Effects of intestinal parasite infection on hematological profiles of pregnant women attending antenatal care at Debre Markos Referral Hospital, Northwest Ethiopia: Institution based prospective cohort study

Abstract

Background Intestinal parasitosis is a common disease that causes misery and disability in poor populations. The number of individuals affected is staggering. From two billion peoples who harbor parasites worldwide, 300 million suffer severe morbidity and more than 25% of pregnant women are infected with hookworm, which causes intestinal bleeding and blood loss, and has been most commonly associated with anemia. Intestinal parasite infection during pregnancy has been associated with iron deficiency, maternal anemia, and impaired nutritional status, as well as decreased infant birth weight. Objective This study aimed to assess the effects of intestinal parasite infection on hematological profiles of pregnant women attending antenatal care in Debre Markos Referral Hospital from December 2017 to February 2019. Method A prospective cohort study design was conducted among 94 intestinal parasite-infected pregnant women as an exposed group and 187 pregnant women free from intestinal parasite were used as a control group. The effect of intestinal parasites on hematological profiles of pregnant women was assessed at Debre Markos Referral Hospital antenatal care ward. Socio-demographic data and nutrition status were assessed by using structured questionnaires and mid-upper arm circumference (MUAC), respectively. Two ml of venous blood and 2 gm of stool samples were collected to analyze the hematological profiles and detect intestinal parasites, respectively. Wet mount and formol-ether concentration (FEC) techniques were used to detect intestinal parasites. Hematological profile was analyzed using Mind ray BC-3000 plus instrument. Data were double entered into EpiData version 3.1 software and exported to SPSS version 24 software for analysis. Results were presented using tables and graphs. Associations of hemoglobin levels with intestinal parasitic infections were determined using binary logistic regression models. P≤0.05 was considered statistically significant. The mean hematological profile difference between parasite-infected and parasite-free pregnant women was computed using independent t-test. Results In the present study, the predominant parasites identified were Entamoeba histolytica, hookworm, Giardia lamblia, Schistosoma mansoni, and Ascaris lumbricoides. About 8.2% of intestinal parasite-infected pregnant women had mild anemia while 4% had moderate anemia. Only 1.2% of intestinal parasite-free pregnant women developed moderate anemia. The mean HGB, HCT, MCV, MCH, and MCHC values of intestinal parasite-infected pregnant women were 12.8g/dl, 38.2%, 94.7fl, 33.1pg and 34.7g/dl, respectively. But the mean HGB, HCT, MCV, MCH and MCHC values of pregnant women who were free from intestinal parasites were 14.4 g/dl, 39.8%, 94.9fl, 33.9pg and 35.5g/dl, respectively. Anemia was strongly associated with hookworm (AOR = 21.29, 95%CI: 8.28–54.75, P<0.001), S.mansoni (AOR = 63.73, 95% CI: 19.15–212, P<0.001) and A.lumbricoide (AOR = 14.12, 95% CI 3.28–60.65, P<0.001). Conclusion Intestinal parasitic infection in pregnant women caused adverse impact on hematological profiles and was an independent predictor of anemia. Intestinal parasitic infection significantly decreased pregnant the level of HGB, HCT, MCV, MCH, and MCHC values. To minimize maternal anemia deworming could be good before pregnancy.

Intestinal parasitic infections in pregnant women in Sao Tome & Principe: are there adverse birth outcomes?

“…Although seldom found, it has been reported in some studies in LMICs. For instance, Rodríguez-Morales et al [11] reported that the most important parasite representing a twofold risk for anemia at pregnancy was A lumbricoides, similar to Demeke G et al in Ethiopia [45].…”

“…There are a few studies that link pregnant women with IPI to an increased risk of maternal complications and adverse perinatal outcomes such as anaemia, low birth weight, and perinatal mortality [11,[43][44][45].…”

Benefit of Iron Supplementation with Ferric Sodium EDTA (NaFe <sup>3+</sup>-EDTA) in the Treatment of Anemia during Pregnancy in Democratic Republic of Congo (FERARI Study)

“…In Sub-Saharan Africa, soil-transmitted helminths including hookworm, urogenital schistosomiasis, and other parasitic infections such as malaria contribute to the high anemia rates in women and young children [37]. Open Journal of Obstetrics and Gynecology Ferric Sodium EDTA is an iron chelate that has been used successfully as a dietary fortifier in several trials in the developing world [38] [39], as in this form, the iron is protected from inhibitors of iron absorption.…”

Prevalence of Urinary Tract Infection during Pregnancy at Tertiary Care Hospital: A Cross-Sectional Study

“…This risk increase even more during pregnancy due to polyuria, glycosuria, and pregnancy hormones. In almost 8 percent of all pregnant women, UTIs occur and 90 percent of the UTIs occur at 24 weeks of pregnancy 10 .…”