Abstract:
Background: Pregnant women, after frequent infections with Plasmodium spp., may develop
immunity that can result in asymptomatic malaria. Though asymptomatic, the women harbor
parasites that can trigger deleterious effects in maternal and child health, and can reserve
gametocytes for perpetuation of transmission in an area. Therefore, this study aimed at
determining the prevalence of asymptomatic malaria and related risk factors among pregnant
women living in the malarious areas of Arba Minch Zuria District, Southern Ethiopia.
Method: A community based cross-sectional study comprising multistage sampling was
conducted from April to June 2013 on 341 pregnant women in the malarious areas of Arba
Minch Zuria District, Southern Ethiopia. Socio-demographic & economic data were collected
with questionnaire. Malaria parasites were detected by Giemsa-stained blood smear microscopy
and SD BIOLINE Malaria Ag Pf/Pv POCT test. Packed cell volume was determined by
microhematocrit centrifugation to define anemia. Data were analyzed by SPSS 16; integrating
both descriptive and inferential statistics with 95% confidence interval for odds ratio
calculation.
Results: Of the total 341 pregnant women participated in this study, 31 women (9.1%) by
microscopy with the mean parasite density of 3202.58/µl, and 33 women (9.7%) by the rapid Ag
test were positive for malaria. The species diagnosed by microscopy & rapid test, respectively,
were P.falciparum (38.71% & 39.4%), P.vivax (48.38% & 48.5%), and mixed Pf+Pv (12.9% &
12.1%). The sensitivity and specificity of the rapid test when compared to microscopy were
100% and 99.35%, respectively. Parasitemia was more likely to occur in primigravidae
[Adjusted odds ratio (AOR)= 84.40, 95% CI: 7.30-976.53, P<0.001], secondigravida
(AOR=16.34, 95% CI: 2.98-89.53, P=0.001), using insecticide treated net (ITN) sometimes
(AOR=10.22, 95% CI: 1.80–57.95, P=0.009), not using ITN at all (AOR=4.61, 95% CI: 1.48-
14.41, P=0.009), age group of 31-35 years (AOR=24.74, 95% CI: 2.31-265.42, P=0.008), and
age group of >35 years (AOR=69.26, 95% CI: 3.99-1200.86, P=0.00) compared to
multigravida, using ITN always & young age(<21 yrs), respectively. Of the total study subjects,
118 (34.6%) were anemic. Anemia was likely higher in Plasmodium infected women
(AOR=12.76, 95% CI: 2.40-67.73, P=0.003), using ITN sometimes (AOR=7.33, 95% CI:1.83-
29.42, P=0.005), not using ITN at all (AOR=2.06, 95%CI: 1.07-3.99, p-value=0.032) related to
malaria negatives & using ITN always, respectively. There was a significant correlation between
increasing malaria parasite load and decreasing hematocrit (r = −0.463, P = 0.009).
Conclusion. The prevalence of asymptomatic malaria in this study is moderate, however it has
shown significant association with anemia in pregnant women. Symptomless malaria may create
problems in Ethiopia where malaria control is essentially based on the treatment of symptomatic
patients & mosquito control. It is, therefore, critical to design strategies that assist to diagnose
pregnant women for asymptomatic malaria through the antenatal care(ANC) service package
