Plasmodium and intestinal parasite infections among pregnant women at first antenatal care contact in northwest Ethiopia: A study of prevalence and associated risk factors.

Background: Parasitic infections in pregnancy are detrimental for both the mother and her fetus. Malaria and intestinal parasite infections among pregnant women at their first antenatal care contact (ANC1) could offer information on their burden in pregnancy, community-level transmission, and intervention coverage, which is vital for targeted interventions. However, data is scarce in Ethiopia. This study investigated Plasmodium and intestinal parasite infections along with their associated risk factors among pregnant women at their ANC1 in northwest Ethiopia.

Materials and methods: A cross-sectional study was conducted among 538 pregnant women attending ANC1 at selected health facilities in Jawi District, northwest Ethiopia, between November 2021 and July 2022. Plasmodium infection was diagnosed by light microscopy, rapid diagnostic tests, and multiplex real-time PCR. Whereas, intestinal parasite infections were examined microscopically using stool wet mount and Kato-Katz techniques. Predictors of Plasmodium and intestinal parasite infections were evaluated using logistic regression analysis. A P-value of < 0.05 was used to indicate statistical significance.

Results: Overall, 43.1% (95% CI: 38.9-47.4%) of women were infected with intestinal parasites, 19.1% (95% CI: 15.9-22.7%) had Plasmodium infections, and 11.7% (95% CI: 9.1-14.7%) were co-infected with Plasmodium and intestinal parasites. About 84.9% of malaria cases were asymptomatic, and 39.8% were sub-microscopic infections. Younger maternal age (adjusted odds ratio (AOR) =  2.01, 95% confidence interval (CI): 1.1, 3.65), primigravidity (AOR =  2.37, 95% CI: 1.43, 3.92), lack of insecticide-treated bed net use (AOR =  2.58, 95% CI: 1.26, 5.3), undernutrition (AOR =  1.89, 95% CI: 1.13, 3.15), and intestinal helminth infection (AOR =  2.09, 95% CI: 1.31, 3.36) were significant predictors of Plasmodium infection. Whereas, rural residency (AOR =  1.62, 95% 1.03, 2.57), habit of soil eating (AOR =  2.06, 95% CI: 1.1, 3.9), consuming raw vegetables and fruits (AOR =  1.59, 95% CI: 1.09, 2.3), and lack of latrine use (AOR =  1.66, 95% CI: 1.06, 2.6) were significantly associated with intestinal parasite infections in pregnancy.

Conclusion: High prevalences of Plasmodium and intestinal parasite infections were observed among pregnant women in northwest Ethiopia. These findings highlight the importance of strengthening prevention and control measures for parasitic infections and implementing malaria screening at ANC1, particularly for young and primigravid women.