THE EFFECT OF MALARIA AND INTESTINAL HELMINTH COINFECTION ON BIRTH OUTCOMES IN GHANA by NELLY J. YATICH PAULINE JOLLY, CHAIR

Both malaria and intestinal helminths are endemic in Sub-Saharan Africa, and their coinfection occurs commonly. Few studies have assessed the occurrence of malaria and intestinal helminth coinfection in pregnancy and its risk factors. This study assessed the prevalence of coinfection in a sample of over 700 pregnant women in Ghana, and identified risk factors for coinfection. A cross-sectional study of women presenting for delivery in two hospitals in Kumasi, Ghana, was conducted during November-December 2006. Sociodemographic information, medical and obstetric histories and anthropometric measures were collected. Venous blood was drawn for determinations of Plasmodium falciparum infection and hemoglobin levels. Malaria Antigen Celisa was used to investigate P. falciparum antigen in the plasma of the study participants, while hemoglobin level was determined using the Sysmex M-2000 blood cell counter. The Kato-Katz and the Baermann techniques were used to assess the prevalence of intestinal helminthes eggs and larvae in stool sample. The prevalence of Plasmodium falciparum infection, intestinal helminth infection(s) and coinfection was 36.3%, 25.7% and 16.6%, respectively. Women with intestinal helminth infection(s) were 4.8 times more likely to have Plasmodium falciparum infection. Young age (<20 years), low income, being single and being primigravid were each independently associated with increased odds of coinfection. These associations were present when assessed separately for primiand multigravid women, but the strength of associations varied considerably for the two groups of women. Young age had the strongest association among both primi (OR= 5.2, CI: 2.2-14.6) and multigravid (OR= 3.2 CI: 1.5-7.5) women. This study illustrates relatively high prevalence rates of malaria, intestinal helminths and coinfection in pregnant women in Ghana.