Effects of Gravidity and Trimester on Malaria-geo-helminth Co-infections and Syndemics among Pregnant Women Attending Antenatal Care at Nandi Hills Sub-County Hospital, Nandi County in Kenya

Abstract

Aim: To investigate the effects of gravidity (primigravidae and multigravidae) and trimester on the co-infection with P. falciparum and geo-helminth parasites in pregnancy. Study Design: The research was a cross sectional study of pregnant women attending antenatal care at Nandi Hills Sub County Hospital, Nandi County (Kenya) in the months of April to December 2015. Nandi Hills Sub-County lies within latitudes 0° and 0°34’ North and Longitudes 34°45’’ and 35°25’’ East. Methodology: Study population constituted consenting pregnant women attending antenatal care at Nandi Hills Sub County hospital in the year, 2015. The selection was an inclusive criteria and the respondents were stratified by gravidity and trimester. Pregnant women were selected by simple random Sampling to attain a sample size of 300. Each participant was provided with a labelled screw caped stool container and informed on how to collect about 5 grams of stool sample. Stool was processed immediately at the hospital using formal- ether concentration technique. Consenting participants donated capillary blood sample by a finger prick. Thick and thin blood smears were prepared and stained using Field Stains A and B. Haemoglobin concentration was determined by drawing blood into the cuvettes and tested using diaspect haemoglobin test machine. Data was processed using statistical package for social sciences (SPSS Version 16). Chi square analysis were used in analysis. Results: Difference in malaria and A. lumbricoides co-infection and malaria and hookworm co-infection in the two groups (primigravida and multigravida) was not significant (P=.09 and P=.10 respectively). Malaria parasites-A. lumbricoides and malaria parasites-hookworm co-infection were counter-syndemic and  syndemic respectively  by gravidity and trimester. Parasitic infections by gravidity and trimester did not significantly affect haemoglobin levels. Conclusion: Gravidity and trimester did not alter the association of malaria – geo-helminth co-infection.