Soil-Transmitted Helminth Infections Among Pregnant Women Attending Antenatal Care In Kisii Teaching And Referral Hospital, Kisii County, Kenya

Abstract

Soil-transmitted helminths (STH) constitutes the commonest human infections across the globe. However, the levels of infection among the vulnerable pregnant women and the risk factors including geophagy and the socio-demographic factors in South Western Kenya are not documented. The purpose of the study was to determine the prevalence of STH in pregnancy, its association with geophagy, and the influence of sociodemographic factors. In a cross-sectional study, 384 pregnant women, recruited by systematic random sampling. In order to collect relevant data on social demographic factors and geophagous substances consumed, a closed ended questionnaire was used. Microscopic examination of fecal samples was achieved through saline method, and further confirmation of helminth species was done through formal-ether concentration technique. Data was analyzed using STATA version 15. Proportions were used to determine prevalence. ꭕ2 was used to determine associations between geophagy, socio-demographic factors and STH infections. To evaluate the association between socio-demographic factors and STH infections, simple logistic regression was used. Results indicated the prevalence of STH in pregnant women was 144 (37.5%) where single/ mono-infections included Ascaris lumbricoides 94 (24.5%), Hookworm 21 (5.5%), Strongyloides stercolaris 5 (1.3%), Trichuris trichiura 1 (0.3%) and Enterobius vermicularis 1 (0.3%). Additionally, mixed infections were observed; A. lumbricoides and Hookworm 16 (4.2%), A. lumbricoides and T. trichiura 2 (0.5%), T. trichiura and E. vermicularis 2 (0.5%), hookworm and S. stercolaris 1 (0.3%) and A. lumbricoides and E. vermicularis 1 (0.3%). A significant association between geophagy and soil-transmitted helminth (STH) infections was determined (ꭕ2=4.99, p=0.02). While consumption of ant hill soil and STH infections was significantly associated (ꭕ2=24.291, p<0.01), consumption of special clay (ꭕ2=3.411, p=0.06), purchased stones (ꭕ2=0.175, p=0.68), and mud from house walls (ꭕ2=0.2124, p=0.64) had no significant association with STH infections. Economic activity was significantly associated with STH infections (ꭕ2=63.485, p=0.01). Subsistence farming in particular was significantly associated with STH infections (ꭕ2=4.580, p=0.03). However, business (ꭕ2=0.001, p=0.97), formal employment (ꭕ2=1.01, p=0.31), and casual labor (ꭕ2=0.298, p=0.58) had no significant association with STH infections. The income levels and STH infections were significantly associated (ꭕ2=16.833, p< 0.01). Lower income levels and STH infections were significantly associated (ꭕ2=10.96, p<0.01). However, there was no significant association between age (ꭕ2=6.871, p=0.07), education (ꭕ2=2.708, p=0.43) and STH infections. In conclusion, STH infection prevalence in pregnant women in KTRH was 37.5%. Consumption of ant hill soil contributed to contraction of STH infections. Pregnant women who were engaged in subsistence farming were particularly prone to STH infections. Early diagnosis, provision of health education and economic empowerment is therefore recommended to control and prevent pregnant women from STH infections. The information could aid healthcare providers in eliminating STH infections among pregnant women.