-made interventions for the different populations, such as parasite presence in humans and resistance to drugs [ 6 – 8 ], resistance of Anopheles vectors to insecticides [ 9 – 13 ], knowledge and health-seeking behaviour of the population affected [ 14 – 16 ], and the burden that malaria poses on specific risk groups like pregnant women [ 17 – 19 ]. However, a lot more needs to be done in these areas.…”