The burden of Intestinal helminthic infection and Anaemia among pregnant women in Kabwe, Zambia; a Cross-Sectional study

Background Zambia is a developing country where intestinal helminthic infections are a serious public health concern. In sub-Saharan Africa alone it is estimated that one-third of pregnant women are infected with soil-transmitted helminthes which can lead to anaemia in pregnancy. The burden of anaemia, associated with helminths, is an important contributor to maternal and fetal mortality. This study aimed to determine the prevalence of intestinal helminthic infection and anaemia among pregnant women attending Antenatal Care (ANC) in Kabwe, Zambia.

Methodology A health facility-based cross-sectional study was conducted among 442 pregnant women from November,2021, to February, 2022, in Kabwe, Zambia. Data were collected using pre-tested questionnaires from three health facilities. Blood and stool specimens were processed using standard operating procedures. Cleaned and coded data were entered and analyzed using SPSS version 28. Multivariate binary logistic regression analysis was used to determine the association of predictors and response variables at P <0.05. Adjusted odds ratio with 95% CI was used to show the strength of association between predictors and outcome variables.

Results A total of 442 pregnant women were enrolled in this study with a median age of 23 years (range 15–41 years). The total prevalence of intestinal helminths was 24.7% (75/442) with the predominance of Hookworm (13.3%) followed by Ascaris lumbricoides (2.3%). Eating raw vegetables (AOR= 19.67, 95% CI: 1.20 to 321.69), drinking water from the well (AOR=2.45, 95% CI: 1.17 to 5.17) and Walking barefoot (AOR=0.25, 95% CI: 0.10 to 0.60) were significant predictors of intestinal helminthic infection. The overall prevalence of anaemia was 64.9% (281/442).

Conclusion The prevalence of intestinal helminths and anaemia was significantly high in this study. Eating raw vegetables, walking barefoot and drinking water from the well were identified as significant contributors to intestinal helminthic infection and anaemia among pregnant women. Therefore, public health measures and intensive antenatal care services are vital to promoting safe pregnancy.

Author Summary Many pregnant women in underdeveloped nations suffer from intestinal helminthic infections and anaemia, which raises their risk of dying during pregnancy and giving birth to underweight babies, who are also more likely to die. Although it has long been known that human worm infection is one of the main causes of anaemia in underdeveloped areas, knowledge of the advantages of treating worm infection during pregnancy has lagged behind that of other primary causes of maternal anaemia. Low coverage of anthelmintic treatment in maternal health programmes in many countries including ours has been the result. After conducting the study Intestinal worms and anaemia were diagnosed in 24.7% and 64.9% of pregnant women in Central Zambia who provided stool and blood samples. In these women, intestinal worm infections caused a modest decrease in haemoglobin (Hb) levels. We observed that increasing worm infection intensity is associated with lower haemoglobin levels in pregnant women. We also estimate that between a quarter and a third of pregnant women in sub-Saharan Africa are infected with worms and at risk of preventable anaemia. Nonetheless, every intervention study that was found demonstrated the advantages of deworming for the health of the mother or child, and we contend that more should be done to ensure that pregnant women receive anthelmintic therapy.