Asymptomatic Malaria Parasitaemia and Anaemia among pregnant women at Antenatal Booking in Southwest Nigeria: Implications for Routine Screening within Maternal Health Services in Endemic Settings

Background: Asymptomatic malaria parasitaemia may be missed when antenatal testing is guided by symptoms, although its association with maternal anaemia remains relevant in endemic settings. Objective: This study assessed the prevalence of asymptomatic malaria parasitaemia and its association with anaemia among pregnant women attending antenatal booking in Ile-Ife, Southwest Nigeria. Methods: A hospital-based descriptive cross-sectional study was conducted over 20 weeks at Seventh-Day Adventist Hospital. Of 156 systematically recruited asymptomatic pregnant women, 146 had complete data and were included in the analysis. Sociodemographic and obstetric information was obtained using an interviewer-administered questionnaire. Malaria parasitaemia was identified by microscopy, and haemoglobin concentration was measured using an automated haematology analyser. Associations were examined using chi-square tests, an independent-samples t-test and multivariable logistic regression. Results: Participants had a mean age of 30.2 ± 4.1 years. Asymptomatic malaria parasitaemia was detected in 56 women (38.4%), while 91 (62.3%) had anaemia. Mean haemoglobin concentration was lower among malaria-positive women (9.76 ± 1.65 g/dL) than among malaria-negative women (10.51 ± 1.62 g/dL; p = 0.008). After adjustment for selected covariates, parasitaemia was associated with increased odds of anaemia (adjusted odds ratio 2.170, 95% confidence interval 1.015–4.639; p = 0.046). Conclusion: Asymptomatic parasitaemia was common and associated with anaemia at booking. These findings support consideration of early malaria assessment alongside established antenatal prevention strategies, while broader studies are needed before changes to routine screening policies.