Malaria and anaemia among pregnant women at first antenatal clinic visit in Kisumu, western Kenya.
OBJECTIVE
To determine the prevalence of malaria and anaemia among urban and peri-urban women attending their first antenatal clinic (ANC) in an area of perennial malaria transmission.


METHODS
Between November 2003 and May 2004 we screened first ANC attenders for malaria and anaemia in a large urban hospital in Kisumu (western Kenya) and interviewed them to obtain demographic and medical information.


RESULTS
Among the 685 study participants, prevalence of malaria parasitaemia was 18.0%, prevalence of any anaemia (haemoglobin < 11 g/dl) was 69.1% and prevalence of moderate anaemia was (haemoglobin < 8 g/dl) 11.8%. Sixteen women were hospitalized during pregnancy, eight because of malaria. In multivariate analysis, young age, living in a house with mud walls, a visit to rural area, peri-urban residence, second trimester of pregnancy and Luo ethnicity were significant risk factors for malaria parasitaemia. Malaria was an important risk factor for any and moderate anaemia; use of an insecticide-treated net (ITN) was a protective factor for any anaemia. Married women with a higher level of education, better-quality housing and full-time employment were more likely to use an ITN.


CONCLUSIONS
Malaria and anaemia are established problems by the time of the first ANC visit. Mechanisms to deliver ITNs to women of child-bearing age before they become pregnant need to be explored. Early ANC visits are warranted in order for women to benefit from policies aimed at reducing the burden of malaria and anaemia.
Ouma
Peter
P
Centre for Vector Biology and Control Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.
van Eijk
Anna M
AM
Hamel
Mary J
MJ
Parise
Monica
M
Ayisi
John G
JG
Otieno
Kephas
K
Kager
Piet A
PA
Slutsker
Laurence
L
D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000175:diagnosis / Q000453:epidemiology*; D000962:Antimalarials / Q000627:therapeutic use; D001512:Bedding and Linens / Q000706:statistics & numerical data; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007306:Insecticides / Q000627:therapeutic use; D007630:Kenya / Q000453:epidemiology; D016014:Linear Models; D008288:Malaria / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D008427:Maternal Health Services; D011247:Pregnancy; D011295:Prenatal Care; D015995:Prevalence; D011739:Pyrimethamine / Q000627:therapeutic use; D012307:Risk Factors; D013413:Sulfadoxine / Q000627:therapeutic use; D014505:Urban Population
D000962:Antimalarials; D004338:Drug Combinations; D007306:Insecticides; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine