Abstract:
Background: Asymptomatic malaria increases the risk of anemia, stillbirths, spontaneous abortion,
premature delivery and low birth weight in pregnant women. The asymptomatic malaria makes it difficult to
easily identify the cases for prompt intervention. It is also a major hurdle for malaria elimination, as infected
hosts serve as silent reservoirs for transmission of malaria. There are different data on prevalence of malaria
and risk factors at institutional level but there is scarce data on asymptomatic malaria among pregnant
women at community level in general and particularly in the current study area.
Objectives: The aim of this study was to determine the prevalence and predictors of asymptomatic malaria
among pregnant women in Merti Woreda.
Methods: A community based cross-sectional study was conducted in Merti Woreda among pregnant
women from March to September, 2018. Study Kebeles were selected using simple random sampling
techniques. 364 pregnant women fulfilling the study criteria residing in the study Kebeles were enrolled and
Data on socio- demographic characteristics and malaria prevention practices were obtained using a structured
questionnaire. About 2ml of peripheral venous blood was obtained from each subject for Rapid diagnostic
test (RDT) and microscopy to determine Plasmodium species, gametocyte carriage rate, parasite density and
anemia. Anemia status was assessed by packed cell volume (PCV) micro-centrifuge method and comparison
was made between women with and without parasitaemia.
Results: The prevalence of asymptomatic Plasmodium infection among pregnant women was 3.6% (13/364)
based on both RDT and microscopy. Plasmodium falciparum and P. vivax accounted for 46.2% and 53.8%
of the cases, respectively. Gametocyte carriage rate was 30.7% among Plasmodium infected individuals. The
sexual and asexual parasite density ranged from 160 to 600 and 320 to 2200 parasites /ul, respectively.
Multivariate analysis showed that previously infection by Plasmodium (AOR= 5.42; 95% CI: 1.19-29.03, p =
0.047), Lack of ITN use (AOR=6.52; 95% CI:1.17-36.44, p = 0.032) and living close to stagnant water
(AOR= 4.18; 95% CI (1.12-17.36, p = 0.049) were significantly associated with asymptomatic malaria in the
study area. The overall prevalence of anemia was 102(28.0%) and it was significantly higher among
Plasmodium infected than non-infected pregnant women (2 = 27.62, p = <0.001).
Conclusion: Treatment of asymptomatic carriers is very important and persistent malaria prevention and
control strategies should be enhanced to achieve the elimination program in malaria endemic areas.
