Intestinal helminth infection and anaemia during pregnancy: A community based study in Ghana

Abstract

Intestinal helminths are among the most common and widespread of human infections, contributing to poor nutritional status, anaemia and impaired growth. Anaemia and iron deficiency in pregnancy is a major public health problem in developing countries, but their causes are not always known. The objective of this study was to assess the prevalence and severity of anaemia and iron deficiency and their association with helminths, among pregnant women in the Ashanti region of Ghana. A cohort study was carried out in the Sekyere east district of the Ashanti region of Ghana. 108 pregnant women were followed until 5-10 weeks postpartum, during the period of December 2005 - November 2006. Haemoglobin and total serum iron concentrations were evaluated in venous blood samples and helminths infections were evaluated in stool samples in each trimester using standard methods. Of the 108 pregnant women, 54.9% were found to be anaemic. The highest prevalence of anaemia and low iron stores (57.4 and 32.4%, respectively) were found in the second trimester. Only 17.6% had evidence of helminths infection, with Necator americanus (hookworm) being the commonest (13.9%). There was a significant association between hookworm infection and low iron stores. The study concluded that hookworm infection is a strong predictor of iron status. These findings reinforce the need to provide anthelminthic therapy to infected women before conception as public health strategy in reducing the prevalence of hookworm infection in addition to providing nutritional and iron supplements to effectively control anaemia in pregnancy.