Title:
Factors Associated with the Occurrence of Malaria Among Pregnant Women Attending Antenatal Care at New Bell District Hospital, Douala, Cameroon

Authors:
Mohnchimbare Christina Mbongueh, Mbabazi Asiati, Fankep Dihewou Alphonse Bertin, Henri Lucien Kamga Fouamno, Uganda

Abstract:

Malaria remains a major public health problem among pregnant women in sub-Saharan Africa and is a significant cause of maternal and neonatal morbidity and mortality. Physiological and immunological changes during pregnancy increase susceptibility to malaria infection, resulting in adverse outcomes such as maternal anemia, spontaneous abortion, stillbirth, preterm delivery, low birth weight, and neonatal mortality. Despite the implementation of preventive measures, including insecticide-treated mosquito nets (ITNs), intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP), and routine antenatal care (ANC) services, malaria continues to pose a considerable challenge in Cameroon. This study aimed to determine the prevalence of malaria and identify factors associated with malaria occurrence among pregnant women attending antenatal care services at the New Bell District Hospital in Douala, Cameroon. A hospital-based analytical cross-sectional study was conducted among 280 pregnant women attending ANC between November 2024 and July 2025. Data were collected using a structured interviewer-administered questionnaire covering socio-demographic characteristics, obstetric history, environmental conditions, malaria prevention practices, and knowledge of malaria. Malaria diagnosis was confirmed through microscopic examination of Giemsa-stained thick and thin blood smears. Data were analyzed using descriptive statistics, Pearson’s Chi-square test, and multivariate logistic regression, with statistical significance set at p < 0.05. Among the 280 participants, 118 tested positives for malaria parasites, yielding an overall prevalence of 42.1% (95% CI: 36.3–47.9). Plasmodium falciparum accounted for 94.1% of infections. Malaria occurrence was significantly associated with younger maternal age, unmarried status, inadequate ANC attendance, inconsistent ITN utilization, insufficient IPTp-SP uptake, and exposure to mosquito breeding environments. Multivariate analysis showed that age ≥30 years (AOR = 0.48; p = 0.024), married status (AOR = 0.41; p = 0.005), regular ITN use (AOR = 0.36; p = 0.001), at least four ANC visits (AOR = 0.54; p = 0.032), and receipt of at least three IPTp-SP doses (AOR = 0.44; p = 0.009) were independently protective against malaria. Strengthening ANC utilization, IPTp-SP coverage, ITN use, and environmental sanitation is essential for reducing malaria burden during pregnancy.

DOI: http://dx.doi.org/10.51505/ijmshr.2026.10405