Association of Anaemia with Parasitic Infection in Pregnant Women Attending Antenatal Clinic at Koshi Zonal Hospital

Abstract

Intestinal parasitic infection (IPI), associated with anaemia is a major health problem during pregnancy in developing countries including Nepal. The present study was designed to find out the association between anaemia and parasitic infection during pregnancy. A total of 200 stool samples from pregnant women on their first consultation to antenatal service in Koshi Zonal Hospital were collected from April 2012 to August 2012. The stool samples were examined for intestinal parasites by direct smear technique, while haemoglobin level of pregnant women were collected from laboratory record of the hospital. Out of 110 anaemic pregnant women 40 (36.3%) had parasitic infection, while from 90 non-anaemic pregnant women; only 18 (20%) of them were infected with intestinal parasites. The association of anaemia with intestinal parasite was statistically significant (p<0.008). The prevalence of Hookworm (76.9%) was most prevalent infection followed by Ascaris lumbricoides (73.3%) in anaemic pregnant women. The Haemoglobin (Hb) levels of 51 pregnant women who were infected with single parasite were reported to be 10.4 ± 1.80 gm/dl (mild anaemia), whereas pregnant women having multiple infections recorded the lowest mean Hb levels of 9.81 ± 0.84 gm/dl (moderate anaemia). However, the overall prevalence of the parasitic infection among pregnant women was 58 (29%). Ascaris lumbricoides (32.3%) was the most predominant followed by Hookworm (26.1%), Giardia lamblia (21.5%), Entamoeba histolytica (10.7%), Trichuris trichiura (6.15%), Strongyloides stercoralis (1.5%) and Hymenolepis nana (1.5%). Also, an overall prevalence of single parasite was 51 (88%) and that of co- infection was 7 (12%), of which co-infection of Ascaris and Hookworm was most predominant 4 (57.1%) followed by Ascaris lumbricoides and Trichuris trichiura, Ascaris lumbricoides and H. nana, and Entamoeba histolytica and Giardia lamblia with 1 (14.3%) observed in each. The prevalence of Intestinal Parasite showed significant association with their residency area (p<0.009), habit of use of latrine (p=0.002) and source of water (p=0.009). The prevalence rate of IPI was increased as the family size of pregnant women increases and the literacy status decreases. An integrated programme for the control of this parasitic infection should be regarded as an issue of public health priority in order to reduce the degree of anaemia during pregnancy.