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Effect of Antenatal Deworming Services on Intestinal Parasite Infection among Pregnant Women in Nigeria

Abstract

Intestinal parasite infection remains an important public health concern among pregnant women in Nigeria and may contribute to anaemia, nutritional deficiencies, impaired maternal wellbeing, and adverse pregnancy outcomes. Pregnant women may be exposed to intestinal parasites through contaminated food and water, inadequate sanitation, poor hygiene practices, and environmental conditions that facilitate parasite transmission. Antenatal deworming services provide an opportunity to prevent and treat soil-transmitted helminth infections during pregnancy as part of routine maternal healthcare. Appropriate deworming, together with sanitation, hygiene, safe water, and other preventive measures, may reduce the burden of intestinal parasite infection among pregnant women. However, differences in antenatal care utilization, availability of deworming medicines, healthcare-provider practices, medication uptake, and access to laboratory diagnosis may affect the effectiveness of antenatal deworming services. Against this background, this study investigates the effect of antenatal deworming services on intestinal parasite infection among pregnant women in Nigeria. The study will be anchored on the Health Belief Model, the Theory of Planned Behavior, and the Social Ecological Model. The Health Belief Model explains how pregnant women's perceptions of susceptibility to intestinal parasite infection, perceived severity, perceived benefits of deworming, perceived barriers, and cues to action may influence participation in antenatal deworming services. The Theory of Planned Behavior explains how attitudes, subjective norms, perceived behavioural control, and intentions may influence women's acceptance and use of deworming services during pregnancy. The Social Ecological Model emphasizes the interaction of individual, household, community, healthcare-system, and environmental factors in determining access to and effectiveness of preventive health services. Collectively, these theoretical perspectives provide a suitable framework for explaining how antenatal deworming services may influence intestinal parasite infection among pregnant women in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cohort research design. The study population will comprise pregnant women attending selected public and private antenatal healthcare facilities across Nigeria. A multistage sampling technique will be used to select states, local government areas, healthcare facilities, antenatal clinics, and eligible pregnant women. Antenatal deworming services will be measured using indicators such as availability of deworming medicines, receipt of recommended deworming treatment, timing of deworming during pregnancy, number of doses received, healthcare-provider counselling, medication adherence, accessibility of deworming services, antenatal care attendance, documentation of deworming, and follow-up services. Intestinal parasite infection will be assessed using indicators such as laboratory-confirmed intestinal parasite infection, stool examination results, parasite species identified, infection intensity where measurable, presence of soil-transmitted helminths, reinfection, and relevant gastrointestinal symptoms. Data will be collected using structured questionnaires, antenatal care records, deworming registers, laboratory reports, stool examination results, and relevant maternal health records. Descriptive statistics will be used to summarize participants' demographic, socioeconomic, and obstetric characteristics, deworming coverage, and patterns of intestinal parasite infection. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, logistic regression, and other appropriate regression techniques, will be used to determine the effect of antenatal deworming services on intestinal parasite infection. Where appropriate, infection rates among women who received deworming services may be compared with those among women who did not receive the services. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that antenatal deworming services have a significant negative effect on intestinal parasite infection among pregnant women in Nigeria. Pregnant women who receive appropriate antenatal deworming services are expected to have a lower prevalence of intestinal parasite infection compared with women who do not receive deworming services. Timely access to recommended deworming medication, appropriate counselling, adherence to treatment, and continued antenatal care may reduce the burden of intestinal parasites during pregnancy. Reduced intestinal parasite infection may also contribute to improved maternal nutritional status and reduce health complications associated with parasitic infections. However, reinfection resulting from contaminated environments, inadequate sanitation, unsafe water, poor hygiene practices, limited access to antenatal care, inconsistent medicine availability, and incomplete treatment uptake may reduce the effectiveness of deworming services. The study therefore expects accessible, appropriately delivered, and well-integrated antenatal deworming services, combined with sanitation and hygiene interventions, to contribute significantly to reducing intestinal parasite infection among pregnant women in Nigeria. The study is expected to contribute to the literature on antenatal deworming services, intestinal parasite infection, pregnant women, maternal healthcare, soil-transmitted helminths, antenatal care, maternal nutrition, preventive healthcare, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, primary healthcare facilities, hospitals, antenatal care providers, obstetricians, midwives, community health workers, public health practitioners, development partners, and policymakers regarding strategies for strengthening maternal infection prevention. The study will also provide evidence-based recommendations for improving availability and uptake of antenatal deworming services, strengthening provider counselling, integrating deworming with routine antenatal care, improving laboratory surveillance of intestinal parasites, promoting sanitation and hygiene education, and developing sustainable programmes for preventing intestinal parasite infection among pregnant women across Nigeria.

Keywords: Antenatal deworming services, intestinal parasite infection, pregnant women, soil-transmitted helminths, antenatal care, maternal health, maternal nutrition, preventive healthcare, deworming, Nigeria, public health.