Prevalence of malaria, factors associated with malaria, and malaria coinfections among pregnant women attending antenatal care in Bweyale Town Council, Kiryandongo District, Uganda: a facility-based cross-sectional study
This facility-based cross-sectional study conducted in Bweyale Town Council, Uganda, found that 12.6% of pregnant women attending antenatal care had malaria, with non-use of long-lasting insecticide-treated nets identified as a significant risk factor and coinfections with HIV and syphilis also observed.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
In many parts of sub-Saharan Africa, a mosquito bite carries a weight far heavier than a simple itch. For a pregnant woman, the parasite that causes malaria can slip past the body's defenses, which are naturally softened during pregnancy to protect the developing baby. This biological shift makes expectant mothers uniquely vulnerable to infection, which can lead to severe anemia, low birth weight, or even the loss of the pregnancy. While health organizations have long promoted a toolkit to fight this threat—ranging from medicines taken during prenatal visits to sleeping under nets treated with insecticide—the reality on the ground often varies. Understanding exactly how many women are still getting sick, what factors put them at risk, and whether they are battling other infections at the same time is essential for saving lives.
Researchers recently set out to map this landscape in Bweyale Town Council, a community in western Uganda that hosts both local families and refugees from neighboring countries. Between April and May 2026, a team of scientists visited three local health centers to speak with 422 pregnant women who had come for their routine check-ups. The goal was to move beyond estimates and find hard facts: how many of these women actually had malaria at that moment, what personal or environmental factors were linked to the infection, and whether they were also carrying other serious diseases like HIV, hepatitis B, or syphilis. The team used rapid diagnostic tests, which work like a quick blood test to confirm the presence of the malaria parasite, and reviewed the women's medical records to check for other infections.
The results revealed that the threat is still very much present. Out of the 422 women studied, 53 tested positive for malaria, meaning roughly one in eight pregnant women attending these clinics was infected at the time of the visit. The researchers also looked for signs of other infections. They found that 4 percent of the women were living with HIV, 2.8 percent had hepatitis B, and 2.6 percent had syphilis. While these numbers were lower than the malaria rate, the study highlighted a concerning overlap: a small number of women were fighting malaria at the same time as one of these other infections. Specifically, two women had both malaria and HIV, and four had both malaria and syphilis. These coinfections are significant because having multiple diseases at once can make pregnancy outcomes much more difficult to manage.
When the team analyzed the data to find out what made a woman more likely to have malaria, one factor stood out clearly above all others: the use of mosquito nets. The study found that women who did not sleep under a long-lasting insecticidal net were more than twice as likely to have malaria compared to those who did. This was the only factor that remained strongly linked to the infection even after the researchers accounted for other variables like age, how many children a woman had already given birth to, or where she lived. Other factors, such as a woman's education level or whether she lived in a rural or urban area, showed some connection in initial checks but did not hold up as independent causes once the net usage was considered. This suggests that while many things influence health, the simple act of sleeping under a treated net is a powerful shield that, when missing, leaves women significantly exposed.
The study also noted that most of the women had received some form of preventive medicine and that many were aware of the risks, yet the infection rate persisted. The researchers concluded that while the overall burden of malaria in this specific area was lower than in some other parts of Uganda, it remained a serious public health issue. The findings point to a clear path forward: strengthening the distribution and use of insecticide-treated nets could significantly reduce the number of infections. By ensuring that every pregnant woman has access to and uses these nets, and by continuing to screen for other infections during prenatal care, health workers can better protect mothers and their babies from the combined dangers of these preventable diseases.
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