All ETDs from UAB

Advisory Committee Chair

Pauline Jolly

Advisory Committee Members

John Ehiri

William Ellis

Ellen Funkhouser

Julian Rayner

Document Type


Date of Award


Degree Name by School

Doctor of Public Health (DrPH) School of Public Health


Several studies have reported the relationship between malaria during pregnancy and adverse pregnancy outcomes including maternal anemia, low birthweight, as well as preterm delivery and small for gestational age infants. Some studies have also demonstrated the linkage between helminth infection and maternal anemia. Few studies have assessed the occurrence of coinfection of these infections in pregnancy and its effects on maternal anemia and birth outcomes. The objective of this dissertation was to assess the effect of malaria and intestinal helminth coinfection on birth outcomes in Ghana. A cross-sectional study of 785 women presenting for delivery in two hospitals in Kumasi, Ghana, was conducted in November-December 2006. Data collection included sociodemographic information, medical and obstetric histories, anthropometric measures, and blood and stool collection. The prevalence of Plasmodium falciparum infection, intestinal helminth infection(s) and coinfection was 36.3%, 25.7% and 16.6%, respectively. Women with intestinal helminth infection(s) were 4.8 times more likely to have Plasmodium falciparum infection. The prevalence of adverse pregnancy outcomes was high in this population (44.6%). Compared to uninfected women, coinfection was associated with a 50-100% increased odds of low birth weight, preterm delivery, and small for gestational age iv infants. The odds of anemia was increased almost a three-fold (OR=2.8, 95% CI=1.7- 4.8). When compared to women with no malaria, malaria increased the risk stillbirth (OR=1.9, 95% CI=1.2-9.3). Our findings have implications for policy and practice. Efforts to reduce the burden of adverse birth outcomes in Sub Saharan Africa should focus on implementing prevention and treatment of malaria, intestinal parasitic infections and anemia. Because some of the infections and conditions are chronic, intervention strategies must consider opportunities for diagnosis and management or preemptive prevention before pregnancy.

Included in

Public Health Commons



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.