Trend of malaria test positivity rate among pregnant women, Savannah Region, Ghana, 2018-2022.

BACKGROUND: Malaria in pregnancy (MiP) remains a serious public health problem due to its adverse effects on maternal health, pregnancy outcomes, and the cost of healthcare delivery. Significant successes have been achieved in controlling malaria globally. However, little is known about the progress made in controlling malaria in pregnancy in the Savannah Region. We described the trend of the MiP test positivity rate in the Savannah Region of Ghana from 2018 to 2022. METHODS: The study employed a retrospective, descriptive, cross-sectional study using data from 2018 to 2022. Data on malaria in pregnancy in the Savannah Region was extracted from the DHIMS 2 database and transferred into Microsoft Excel version 19. Descriptive statistical analyses were done. Results were summarised into frequencies and percentages and presented in tables, graphs, and maps. RESULTS: Overall, the MiP testing rate was 90.8% (46,734/51,479) and 54.5% (95% CI: 54.0-55.0) of pregnant women tested positive. The majority, 68.0%, of MiP cases in the region were mothers aged 20-34 years. However, the MiP test positivity rate was highest among mothers aged below 20 years, 59.3% (95% CI: 58.1-60.6). Bole District had the highest MiP test positivity rate, 70.1% (95% CI: 69.3-70.8) and accounted for 40.5% (10,315/25,463) of all MiP cases. There was a decline in the MiP test positivity rate from 2018 to 2022 from 60.4% (95% CI: 59.3-61.5) to 51.6% (95% CI: 50.7-52.6). CONCLUSION: The MiP test positivity rate in the Savannah Region is high, with disparities among Districts. However, there is an apparent decline over the study period. There is a need to strengthen existing malaria prevention interventions in pregnancy, such as the use of SP for IPTp and ITNs to prevent negative maternal and fetal birth outcomes. Public health education programmes could improve the uptake and utilisation of ITNs. Further research should be conducted to unravel the reasons for the disproportionately high MiP test positivity rate in the Bole District to enable the implementation of preventive measures.