title: Malaria and anaemia among pregnant women at first antenatal clinic visit in Kisumu, western Kenya.
abstract: 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.
authors: Centre for Vector Biology and Control Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.
authors: Peter
authors: P
authors: Ouma
authors: Anna M
authors: AM
authors: van Eijk
authors: Mary J
authors: MJ
authors: Hamel
authors: Monica
authors: M
authors: Parise
authors: John G
authors: JG
authors: Ayisi
authors: Kephas
authors: K
authors: Otieno
authors: Piet A
authors: PA
authors: Kager
authors: Laurence
authors: L
authors: Slutsker
mesh_terms: 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
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; D007306:Insecticides; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine