Asymptomatic Malaria During Pregnancy: Prevalence, Influence on Anemia and Associated Factors in West Guji Zone, Ethiopia – A Community-Based Study

Abstract

Background

Pregnant women with asymptomatic malaria parasitemia are at increased risk of anaemia, stillbirth, miscarriage, and preterm delivery. The asymptomatic nature of the population makes diagnosis difficult, and there is generally a lack of urgency to address this specific outcome.

Objective

This study aimed to determine the prevalence of asymptomatic malaria and associated factors among pregnant women in West Guji Zone, Oromia, Ethiopia.

Methods

A community-based cross-sectional study was conducted among randomly selected 557 asymptomatic pregnant women in the West Guji Zone from February to March 2022. A standardized questionnaire was used to collect information on socio-demographic and obstetric characteristics. Approximately 2 milliliters of peripheral blood was collected for microscopy to identify species and parasite density. Epi-Data and SPSS were used for data entry and analysis respectively. Binary logistic regression was used to identify risk factors.

Results

The prevalence of malaria among asymptomatic pregnant women was 24.10% (95% CI: 20.55%-27.65%). The prevalence of Plasmodium vivax and falciparum prevalence was 73 (54.5%) and 61 (45.5%), respectively. Of the study subjects, 105 (78.4%) had mild parasitemia and 29 (21.6%) had moderate parasitemia. Pregnant women with Plasmodium infection were anaemic in two-thirds (66.5%) of cases. Living near standing water (AOR=2.6, 95% CI: 1.74–3.96), having a history of Plasmodium species infection (AOR=2.12, 95% CI: 1.36–3.31), not using indoor residual spraying (AOR=2.0, 95% CI: 1.32–3.14), and not using insecticide-treated bed nets (AOR=1.62, 95% CI: 1.02–2.55) were all factors that were significantly associated with asymptomatic infection. Pregnant women with Plasmodium infection had a significantly higher rate of anaemia than those who were not infected (OR = 6.31, p = 0.000).

Conclusion

Pregnant women had a significant prevalence of asymptomatic Plasmodium infection. Regular screening, appropriate treatment for those who test positive, and health education for pregnant women should be provided by the West Guji Zone Health Bureau.

Keywords:

• prevalence
• asymptomatic malaria
• plasmodium infection
• pregnant women
• anaemia
• Ethiopia

Abbreviation

BHU, Bule Hora University; ART, Artemisinin-based Combination Therapy; OR, Odd ratio; SSA, Sub-Sahara African; WHO: World Health Organization; ANC, Antenatal Care; EDTA, Ethylene Diamine Tetra Acetic Acid; RDT, Rapid Diagnostic Test; ITN, Insecticide Treated Nets; LBW, Low Birth Weight; IRS, indoor residual spray; API, asymptomatic plasmodium infection.

Data Sharing Statement

All necessary data sets on which the conclusion of this paper is based are included in the manuscript.

Ethical Approval

The study protocol was approved by the Ethical Review Board (IRB) of Bule Hora University. The study was conducted in accordance with Helsinki Declaration. All study participants gave written, informed consent. For those under the age of 18, their husbands gave written informed consent, and the participants gave their assent. Each study participant’s information was kept confidential and used only for research purposes. Lab test results were also kept confidential. The results of participants with parasitic infections were reported to the study participants. The pregnant women who tested positive for the Plasmodium parasite were referred to the ANCs in the surrounding health facilities for treatment and medical advice, and then followed up to ensure proper treatment.

Acknowledgment

First of all, we would like to thank Bule Hora University for funding this research. We would also like to thank the Municipality of Bule Hora for their assistance in collecting the sample. Finally, we would like to thank the participants for their willingness to participate in the study.

Author Contributions

All authors have made a substantial contribution to the work reported, be it in the conception, design, conduct, collection, analysis, and interpretation of data, or in all these areas; have been involved in drafting, revising, or critically reviewing the article; have given final approval for the version to be published; have agreed on the journal to which the article will be submitted; and agree to take responsibility for all aspects of the work.

Disclosure

The authors have no competing interests in this work and no competing interests in any activities related to this research. The funder was not involved in manuscript writing, editing, approval, or decision to publish.

Additional information

Funding

Funding has been received for this paper from the Bule Hora University (grant number 6223).