Intestinal parasitosis is one of the most prevalent infectious diseases in the tropical and subtropical areas of the world. It is a medical and public health problem in sub-Saharan countries including Ethiopia. Pregnant women are one of the most vulnerable groups for this infection due to their immune suppression during their pregnancy. In the present study, the overall prevalence of intestinal parasitic infection among pregnant women was 43.8% (n = 315). This finding is consistent with similar studies conducted among pregnant women in Nigeria (12) and Gilgel gibe, South West Ethiopia (23) with the prevalence of 43.4% and 41% respectively.
However, this finding is lower when compared with studies conducted among pregnant women in Venezuela (73.9%) (8), Makurdi, Benue state (56.8%) (11), Gabon (49%) (13) and Mecha district, North West Ethiopia (70.6%) (22). The possible reason for disparity might be due to difference in the geographical area, implementation of various intervention recently such as better awareness created through various media and mass deworming program, diagnostic methods varied from one study to another and increased trend of ANC attendant.
But, this finding is higher than studies done in Bogota, Colombia (1.2%) (7), Nepal (35%) (9), kwale district of Kenya (25.23%) (14), Bahirdar, North West Ethiopia (31.5%) (16), Gandhi memorial hospital (25.2%) (17) and Debre Markos, North West Ethiopia (27.4%) (19). The variations might be due to difference in socio-demographic status, inappropriate handwashing practice, poor shoe wearing habit and difference in existing sanitation facilities and practices.
The predominant intestinal parasite in this study was Hookworm (33.7%) followed by Ascaris lumbricoides (7.3%). Higher prevalence of Hookworm in the present study is similar to other studies conducted in Ethiopia (18, 23, 24). Conversely, this finding is different from studies conducted in Venezuela (8), Nepal (9), Kenya (15) and Wondo Genet, Southern Ethiopia (20) where authors reported Ascaris lumbricoides as the predominant intestinal parasite. The possible difference might be due to the geographical difference (tropical nature of our study area), the difference in habit of walking barefoot which favors for the transmission of hookworm, low level of income and educational attainment.
In the present study being a farmer, walking barefooted and absence of appropriate handwashing habit after latrine significantly increases intestinal parasitic infection. This finding was in line with the study conducted in Kenya (15) and Mecha district (22), but it was inconsistent with the study conducted in Gandhi Memorial Hospital, Addis Ababa (17). This might be since in the present study most of the participants were rural dwellers that are from farmer households, difference socio-demographic status and difference in the level of awareness from those of urban dwellers.
In this study, pregnant women with a habit of walking barefoot were six times more likely infected by hookworm than who wear shoe regularly. This finding was comparable with the study conducted in Mecha district, Hosanna, South Ethiopia and Anbesame, North West Ethiopia were not wearing shoe regularly increases the odds of infection higher than their counterparts. This is because the larvae of hookworm penetrate exposed human skin from contaminated soil (21, 22, 24).
Those pregnant women from farmer households were more likely infected by intestinal parasites when compared with Government employee. This finding is in line with the study done in Ibadan of Nigeria (12) and Kitale district of Kenya (15) where being farmers (engaged in agricultural activity) had statistically significant association with IPI since this activity enables them to have frequent contact with contaminated soil. Contamination of the soil arises from the improper disposal of human wastes.
In the present study, washing hands with water only after latrine increases the odds of IPI in pregnant women by 5.36 folds higher. This finding was consistent with the study done in Makurdi, Benue State (11), Bahirdar, North West Ethiopia (16) and Anbesame, North West Ethiopia (24) whereas it was inconsistent with the study done in East Wollega (18) and Hosanna (21). This might be since in the present study only (32.7%) of the study participants had the habit of handwashing with soap and water frequently.
On the other hand, research done in Hosanna, Southern Ethiopia (21) reported unprotected source of water, family size, and low monthly income (<1000 birr) had a positive association with IPI which is different from the present study. The possible explanation for the difference could be due to the fact that in the current study all of the pregnant women using unprotected source of water and more than half, (51.7%) of pregnant women had monthly income of (> 1000 birr) and having more than three family sizes were not statistically associated with IPI according to present study.
As a limitation of this study, fail to estimate the worm burden in infected pregnant women as this study only focused on determining the prevalence of infection and use of a single stool specimen to assess the infection status which may have underestimated the presence of the infection. Additionally, due to the cross-sectional nature of the study design, we cannot establish a causal relationship between intestinal parasitic infection and the independent variables. Apart from this, the study used trained data collectors and oriented the participants well before data collection started to increase the response rate.