Prevalence and predictors of asymptomatic malaria among pregnant women in merti woreda, arsi zone, oromia, Ethiopia

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.