The Prevalence of Malaria Among Pregnant Women at a Tertiary Care Hospital in Somalia: A Cross‐Sectional Study

<b>Background:</b> In countries like Somalia, where health infrastructure is inadequate and malaria is endemic, immunosuppression during pregnancy increases the risk of placental malaria; this, in turn, leads to anemia, low birth weight, preterm delivery, and stillbirth, causing severe complications that pose a life-threatening risk to both the mother and fetus. <b>Aim:</b> The aim of this study was to investigate the prevalence and associated factors of malaria parasitemia among pregnant women attending the obstetric clinic of a tertiary hospital in Somalia. <b>Method:</b> This cross-sectional study, conducted from November 2022 to January 2023 at a tertiary hospital in Mogadishu, involved 398 pregnant women. Both symptomatic and asymptomatic participants were screened for malaria using Giemsa-stained blood smear microscopy. Associations between variables and malaria prevalence were analyzed using IBM SPSS 22 with chi-square tests and logistic regression. <b>Results:</b> Among 398 pregnant women, 238 (59.8%) tested positive for malaria. Of the 238 malaria cases, 218 (91.6%) were revealed as <i>Plasmodium falciparum</i> cases. Being in the second trimester (OR: 0.524, 95% CI: 0.279-0.983; <i>p</i> = 0.044), third trimester (OR: 0.442, 95% CI: 0.245-0.797; <i>p</i> = 0.007), and indoor residual spraying (IRS) (OR: 0.192, 95% CI: 0.108-0.342; <i>p</i> < 0.001) were significantly associated with decreased odds of malaria in pregnancy. <b>Conclusion:</b> The study revealed a high prevalence of malaria in pregnancy, predominantly caused by <i>Plasmodium falciparum</i>. Targeted education campaigns focusing on women in the second trimester and those not using preventive measures such as IRS or ITNs should be prioritized, along with routine malaria screening at every antenatal care visit.