Helminth infection and iron status of pregnant women in two geo-climatic areas in Indonesia

Introduction: Helminthiasis is known to contribute to iron deficiency (ID). The aim of this study was to identify the associations between helminth infection and iron status among pregnant women in two different geo-climatic areas in Indonesia. Methods: A cross-sectional study was conducted among pregnant women in two districts, stratified by wet-lowland (n=135) and wet-highland (n=120) areas. Data on general characteristics, helminth infection, and iron status were obtained. Helminth infection was determined using the Kato-Katz and Harada Mori technique. Iron status was measured using simple-sandwich ELISA techniques for plasma ferritin (PF) and transferrin receptor (TfR), while haemoglobin (Hb) values were determined by the haematology analyser, and the TfR/PF ratio for body iron stores (BIS) was calculated. Results: Prevalence of hookworm infestation was significantly higher (30% vs. 17.8%)while T. trichiura was significantly lower (0.8% vs. 11.9%) in wet-highland compared to wet-lowland areas. The overall iron status was relatively good and not significantly different between the two areas: 17.3% anaemia (Hb<110 g/L), 6.9% depleted iron store (PF<15 μg/L), 2.4% tissue ID (TfR>8.5 mg/L), 3.3% had BIS<0 mg/kg body weight, and 2.3% anaemia with ID. Prevalence of tissue ID and negative body iron store (BIS) was significantly higher among helminth infected women than in the non-infected women (p<0.05). Conclusions: Differences in helminthiasis profiles, but not in the iron status of the pregnant women, were found in the two geo-climatic areas studied. Prevalence of helminth infection especially hookworm was high, and significantly higher in wet-highland area. Hookworm infection was weakly correlated with TfR concentration and BIS. There is a need for parasitic control in the form of health education to be in place.