Abstract:

Background: In areas where malaria and HV-1 infection are endemic, co-infections are common and one of the co-morbidity of the two diseases in anaemia, which is of a public health concern especially during pregnancy. However, despite these infections to be endemic in northwest Tanzania, very little is known about their prevalence and their associated risk factors among pregnant women attending rural antenatal clinics. Therefore, the objective of the present analytical cross-sectional survey was to determine the prevalence of P. falciparum malaria, HIV-1, anaemia and their associated risk factors among pregnant women in rural Sengerema district, northwest Tanzania.

Methods: The study was conducted among 390 pregnant women between July and August 2011. A finger prick blood sample was obtained and tested for HIV infections according to Tanzania HIV National guideline. Thick and thin blood smears were stained with Giemsa and examined microscopically for any malaria parasites stages. A pre-tested questionnaire was used to collect demographic and other information related to malaria, HIV-1 and anaemia.

Results: Of 390 pregnant women studied, 8.2% (32/390, 95%CI, 5.5 – 10.92) and 3.8% (15/390, 95%CI, 33.6-43.22) had P. falciparum malaria and HIV-1 infections respectively. The prevalence of anaemia (< 11g/dl) was 59.74% (233/390, 95%CI, 54.9-64.6). Majority of the primigravidae, 44.8% (39/87, 95%CI, 39.9-49.7) and multigravidae women, 44.2% (134/303, 95%CI, 38.6-49.8) had mild anaemia (Hb 10.0 – 10.9g/dl). Only 0.2% (1/390, 95%CI, 0-2.76) had co-infections of P.falciparum malaria, HIV-1 and mild anaemia. No significant association was observed between malaria and HIV-1 (OR=1.39, 95%CI, 0.47 – 4.19, p=0.79), HIV and anaemia (OR=0.76, 95%CI, 0.09 – 5.98, p=0.55), malaria and anaemia (OR=2.18, 096 – 5.00 p=0.06). Risk factors for malaria were primigravidae (AOR=2.79, 95%CI, 1.28-6.08) and non-use of ITNs (AOR= 3.58, 95%CI, 1.29-9.29). While for HIV-1 the risk factor was past history of sexual transmitted disease (AOR=4.23, 95%CI, 1.07-16.75, p<0.04). Anaemia (<11g/dl) was associated with 1st trimester (AOR=3.85, 95%CI, 1.14-13.08, p<0.03) and 2nd trimester (AOR=3.91, 95%CI, 1.13 – 13.47, p<0.03) respectively.

Conclusion: A proportion of pregnant women had P. falciparum malaria, HIV-1 and majority had mild anaemia. However, given the health impact of the diseases in pregnancy, antenatal interventions for malaria, HIV-1 and anaemia are needed for pregnant women in the study area. There is a need for enhanced effort in the prevention of mother to child transmission of HIV and for intervention of malaria and anemia during pregnancy. Antenatal clinics could serve as the pivotal entry point for simultaneous delivery of interventions of all the interventions.