The Effect of Malaria and Intestinal Helminth Coinfection on Birth Outcomes in Kumasi, Ghana

Abstract

Abstract. This study was conducted to investigate the effect of Plasmodium falciparum and intestinal helminth coinfection on maternal anemia and birth outcomes. A cross-sectional study of 746 women who delivered in two hospitals in Kumasi was conducted. Data were collected using an investigator-administered questionnaire and from patients' medical records. Blood was collected for determination of P. falciparum and hemoglobin levels. Adverse pregnancy outcomes were high (44.6%). Coinfection (versus no infection) was associated with 3-fold increase in low birth weight. For women with anemia, coinfection was 2.6 times and 3.5 times as likely to result in preterm deliveries and small for gestational age infants. The odds of having anemia was increased almost 3-fold by coinfection. Coinfection (versus helminth only) resulted in increased risks of anemia, low birth weight, and small for gestational age infants. This study demonstrates that women with malaria and intestinal helminth coinfection are at particular risk of adverse birth outcomes.

Birthweight in Offspring of Mothers with High Prevalence of Helminth and Malaria Infection in Coastal Kenya

“…[13][14][15] These data are consistent with those of recent studies in sub-Saharan Africa. 5,6 Another important outcome to draw from this data is the high percentage of infants born with LBW and a low WZS.…”

“…And in those women with anemia, co-infection was associated with an increased risk of LBW, preterm delivery, and small size for gestational age, which was not completely explained by the presence of malaria infection. 13 Another study in Nigeria showed a high prevalence of malaria infected pregnant women who were co-infected with helminths (45%) and suggested a trend towards lower maternal hemoglobin levels in those co-infected. 14 Apart from maternal anemia and other measures of perinatal health such as birthweight, prematurity, and stillbirths, there are other potential morbidities from helminth infection and polyparasitism on fetuses that warrant attention.…”

“…11,12 Furthermore, co-infection with malaria and helminths has been found to be an important factor in adverse birth outcomes. 13,14 However, studies of helminth infections during pregnancy and of the benefits of treating pregnant women are still few in number and have shown mixed results. 6,15,16 The consensus is now shifting to giving pregnant women anti-helminth treatment because of apparent safety after years of inadvertent doses given to women unknowingly pregnant.…”

Iron Supplementation Alters Heme and Heme Oxygenase 1 (HO-1) Levels In Pregnant Women in Ghana

“…Previous studies have demonstrated that placental malaria at delivery was associated with an increased risk of LBW and PTD [29]. This led us to hypothesize that parasite derived factors and host factors such as heme and heme oxygenase-1 play a role in the pathogenesis of malaria.…”

Epidemiology of Hookworm Infection in Kintampo North Municipality, Ghana: Patterns of Malaria Coinfection, Anemia, and Albendazole Treatment Failure

“…51 By contrast, others have reported varying increases in the risk of anemia with malaria and helminth coinfection across various age groups. 46,[52][53][54][55][56] Given that there are more than 400 million cases of P. falciparum each year, 57 many occurring in areas endemic for helminths, a greater understanding of the interaction between these two highly prevalent and clinically important parasitic diseases could lead to the formulation of more effective control strategies for both.…”