Prevalence, common helminthes, and factors associated with helminthes among pregnant women attending antenatal clinic at a tertiary hospital in Uganda

TL;DR

This study found that 27.5% of pregnant women in Uganda had helminth infections, with hookworm being the most common, and identified risk factors like poor sanitation and hygiene.

Contribution

The study provides new insights into helminth prevalence and risk factors among pregnant women in Uganda, emphasizing the need for improved public health interventions.

Findings

The overall prevalence of helminth infections among pregnant women was 27.54%.

Hookworm was the most common helminth infection, affecting 83.7% of infected women.

Key risk factors included rural residence, lack of toilet facilities, and poor hygiene practices.

Abstract

Helminthes in pregnant women is among the neglected tropical diseases. The Uganda ministry of health adopted the WHO recommendation of routine biannual deworming for girls and women of reproductive age and twice in pregnancy during the second and third trimesters. Despite the measures put in place, the prevalence of Helminthes among pregnant women in Uganda is still high which has implications for both the mother and to the developing fetus.

This was a hospital-based cross-sectional study carried out from January to April, 2024. Using Consecutive sampling method, 334 pregnant women were enrolled. Data was collected using pre-tested questionnaires, and a single stool specimen was collected from each woman and freshly voided stool specimens was directly examined microscopically. The data was analyzed using STATA Version 14.2. A bivariate and multivariate analysis were used to show the association between the dependent and independent variables, considering P < 0.05 as the level of significance and the 95% confidence interval.

The overall prevalence of Helminthes was 27.54%. Among all pregnant women who tested positive, common helminth was Hook worm (83.7%), followed by Ascaris lumbricoides (31.5%), and Trichuris triciuria (21.7%). Age, rural residence, having no toilet facility, no hand washing after toilet use, walking bare footed, no hand washing before meals were significantly associated with Helminthes with (aOR = 0.2; 95% CI = [0.085-0.588]; P = 0.002), (aOR = 9.0; 95% CI = [1.684-48.325]; P =0.010), (aOR = 3.6; 95% CI = [1.788-7.101]; P = 0.001), (aOR = 4.7; 95% CI = [1.359-16.419]; P = 0.015), (aOR = 1.9; 95% CI = [1.014-3.674]; P = 0.045), (aOR = 13.1; 95% CI = [5.146-33..578]; P = 0.001), respectively.

In this study, the overall prevalence of Helminthes was low in pregnancy compared to the global prevalence. The common helminthes among pregnant women was Hook worm infestation. The infection was independently associated with respect to Age, rural residence, having no toilet facility, no hand washing after toilet use, walking bare footed, no hand washing before meals.

Helminth infections are parasitic worm infections that are common in low- and middle-income countries, especially in areas with poor sanitation and hygiene practices. Pregnant women are particularly vulnerable to these infections, which can lead to significant health issues for both the mother and the unborn child, including anemia and complications during pregnancy. Despite the World Health Organization’s recommendation for routine deworming during pregnancy, many women in Uganda and similar settings continue to be affected by helminth infections due to gaps in public health interventions.

In this cross-sectional study, we investigated the prevalence, common helminths, and associated factors among 334 pregnant women attending antenatal care at a tertiary hospital in Uganda. We found that 27.5% of participants were infected, with hookworm being the most common parasite. Key risk factors included rural residence, lack of access to toilet facilities, walking barefoot, and poor hand hygiene before meals. These findings emphasize the urgent need for community-wide deworming campaigns, improved access to sanitation, and strengthened hygiene education as part of antenatal care services.

Our study sheds light on the current burden of helminth infections in pregnant women and highlights practical recommendations for public health interventions to improve maternal and neonatal health outcomes.

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