Abstract
BACKGROUND: Malaria is the disease caused by intracellular parasites known as Plasmodium species and is mainly transmitted by blood sucking female Anopheles mosquitoes. During pregnancy, malaria results in severe complications to the mother, the fetus and the newborn. Symptoms of malaria, such as fever, malaise, headache, nausea and vomiting, in pregnant women can be mistakenly attributed solely to pregnancy. In Ethiopia, the prevalence of malaria in asymptomatic pregnant women has been well documented. However, studies indicating the prevalence and clinical presentation of malaria in pregnant women are lacking. Therefore, there is little information on the prevalence of malaria and significantly associated signs and symptoms in pregnant women. The aim of this cross-sectional study was to determine the prevalence of malaria and identify clinical signs and symptoms associated with malaria which suggest presence of malaria in pregnant women at Hamusit Health Center, Northwest Ethiopia. METHODS: A health facility-based cross-sectional study was conducted on 231 malaria symptomatic pregnant women from April to June 2023. A convenience sampling technique was employed. The socio demographic and clinical data of the study participants was collected through face-to-face interview using questionnaire. Thick and thin blood films were prepared from capillary blood and stained with 10 % Giemsa. The stained blood smear was washed with clean water, air dried and examined under a light microscope. The Statistical Package for Social Sciences software version 20 (SPSS 20) was used to analyses data. Logistic regression was used to assess signs and symptoms associated with malaria. An adjusted odds ratio with a 95 % confidence interval was calculated, and a P value < 0.05 was considered statistically significant. RESULTS: The overall prevalence of malaria among symptomatic pregnant women in the study area was 22.9 % (53/231) (95 % CI: 17.3-29 %). The most prevalent species was P. falciparum, with a frequency of 14.3 % (33/231) (95 % CI: 10 %-18.6 %), followed by P. vivax, 5.2 % (12/231) (95 % CI: (2.6 %-8.2 %). The remaining 3.5 % (8/231) (95 % CI: 1.8 %-6.7 %) were mixed infections of P. falciparum & P. vivax. Primigravidae (62.3 %) and first trimester pregnancies (52.8 %) were more affected. Malaria signs and symptoms mainly, fever [(P = 0.002, AOR (95%CI); 5.1(1.84, 14.30)], joint pain [(P = 0.001, AOR (95%CI); 7.8(2.24, 27.32)], vomiting [(P = 0.007, AOR (95%CI); 2.9(1.34, 6.43)], malaise [(P = 0.005, AOR (95%CI); 3.6(1.48, 8.67)] and fatigue [(P = 0.0039, AOR (95%CI); 2.1(1.04, 4.37)], were significantly associated with malaria infection in pregnant women. CONCLUSIONS: Malaria positivity in pregnant women with fever, joint pain, vomiting, malaise and fatigue is considerably high in the study area. These signs and symptoms in pregnant women are strong indicators of malaria infection.