Malaria and soil transmitted helminth infection and associated factors among pregnant women attending public health facilities in Dilla town, South Ethiopia: cross sectional study design.

Abstract

Background: Malaria and soil transmitted helminth (STH) are co-endemic and major public health problems in Ethiopia including study area. Understanding the burden and co-occurrence of these infections is crucial for informing effective antenatal interventions. This study aimed to assess the prevalence of malaria, STH infections, and malaria-STH co-infection, as well as identify associated risk factors among pregnant women attending antenatal care services in public health facilities in Dilla town, Gedeo Zone, Southern Ethiopia.

Methods: A facility-based cross-sectional study was conducted using a systematic random sampling of 331 pregnant women attending antenatal care at public health facilities in Dilla town between April 1 and June 24, 2023. Data were collected through face-to-face interviews using structured questionnaires. Faecal specimens were examined using both the direct wet mount and formol-ether concentration techniques. Thick and thin blood films were analyzed using microscopy. The collected data were entered into Epi-Data version 4.6 and subsequently exported to SPSS version 25 for analysis. A logistic regression model was used to assess the association between independent variables and the outcome variable. Variables with p ≤ 0.25 in bivariate analysis were included in multivariable logistic regression; p < 0.05 was considered statistically significant.

Result: The overall prevalence of STH, malaria, and malaria-STH co-infection was 60/331 (18.1%) [95% CI: 13.9-22.3], 29/331 (8.8%) [95% CI: 5.7-12.1], and 19/331 (5.7%) [95% CI: 3.3-8.5] respectively. Ascaris lumbricoides (45/331, 13.6%) was the predominant STH, followed by hookworms (8/331, 2.4%). Plasmodium vivax and Plasmodium falciparum proportions were (16/331, 4.8%) and (13/331, 4.0%), respectively. Study participants who resided in rural areas, lived near stagnant water, and did not use insecticide-treated nets (ITNs) had 2.66, 3.09, and 3.67 times the odds of being infected with malaria, respectively. Study participants who resided in rural areas, did not practice handwashing with soap and water before meals, did not wash their hands after using the toilet, and ate raw vegetables had 2.22, 3.93, 3.23, and 2.23-times odds of being infected with STHs, respectively. Additionally, living near stagnant water, not practicing handwashing with soap and water before meals, and the habit of eating soil were associated with 3.76, 3.82, and 9.45-times odds of acquiring malaria-STH co-infection, respectively.

Conclusion: This study highlights the prevalence of malaria, STH, and malaria-STH co-infections among pregnant women in Dilla town. In the study area, intestinal parasites, malaria, and their co-infection remain a health concern. To improve preventive and early intervention among pregnant women, prenatal care services should include routine screening and integrated diagnosis for STH infections and malaria, as well as focused health education.