Prevalence of Soil Transmitted Helminthiasis and Malaria Coinfection and Associated Risk Factors among Pregnant Women in Gilgel Gibe dam Area, Southwest Ethiopia

Abstract

Introduction: Malaria and Soil Transmitted Helminthiasis (STH) are causes of significant morbidity, mortality, severe illness and poor economic development worldwide. These diseases are most of the time Co-endemic in Ethiopia with overlapping geographical distrubution. Objectives: The main objective of this study was to determine the prevalence of malaria - soil transmitted helminths co-infection and anaemia, as well as to assess associated risk factors for the co-infection and anaemia among pregnant women in Gilgel-Gibe dam area, southwestern Ethiopia. Materials and Methods: A cross-sectional community based study was conducted to assess malaria andsoil transmitted helminth co-infection in Gilgel Gibe area, southwestern Ethiopia. In this study 388 pregnant women were randomly selected from 6 rural and 6 urban kebeles found in three waredas around Gigel Gibe Dam area. Socio-demographic and socio-economic data were collected using semi-structured questionnaire. Stool samples were collected from all study participants and processed following the standard procedure of McMaster concentration technique. Thick and thin blood film were collected and examined microscopically following the methods described by Cheesbrough.Haematocrit value was determined using hematocrit centrifugation to determine the prevalence of anaemia. Results: In the current study, the prevalence of soil transmitted helminths and malaria was 159 (41%) and 45(11.6%), respectively and the prevalence of soil transmitted helminths /malaria co-infection was 30(7.7%). The prevalence of anaemia in this study was 209(53.9%). Parasitic infection and anaemia were more prevalent in the rural than urban setting (p<0.05) mainly because of the increased exposure for parasitic infections in the rural resedence. Pregnant women with soil transmitted helminth were 3 times more likely to have malaria than women without helminthic infection (OR=3.3, 95% CI:1.72-6.40, p<0.001). Hook worm was the most prevalent 114(29.4%) soil transmitted helminthiasis infection followed by A. lumbricoides 58(15%) and T. trichuira 13(3.4%). Hookworm parasitic load was positively correlated with malaria parasitic load (r = 0.299, p<0.001) while A. lumbricoides parasitic load was negatively correlated with malaria parasitic load (r= -0.095, p<0.001). There were a statistically significant association between soil transmitted helminthiasis and anemia (p<0.001). Pregnant women coinfected with malaria and soil transmitted helminthaisis were 6 times more likely to be anaemic compared to those women infected with soil transmitted helminthes only (OR=5.9, 95% CI: 1.69-20.41, p=0.001). Habit of eating soil (p=0.008), Presence of stagnant water near study participants’ house (p=0.012) and habit of using human feces as a fertilizer (p<0.001) were found to be risk factors for malaria and STH coinfection. Conclusion: Malaria, STH and malaria/STH co- infection were found to be serious health problems among pregnant women in the study area with higher prevalence in the rural resedents. Infection with STH was found to increase malaria prevalence and eventhough infection with A.lumbricoides were found to reduce the severity of malaria; infections with the rest STH were associated with increased parasitic load. Moreover, the severity of anaemia was more pronounced in pregnant women with malaria/STH coinfection. Hence, pregnant women should be diagnosed for STH as well as malaria during their visit for ANC for prompt treatment of malaria and STH infection and to control anaemia associated with STH/malaria co-infection in pregnant women.