Anaemia and associated risk factors among pregnant women in Gilgel Gibe dam area, Southwest Ethiopia Million Getachew1, Delenesaw Yewhalaw2, Ketema Tafess1*, Yehenew Getachew3 and Ahmed Zeynudin4 * * Corresponding author: Ketema Tafess [email protected] Author Affiliations

1 Department of Biomedical Sciences, School of Health, Adama Science and Technology University, Asella, Ethiopia 2 Departments of Biology, College of Natural Sciences, Jimma University, Jimma, Ethiopia 3 Department of Information Communication Technology, College of Agriculture and Veterinary Medicine, Jimma University, Jimma, Ethiopia 4 Department of Laboratory Technology and Pathology, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia For all author emails, please log on.

Parasites & Vectors 2012, 5:296 doi:10.1186/1756-3305-5-296

The electronic version of this article is the complete one and can be found online at: http://www.parasitesandvectors.com/content/5/1/296

Received: | 27 June 2012 |
Accepted: | 10 December 2012 |
Published: | 17 December 2012 |
© 2012 Getachew et al.; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract

Background
Anaemia is known to be one of the outcomes of parasitic infection and it may result in impaired cognitive development, reduced physical work capacity and in severe cases increased risk of mortality, particularly during the prenatal period. The aim of this study was to determine the prevalence and associated risk factors of anaemia among pregnant women in Gilgel-Gibe dam area, southwestern Ethiopia. Methods

A cross-sectional community based study was conducted on 388 pregnant women living in three districts around Gilgel Gibe Dam area, southwestern Ethiopia. Socio-demographic and socio-economic data were collected from each participant. A single stool sample was also collected from each selected pregnant woman. Haemoglobin concentration was determined by the cyanmethemoglobin method. Plasmodium infection prevalence and intensity were assessed with thin and thick blood film examination. Results

Of the total 388 study participants, 209 (53.9%) were anaemic. Pregnant woman who were rural residents (Adjusted odds ratio (AOR) = 1.62, 95% C.I: 1.02-2.62, P= 0.042), not using insecticide treated nets (ITNs) during the study period (AOR = 2.84, 95% C.I: 1.33-6.05, p = 0.007), those who were Plasmodium malaria infected (AOR = 11.19, 95% C.I: 3.31-37.7, p= 0.01) and those with Soil Transmitted Helminth (STH) infections (AOR=1.82, 95% C.I: 1.16-2.87, p=0.001) had higher odds of being anaemic than those who were urban residents, using ITNs, free of Plasmodium malaria and Soil transmitted helminth infection, respectively. There was a significant correlation between increasing hookworm parasite load (r = −.110, P< 0.001), Ascaris lumbricoides (r = −.122, P < 0.001) and Trichuris trichiura (r = −.025, P < 0.001) and decreasing hematocrit values. Conclusion

The high prevalence of anaemia indicates it is currently a serious health problem of pregnant women living in Gilgel Gibe Dam area. Plasmodium malaria and soil transmitted helminth infections were significantly associated with anaemia. Antenatal care should promote de-worming and education on personal hygiene. Therefore, there is a need to design strategies that help to diagnose pregnant women for malaria and STH infections during their antenatal care (ANC) visit instead of testing for only haemoglobin (Hgb) levels and blood group. Keywords:

Co- infection; Pregnant women; Soil Transmitted Helminths; Anaemia; Malaria; Ethiopia Background
Anaemia is a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient to meet physiologic needs, which varies by age, sex, altitude, smoking, and pregnancy status. Parasitic diseases, including helminth infections and P. falciparum, have long been recognized as important contributors to anaemia in endemic countries [1]. The effects of infection with a single helminth species on the risk of anaemia are also well documented, with risk correlated to infection intensity [2]. Hookworm causes iron deficiency anaemia through the process of intestinal blood loss and through nitric oxide (NO) release [3]. Ascaris lumbricoides and Trichuris trichiuria typically have little impact on iron status, and thus on anaemia. Because the mechanisms by which malaria and intestinal helminth infections cause anaemia differ, it is possible that their impact on anaemia are additive [4] and could exacerbate adverse birth outcomes [5]. Malaria due to P. falciparum also clearly contributes to anaemia throughout life and specifically during pregnancy. It is estimated that in sub-Saharan Africa 23 million pregnant women are exposed to malaria infection annually and approximately 400,000 pregnant women develop moderate or severe anaemia (haemoglobin < 80 g/L or hematocrit < 0.25) each year in sub-Saharan Africa as a result...

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