Intestinal Amebiasis and associated risk factors among pregnant Women attending University of Maiduguri Teaching Hospital, Nigeria

Abstract

Background: Entameba histolytica (E. histolytica), the etiological agent of intestinal amebiasis poses significant community health concern especially in pregnant woman due to their physiological status. Pregnancy-induced immunodeficiency can lead to reduced IgA activities which makes pregnant women susceptible to penetration of intestinal mucosal linings and placental barrier especially by E. histolytica. Objective of study
This study aimed to determine the prevalence and associated risk factors of intestinal amebiasis among pregnant women with acute diarrhea (˂3 days post onset) attending University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Nigeria.
Materials and Methods: This hospital-based cross-sectional study was conducted among 200 randomly selected acute diarrheic pregnant women attending UMTH. Fresh fecal samples were collected and immediately analyzed microscopically for E. histolytica oocytes using iodine wet  preparation method. Structured questionnaires were used to assess sociodemographic variables and risk factors for amebiasis. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 22 (IBM, California Inc., USA).
Results: Out of the 200 fecal samples analyzed for E. histolytica, 10 (5%) were positive. Those infected by moderate E. histolytica cysts had the highest occurrence rate, 4 (40%) and least by those infected by many E. histolytica cysts, 1 (10%). E. histolytica infection was associated with rural residence (OR=6.86 [95% CI:1.42-33.2]), lower Socioeconomic status (OR=22.0 [95% CI: 4.69-103.1]) and primigravity (OR= 5.76 [95% CI:1.19-27.8]) (p˂0.05). Drinking water from borehole (OR=0.24 [95% CI: 0.06-0.95], p=0.043) and large household (OR=0.1 [95% CI: 0.02-0.41], p=0.001) were significant risk factors of intestinal amebiasis.
Conclusion: The results indicate that E. histolytica infection is one of the etiological agents of acute diarrhea in study participants. Its recommended that pregnant women should avoid risk factors for intestinal amebiasis identified in this study.

Keywords: Immunosuppression, Amebiasis, Risk factors, Diarrhea.