Epidemiology of schistosomiasis, soil-transmitted helminths, malaria, coinfections and anaemia among pregnant women in southern Busia County, Kenya: a cross-sectional study
This cross-sectional study of 209 pregnant women in southern Busia County, Kenya, found that while schistosomiasis and hookworm infections persist at low intensities with rare coinfections, the high prevalence of anaemia (64.1%) appears driven primarily by non-parasitic factors rather than the detected parasitic infections.
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 the world, the health of a pregnant woman is a delicate balance, influenced by everything from her diet to the invisible world of parasites living in her environment. Two of the most persistent threats in these regions are worms that live in the soil and water, and a blood disease carried by mosquitoes. The worms, known as soil-transmitted helminths and schistosomes, enter the body through contaminated soil or water, often settling in the intestines or blood vessels where they feed and reproduce. The mosquito-borne disease, malaria, invades the blood cells, causing fever and weakness. When these infections take hold, they can strip the body of iron and nutrients, leading to a condition called anaemia, where the blood cannot carry enough oxygen to support the mother and her growing baby. While doctors have long known that these parasites are dangerous, the specific picture of how they affect women in the final stages of pregnancy in certain rural areas has remained blurry, leaving public health officials without a clear map for intervention.
To fill this gap, a team of researchers traveled to southern Busia County in western Kenya, a region bordering Lake Victoria where the warm waters and rich soil create a perfect breeding ground for these parasites. Between May 2023 and November 2024, they invited 209 women who had come to two local hospitals to give birth to participate in a detailed health check. The scientists did not rely on guesswork; they collected fresh stool samples to look for worm eggs under a microscope, took small drops of blood to check for malaria parasites, and measured the amount of haemoglobin, the oxygen-carrying protein in the blood, to determine if the women were anaemic. They also asked the women about their daily lives, including their jobs, where they got their drinking water, and whether they had contact with the lake, to see if these habits influenced their risk of infection.
The results painted a picture of a community where some threats have faded while others linger stubbornly. The researchers found that malaria was surprisingly rare, detected in only about three out of every hundred women. Similarly, infections with the common soil-transmitted worms were low, affecting roughly one in ten women, and when they were present, the number of worms was generally small. However, a different type of worm, the blood fluke that causes schistosomiasis, was more common, found in nearly one in eight women. Despite the relatively low rates of these specific infections, the health of the mothers was in serious trouble. More than sixty percent of the women were anaemic, a rate that remained high even though most of them did not have heavy worm or malaria infections. This suggests that while the parasites are still present, they are not the sole cause of the widespread lack of oxygen in the blood; other factors, likely related to nutrition or genetics, are playing a major role.
When the scientists looked closer at the data, they found that having a worm infection did not automatically mean a woman would be anaemic. In fact, for most of the parasites, there was no clear statistical link to the low blood counts. The only exception was hookworm, a specific type of soil-transmitted worm that feeds on blood in the gut. Women with this infection had slightly lower haemoglobin levels than those without it, though the difference was small. The researchers also discovered that the women's backgrounds mattered in unexpected ways. For instance, being a student was the only factor that stood out as being linked to a higher chance of having hookworm, a finding that hints at specific behaviors or exposures unique to that group, though the exact reason remains unclear. Coinfections, where a person carries both a worm and malaria at the same time, were almost non-existent in this group, appearing in only two women.
The study concludes that while the fight against malaria and some worms has made progress in this area, the battle is far from over. The persistence of schistosomiasis and hookworm indicates that transmission is still active in the communities around the lake, likely due to ongoing contact with contaminated water and soil. Yet, the high rate of anaemia cannot be blamed on parasites alone. The researchers suggest that to truly protect mothers, health strategies must go beyond just treating worms and mosquitoes. They need to address the broader picture, including improving nutrition, ensuring clean water and sanitation, and understanding the genetic and dietary factors that are driving the high rates of anaemia. By looking at the whole person rather than just the infection, health workers can better support the women who are about to bring new life into the world.
Drowning in papers in your field?
Get daily digests of the most novel papers matching your research keywords — with technical summaries, in your language.