title: Effect of Malaria and Geohelminth Infection on Birth Outcomes in Kumasi, Ghana.
abstract: OBJECTIVE
  In 2005, the Ghana Health Service mandated malaria and helminths chemoprophylaxis during antenatal care visits. The aim of this study was to investigate the prevalence of malaria and helminth infections and their relationship with adverse birth outcomes (low birth weight, stillbirth, and preterm) following the implementation of these treatments.
  
  
  METHODS
  A quantitative cross-sectional study.
  
  
  METHODS
  The study was conducted on 630 women presenting for delivery in the Komfo Anokye Teaching Hospital and the Manhyia District Hospital from July to November 2011. Socio-demographic information and medical and obstetric history were collected. Laboratory analyses for the presence of malaria and helminths were performed. Association of malaria and helminths with birth outcomes was assessed using logistic regression to obtain odds ratios (ORs) and 95% confidence intervals.
  
  
  RESULTS
  The prevalence of malaria, helminths and adverse birth outcomes was 9.0%, 5.0% and 22.2%, respectively. Compared with women who received malaria prophylaxis, women without malaria prophylaxis were two times more likely to have malaria infection (aOR = 2.1; 95% CI = 1.06-4.17). Women who were not screened for helminths were twice as likely to be infected with helminths (aOR = 2.4; 95% CI = 1.15-5.12) than women who were screened for helminths. For women infected with hookworm orSchistosoma mansoni, the odds of having an adverse birth outcome (aOR = 3.9; 95% CI = 1.09-14.20) and stillbirth (aOR = 7.7; 95% CI = 1.21-36.38) were greater than for women who were not infected.
  
  
  CONCLUSIONS
  The prevalence of malaria, helminths and adverse birth outcomes was lower than previously reported 9.0% vs. 36.3, 5.0% vs. 25.7 and 22.2% vs. 44.6, respectively. Helminth but not malaria infection was found to be significantly associated with adverse birth outcomes.
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
authors.forename: Ntui N
authors.initials: NN
authors.lastname: Asundep
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
authors.forename: Pauline E
authors.initials: PE
authors.lastname: Jolly
authors.affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
authors.forename: April P
authors.initials: AP
authors.lastname: Carson
authors.affiliation: Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Cornelius A
authors.initials: CA
authors.lastname: Turpin
authors.affiliation: Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
authors.forename: Kui
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, GA 30310, USA.
authors.forename: Nana O
authors.initials: NO
authors.lastname: Wilson
authors.affiliation: Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, GA 30310, USA.
authors.forename: Jonathan K
authors.initials: JK
authors.lastname: Stiles
authors.affiliation: Center for Computational Epidemiology, Bioinformatics and Risk Analysis (CCEBRA), Tuskegee University, Tuskegee AL 36088, USA.
authors.forename: Berhanu
authors.initials: B
authors.lastname: Tameru
keywords: Geohelminths; Kumasi; malaria; pregnancy outcomes