Malaria Burden and its Possible Risk Factors Among Pregnant Women Attending Antenatal Care at Iten County Referral Hospital, Elgeiyo-Marakwet County, Kenya

Background Malaria in pregnancy is one of the leading causes of maternal and child morbidity and mortality worldwide, mainly in high endemic areas and has remained a serious public health concern with substantial risks for the pregnant woman, her fetus, and the newborn child. Its morbidity rate is higher in antenatal mothers and about 5 % of the world�s population is infected with malaria of which 1 % are antenatal mothers (WHO, 2018). The diagnosis of malaria in a pregnant mother is often times difficult and this is due to its non-specific symptoms which resemble any other viral infection. The aim of this study was to determine the prevalence and possible risk factors for malaria in pregnant women attending antenatal clinic at Iten County Referral Hospital in Elgeiyo Marakwet County. Methods A cross sectional facility based study was conducted from the month of June to August 2018 at Iten Referral Hospital. A total of 262 pregnant women were selected. A structured questionnaire was used to collect data on socio-demographic characteristics and possible risk factors. Pregnant women attending antenatal clinic (ANC) were included in the study after signing informed consent. For each participant, the social-demographic profile, malaria and obstetric histories were investigated through a questionnaire. Peripheral blood was collected and thick and thin blood smears were prepared to check Plasmodium falciparum parasitaemia. Hemoglobin concentration was measured. The associations between age, parity, gestational age, schooling, number of ANC visits, use of IPTp-SP, use of insecticide-treated nets (ITN) and anemia with the occurrence of P. falciparum malaria infection during pregnancy were analyzed through logistic regression. Results During the period of study, 59 (22.5 %) out of 262 pregnant women were infected with P. falciparum. The hemoglobin concentration mean was 10.5 � 1.7/dL and was significantly lower in pregnant women with malaria infection (9.8 g/dL �1.6) than in those who had no malaria infection (10.6 g/dL �1.7) (P less than 0.001). Multivariate analysis indicated that, education (AOR 1.9, 95 % CI = [1.2-3.2]), parity [primigravidae (AOR 5.0, 95 % CI = [2.5-9.8]) and secundigravidae (AOR 2.1, 95 % CI = [1.2-3.8])], and anaemia (AOR 2.1, 95 % CI = [1.3-3.5]) were significantly associated with P. falciparum malaria infection. The use of IPTp-SP was not associated with P. falciparum malaria infection. Conclusions P. falciparum malaria infection is common in pregnant women attending antenatal clinic and anaemia is an important complication. The results show that the use of IPTp-SP does not reduce the risk of malaria incidence during pregnancy. Recommendations: This study recommends advocating for support community participation, collaboration and integration in malaria control programmes on antenatal mothers. Educating antenatal mothers on good housing and the importance of using conventional methods for control of malaria is important. More studies on factors contributing to prevalence of malaria of antenatal mothers should be done.