Malaria and Anaemia: Prevalence, Risk Factors and Impact of Preventive Methods among Pregnant Women in the Akatsi South District, Ghana: A Hospital-Based Cross-Sectional Study.
This study entailed a hospital based cross-sectional study using simple random sampling technique among 200 pregnant women receiving antenatal care and laboratory services at the Akatsi South District Hospital, Ghana from May to July, 2016. Data collection A semi-structured questionnaire was administered to the pregnant women by the researchers. Data collected included sociodemographic characteristics of the respondents i.e., maternal age, level of education, occupation, location etc.; Obstetric details included gravidity, parity, gestational period in weeks; Malaria preventive methods i.e., IPTp-SP use, sleeping under LLIN and mosquito repellent use. Laboratory investigations Blood film for malaria parasites The blood film preparation and observation was done following standard procedures outlined by Monica Chesbrough (District Laboratory Practice in Tropical Countries. Second ed. New York: Cambridge University Press; 2009. 244-8 p.). Reading of the slides were carried out by two trained microscopists. Absence of malaria parasite after 200 high power fields were examined was considered negative for malaria. A discrepancy in the slide reading outcome between the two initial scientists was resolved by a third opinion from a senior microscopist. Hemoglobin estimation Participant’s haemoglobin concentration was determined using the fully automated Sysmex XS-800i hematology analyzer (https://www.sysmex-europe.com/n/products/products-detail/xs-800i.html; Europe) following standard quality-controlled procedures. Anaemia in pregnant women was defined as hemoglobin concentration less than 11.0 g/dL while hemoglobin concentrations greater than or equal to 11.0 g/dL was considered normal. Anemia was further subclassified as mild (hemoglobin :10-10.9 g/dL), moderate (hemoglobin: 7-9.9 g/dL) and severe anemia (hemoglobin <7 g/dL) . Brief Findings Prevalence of anaemia in pregnancy (AiP), malaria in pregnancy (MiP) and AiP/MiP comorbidity was 63.5% (95% CI:56.4-70.2), 11.0% (96% CI:7.0-16.2) and 10.5% (95% CI:6.6-15.6) respectively. Prevalence rates of AiP (66.7%) and MiP (18.5%) predominated among pregnant women aged < 20 years. High IPTp-SP (64.0%) and LLIN (90.0%) use was observed in this study. Only 42.0% used repellent. Not being on the IPTp-SP program independently posed a 10.44 times risk of malaria (95% CI:2.01-54.19; p=0.005) compared to pregnant women on the IPTp-SP program. Similarly, not sleeping under LLIN posed a 6.63 risk of malaria (95% CI:1.51-29.01; p=0.012) compared to pregnant women who slept under LLIN. Meanwhile, being positive for malaria posed a significantly 10.73 times risk (95% CI:1.35-85.06; p=0.025) of anemia compared to those negative for malaria whereas failure to adhere to IPTp-SP posed 6.24 times risk (95% CI:1.78-21.89; p=0.004) of anemia among the pregnant women studied. Data is an SPSS file and coded with appropriate labels. All reference variables are coded 0.