Abstract / Summary
Abstract Background Malaria during pregnancy remains a major cause of preventable maternal and neonatal morbidity and mortality in sub-Saharan Africa despite the availability of effective preventive interventions. Pregnant women with malaria may also have concurrent infections such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), and syphilis, which can further worsen pregnancy outcomes. However, little is known about burden of malaria, associated factors, and malaria coinfections among pregnant women in Bweyale Town Council, Uganda. This study determined the prevalence of malaria, factors associated with malaria, and malaria coinfections among pregnant women attending antenatal care (ANC) in Bweyale Town Council, Kiryandongo District, Uganda. Methods A facility-based cross-sectional study was conducted between April and May 2026 at three health centres in Bweyale Town Council. Participants were recruited using convenience sampling. Malaria was confirmed using a pan-species rapid diagnostic test, while HIV, hepatitis B and syphilis results were extracted from antenatal records using interviewer-administered questionnaires. Factors associated with malaria were assessed using modified Poisson regression with robust standard errors, and adjusted prevalence ratios (aPRs) with 95% confidence intervals were reported. Statistical significance was set at p < 0.05. Results A total of 422 pregnant women were enrolled. The median age was 24 years (IQR: 20–27), and 95.3% (402/422) were married. The prevalence of laboratory-confirmed malaria was 12.6% (53/422; 95% CI: 10.0%–16.0%). HIV, HBV, and syphilis prevalence were 4.0%, 2.8%, and 2.6%, respectively. Malaria-HIV and malaria-syphilis coinfections occurred in 0.5% and 1.0% of participants, respectively. Women who did not sleep under long-lasting insecticide-treated nets (LLINs) had more than twice the prevalence of malaria compared with net users (aPR 2.45, 95% CI 1.47–4.09; p = 0.001). Conclusion About one in eight pregnant women attending ANC in Bweyale Town Council had malaria, and malaria coinfections with HIV and syphilis were also identified. Failure to sleep under an insecticide-treated net was independently associated with malaria. Strengthening LLINs utilization and integrating malaria prevention with routine maternal infection screening could further reduce malaria and adverse pregnancy outcomes.