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
Authors: Ahadzi-Sogli Asiwome , Addai-Mensah Otchere , Abaka-Yawson Albert , Setroame Anita Mawuse , KWADZOKPUI PRECIOUS KWABLAH 
Published: February 2021

Abstract
Background: Anemia and malaria infection during pregnancy are major public health problems in tropical and subtropical regions throughout the world. This study therefore aimed to ascertain the prevalence and risk factors of malaria and anaemia as well as the impact of preventive methods among pregnant women at the Akatsi South District Hospital. Subjects and Methods: A hospital based cross-sectional study using simple random sampling technique was conducted among 200 pregnant women receiving antenatal care and laboratory services at the Akatsi District Hospital from May 2016 to July 2016. A semi-structured questionnaire was administered to obtain participant’s malaria preventive methods in addition to demographic and gestational details including age, level of education, occupation, gravidity, parity, and gestational period. Participant’s hemoglobin and malaria status was assessed using one milliliter (1 ml) whole blood collected into an Ethylenediamine tetraacetic acid (EDTA) tube using sterile syringe and needle. Ordinary one-way ANOVA was used to determine statistical variations among continuous variables whereas chi-square and Fisher’s exact test where appropriate were used to assess statistical associations between categorical variables. P-values of < 0.05 was considered significant. Results: Of the 200 participants, majority (52.0%) were aged 20-29 years. The preponderance (67.0%) had their basic education level, were married (76.0%), lived in the urban communities (58.5%) and worked in the formal sector (44.5%). Prevalence of anaemia, malaria and malaria/anaemia comorbidities was 65.5%, 11.0% and 10.5% respectively. Significantly (p<0.05) high likelihood of malaria infection in first [OR=28.1; 95% CI (1.6-497.5)] and second [OR=17.9; 95% CI (1.0-309.2)] trimester was observed. Not on Intermittent Preventive Therapy (IPT) [OR=14.9; 95% CI (4.2-52.6)] program and not sleeping under Insecticide Treated Net (ITN) [OR=14.0; 95% CI (4.9-40.2)] were significant contributors of malaria infection. Similarly, no IPT use and not sleeping under ITN were twice [OR=2.0; 95% CI (1.1-3.8)] and approximately four times [OR=3.6; 95% (1.0-12.8)] likely anaemia contributors. Meanwhile, with non-malaria pregnant women as yardstick, malaria positive pregnant women were 16.4 (95% CI; 2.2-124.5) times likely to suffer from anaemia. Conclusion: Prevalence of malaria and anaemia among pregnant women in the Akatsi South District is high. Intensified health education and interventions so as to ensure the safety of the Ghanaian pregnant women is advised.Plain English Summary Malaria and anaemia have remained a major public health problem in Ghana for decades despite the considerable health interventions by the Ghana government and relevant concerned institutions. This study therefore determined the prevalence of malaria and anaemia, its associated risk factors and the impact of preventive methods among pregnant women in the Akatsi South District of Ghana (ASD-G). A total of 200 pregnant women receiving antenatal care and laboratory services at the ASD-G were recruited. A fit-for-purpose questionnaire was used to capture the participant’s demographic, gestational and malaria prevention methodology details. Blood samples were collected from the pregnant women and their hemoglobin levels and malaria status determined. Majority of the 200 pregnant women (52.0%) studied were between 20-29 years, had their basic education (67.0%), were married (76.0%), lived in the urban communities (58.5%) and worked in the formal sector (44.5%). The proportion of pregnant women with anaemia, malaria and the combination of malaria/anaemia was 65.5%, 11.0% and 10.5% respectively. The likelihood of malaria infection during first (0-13 weeks) and second (14-26 weeks) trimester was very high. Pregnant women who were not on IPT program and do not sleep under ITN were highly at risk of malaria infection and anaemia. Meanwhile, women who had malaria were approximately sixteen times at risk of suffering from malaria. In conclusion, prevalence of malaria and anaemia among pregnant women in the Akatsi South District is high. Intensified health education and interventions so as to ensure the safety of the Ghanaian pregnant women is strongly advised.