Geohelminth Infections among pregnant women in rural western Kenya; a cross-sectional study.
BACKGROUND
Geohelminth infections are common in rural western Kenya, but risk factors and effects among pregnant women are not clear.


METHODS
During a community-based cross-sectional survey, pregnant women were interviewed and asked to provide a blood sample and a single fecal sample. Hemoglobin was measured and a blood slide examined for malaria. Geohelminth infections were identified using the concentration and Kato-Katz method.


RESULTS
Among 390 participants who provided a stool sample, 76.2% were infected with at least one geohelminth: 52.3% with Ascaris lumbricoides, 39.5% with hookworm, and 29.0% with Trichuris trichiura. Infection with at least one geohelminth species was associated with the use of an unprotected water source (adjusted odds ratio [AOR] 1.8, 95% confidence interval [CI] 1.1-3.0) and the lack of treatment of drinking water (AOR 1.8, 95% CI 1.1-3.1). Geohelminth infections were not associated with clinical symptoms, or low body mass index. A hookworm infection was associated with a lower mid upper arm circumference (adjusted mean decrease 0.7 cm, 95% CI 0.3-1.2 cm). Hookworm infections with an egg count > or =1000/gram feces (11 women) were associated with lower hemoglobin (adjusted mean decrease 1.5 g/dl, 95% CI 0.3-2.7). Among gravidae 2 and 3, women with A. lumbricoides were less likely to have malaria parasitemia (OR 0.4, 95% CI 0.2-0.8) compared to women without A. lumbricoides, unlike other gravidity groups.


CONCLUSIONS
Geohelminth infections are common in this pregnant population; however, there were few observed detrimental effects. Routine provision of antihelminth treatment during an antenatal clinic visit is recommended, but in this area an evaluation of the impact on pregnancy, malaria, and birth outcome is useful.
van Eijk
Anna M
AM
Department of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. amvaneijk@gmail.com
Lindblade
Kim A
KA
Odhiambo
Frank
F
Peterson
Elizabeth
E
Rosen
Daniel H
DH
Karanja
Diana
D
Ayisi
John G
JG
Shi
Ya Ping
YP
Adazu
Kubaje
K
Slutsker
Laurence
L
D000293:Adolescent; D000328:Adult; D000818:Animals; D001196:Ascariasis / Q000453:epidemiology*; D017164:Ascaris lumbricoides; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006725:Hookworm Infections / Q000453:epidemiology*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008288:Malaria / Q000453:epidemiology; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D014257:Trichuriasis / Q000453:epidemiology*; D014258:Trichuris