Reproductive Health Vulnerabilities Associated with Tropical Infectious Diseases in Women in North Sumatra: A Population-Based Study

Abstract

Background: In tropical regions, women of reproductive age face a double health burden from obstetric risks and endemic infectious diseases. However, population-based data quantifying the interaction between tropical infections and reproductive health outcomes in Indonesia are scarce, hindering the development of effective interventions. Objective: This study aimed to analyze the association between malaria and soil-transmitted helminth (STH) infections with adverse reproductive health outcomes among women aged 15-49 in North Sumatra. Methods: A population-based, cross-sectional study was conducted involving 1,420 women selected via stratified random sampling. Data were collected through structured interviews and biological sample analysis. Multivariate logistic regression was used to measure associations after controlling for confounding variables. Results: The overall prevalence of at least one tropical infection was 28.2%. Malaria infection was independently and significantly associated with an increased risk of anemia (Adjusted Odds Ratio [aOR] = 3.15; 95% CI: 2.20–4.51) and a history of preterm birth (aOR = 1.89; 95% CI: 1.15–3.10). STH infection was also a strong predictor of anemia (aOR = 2.10; 95% CI: 1.60–2.75). Implications: These findings provide robust evidence supporting the need to integrate infectious disease control programs into maternal and child health services. Active screening for malaria and STH should be a standard component of antenatal care in endemic areas to mitigate adverse maternal and neonatal outcomes.