Seasonal Burden of Malaria Among Pregnant Women Attending Antenatal Care in Cape Coast, Ghana (2019 - 2021): A Retrospective Surveillance Report

BackgroundMalaria during pregnancy contributes to maternal anemia and adverse birth outcomes in sub-Saharan Africa. This study assessed seasonal malaria burden among pregnant women in Cape Coast, Ghana, during 2019-2021. MethodsRetrospective surveillance analysis of pregnant women attending Cape Coast Teaching Hospital. Malaria was diagnosed by microscopy, and hemoglobin levels were measured. Seasonal trends and demographic characteristics were analyzed using descriptive statistics and chi-square tests. ResultsAmong 334 pregnant women, 294 (88.0%) were tested for malaria. Overall prevalence was 2.04% (6/294; 95% CI: 0.75-4.41%), exclusively Plasmodium falciparum. Prevalence was higher in the dry season (2.26%) than wet season (1.27%), with 67% of cases in Q4 2021. Mean age was 35.0 {+/-} 5.1 years, and 79.4% presented in third trimester. Anemia (Hb <11 g/dL) affected 41.3% of participants despite low malaria prevalence. Sensitivity analyses confirmed robust estimates across analytical approaches. ConclusionsLow malaria prevalence reflects progress toward Ghanas elimination goals, though the unexpected dry season pattern warrants investigation. High anemia burden despite low malaria indicates non-malarial causes require attention. Year-round screening and comprehensive antenatal care remain essential as Ghana transitions toward elimination.