Asymptomatic Malaria During Pregnancy: Prevalence, Influence on Anemia and Associated Factors in West Guji Zone, Ethiopia – A Community-Based Study

BACKGROUND: Pregnant women with asymptomatic malaria parasitemia are at increased risk of anaemia, stillbirth, miscarriage, and preterm delivery. The asymptomatic nature of the population makes diagnosis difficult, and there is generally a lack of urgency to address this specific outcome. OBJECTIVE: This study aimed to determine the prevalence of asymptomatic malaria and associated factors among pregnant women in West Guji Zone, Oromia, Ethiopia. METHODS: A community-based cross-sectional study was conducted among randomly selected 557 asymptomatic pregnant women in the West Guji Zone from February to March 2022. A standardized questionnaire was used to collect information on socio-demographic and obstetric characteristics. Approximately 2 milliliters of peripheral blood was collected for microscopy to identify species and parasite density. Epi-Data and SPSS were used for data entry and analysis respectively. Binary logistic regression was used to identify risk factors. RESULTS: The prevalence of malaria among asymptomatic pregnant women was 24.10% (95% CI: 20.55%-27.65%). The prevalence of Plasmodium vivax and falciparum prevalence was 73 (54.5%) and 61 (45.5%), respectively. Of the study subjects, 105 (78.4%) had mild parasitemia and 29 (21.6%) had moderate parasitemia. Pregnant women with Plasmodium infection were anaemic in two-thirds (66.5%) of cases. Living near standing water (AOR=2.6, 95% CI: 1.74–3.96), having a history of Plasmodium species infection (AOR=2.12, 95% CI: 1.36–3.31), not using indoor residual spraying (AOR=2.0, 95% CI: 1.32–3.14), and not using insecticide-treated bed nets (AOR=1.62, 95% CI: 1.02–2.55) were all factors that were significantly associated with asymptomatic infection. Pregnant women with Plasmodium infection had a significantly higher rate of anaemia than those who were not infected (OR = 6.31, p = 0.000). CONCLUSION: Pregnant women had a significant prevalence of asymptomatic Plasmodium infection. Regular screening, appropriate treatment for those who test positive, and health education for pregnant women should be provided by the West Guji Zone Health Bureau.