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Intestinal helminth infections among pregnant Cameroonian women
Abstract
Objectives: To investigate the prevalence and intensity of intestinal helminth infections in pregnant Cameroonian women and assess their anaemic status.
Design: Longitudinal study.
Setting: Buea Integrated Health Centre, Muea Health Centre, Mutengene Integrated Health Centre and the University of Buea Life Sciences Laboratory.
Subjects: Two hundred and six pregnant women.
Interventions: Stool and blood samples were collected from 206 pregnant women during three consecutive visits of each participant to the clinic, and used for identification and quantification of eggs of soil-transmitted nematodes and determination of packed cell volume respectively. The pregnant women received mebendazole and iron tablets on the day of enrollment at the antenatal clinic to control helminth infections and
anaemia.
Main outcome measures: The impact of antenatal clinical visits on the prevalence of helminth infections and the anaemic status of the women during pregnancy were assessed.
Results: The results revealed that infection rate of intestinal nematodes was 47.10/0 during the first antenatal visit. This dropped to 27.2% during the second visit and 8.70/0 during the third visit. The prevalence was significantly higher in primigravidae than multigravidae during the first (P<0.001) and second (P<0.03) antenatal visits. More single women than married women were found infected with intestinal nematodes during the three visits, the difference being significant only during the first visit
(P<0.01). Most of the infected women were those who attended clinic at Muea, a semiurban community. At the first antenatal visit, multigravidae had a heavier load of all three nematode species than primigravidae while single women carried a heavier burden of A. lumbricoides and T. trichiura than married women. At the second visit, primigravidae and single women carried a heavier burden of Ascaris and hookworm than multigravidae and married women respectively. Overall, the intensity of helminth infection increased after the first visit while prevalence dropped, but both had dropped by the third visit. The Ascaris/Trichuris combination was the most prevalent in mixed species infections, while A. lumbricoides was the most prevalent in single species infection. The prevalence of anaemia (PCV<31%) was 53.4% on the first antenatal visit, 50.0% on the second and 28.2% on the third antenatal visit. Significantly more primigravidae than multigravidae were anaemic on the first and second visits (P<0.003
and P<0.001 respectively). More anaemic cases were recorded among women attending clinic in Mutengene than in Muea and Buea (P<0.05).
Conclusion: Prevalence of soil-transmitted helminth infections in pregnant Cameroonian women was 47.1 %, with single and mixed species infections present at 28.6% and 18.5% respectively. Primigravidae and single women were more vulnerable to helminth infections than multigravidae and married women. The results provide evidence in support of anthelmintic treatment in prenatal programmes.
Design: Longitudinal study.
Setting: Buea Integrated Health Centre, Muea Health Centre, Mutengene Integrated Health Centre and the University of Buea Life Sciences Laboratory.
Subjects: Two hundred and six pregnant women.
Interventions: Stool and blood samples were collected from 206 pregnant women during three consecutive visits of each participant to the clinic, and used for identification and quantification of eggs of soil-transmitted nematodes and determination of packed cell volume respectively. The pregnant women received mebendazole and iron tablets on the day of enrollment at the antenatal clinic to control helminth infections and
anaemia.
Main outcome measures: The impact of antenatal clinical visits on the prevalence of helminth infections and the anaemic status of the women during pregnancy were assessed.
Results: The results revealed that infection rate of intestinal nematodes was 47.10/0 during the first antenatal visit. This dropped to 27.2% during the second visit and 8.70/0 during the third visit. The prevalence was significantly higher in primigravidae than multigravidae during the first (P<0.001) and second (P<0.03) antenatal visits. More single women than married women were found infected with intestinal nematodes during the three visits, the difference being significant only during the first visit
(P<0.01). Most of the infected women were those who attended clinic at Muea, a semiurban community. At the first antenatal visit, multigravidae had a heavier load of all three nematode species than primigravidae while single women carried a heavier burden of A. lumbricoides and T. trichiura than married women. At the second visit, primigravidae and single women carried a heavier burden of Ascaris and hookworm than multigravidae and married women respectively. Overall, the intensity of helminth infection increased after the first visit while prevalence dropped, but both had dropped by the third visit. The Ascaris/Trichuris combination was the most prevalent in mixed species infections, while A. lumbricoides was the most prevalent in single species infection. The prevalence of anaemia (PCV<31%) was 53.4% on the first antenatal visit, 50.0% on the second and 28.2% on the third antenatal visit. Significantly more primigravidae than multigravidae were anaemic on the first and second visits (P<0.003
and P<0.001 respectively). More anaemic cases were recorded among women attending clinic in Mutengene than in Muea and Buea (P<0.05).
Conclusion: Prevalence of soil-transmitted helminth infections in pregnant Cameroonian women was 47.1 %, with single and mixed species infections present at 28.6% and 18.5% respectively. Primigravidae and single women were more vulnerable to helminth infections than multigravidae and married women. The results provide evidence in support of anthelmintic treatment in prenatal programmes.
