Co-infection with Malaria and Urinary Tract Infection among Outpatient Pregnant Women: Prevalence, Risk Factors, and Antimicrobial Susceptibility Patterns - ACross-Sectional Study

Abstract

The aim of this cross-sectional study was to determine the prevalence of co-infection with malaria and urinary tract infection (UTI) among outpatient pregnant women, identification associated risk factors, evaluate antimicrobial susceptibility patterns, and assess the impact on pregnancy outcomes. Out of 600 pregnant women screened 90 (15%) had co-infections, while 20% had malaria alone, 25% had UTI alone, and 40% had neither infection. Co-infection was significantly associated with older age, higher gravidity, low socioeconomic status, a history of UTIs, and lack of access to clean water. Risk factors for co-infection included age over 30 years (OR: 2.8), low income (OR: 3.1), low educational level (OR: 2.4), poor sanitation (OR: 2.7), lack of access to clean water (OR: 2.9), limited prenatal care (OR: 2.5), and previous episodes of malaria (OR: 2.1). Escherichia coli was the most prevalent bacterial isolate, followed by Staphylococcus aureus and K l e b s i e l l a a e ro g e n e s . A n t i m i c r o b i a l susceptibility testing revealed high effectiveness of ciprofloxacin and ceftriaxone, whereas amoxicillin and trimethoprim-sulfamethoxazole had higher resistance rates. Co-infection was associated with adverse pregnancy outcomes, including higher rates of preterm birth (22.2% vs. 7.8%), low birth weight (27.8% vs. 9.8%), maternal anaemia (38.9% vs. 13.7%), and neonatal mortality (5.6% vs. 2.0%). These findings underscore the need for integrated healthcare strategies to manage and prevent co-infections among pregnant women to improve maternal and neonatal health outcomes.