Malaria Alters Iron Status and Immunohaematological Indices Among Pregnant Population in Northern Ghana

Background Globally, malaria remains a leading cause of morbidity and mortality, with pregnant women at the highest risk. However, Plasmodium falciparum and Plasmodium vivax are the main species affecting pregnant women, significantly contributing to anaemia and related complications. Iron deficiency (ID) and malaria-induced inflammation play life-threatening roles in women at various stages of pregnancy, especially in sub-Saharan Africa, where malaria is endemic. Our study aimed to assess the influence of malaria on iron and immunohaematological indices among pregnant women in the Upper East Region of Ghana. Methods A prospective cross-sectional study was conducted at selected urban and rural health facilities in the Upper East Region, Ghana, recruiting 150 pregnant women with or without malaria. Participants’ sociodemographic and economic characteristics were collected through a structured questionnaire. Five millilitres of venous blood were collected from study participants for haematological analysis, malaria microscopy, Rapid Diagnostic Tests (RDTs), and enzyme-linked immunosorbent assay (ELISA). Results Iron deficiency anaemia (IDA) prevalence was 31.4% of the study population, and anaemia was marginally associated with age (p = 0.050). In adjusted analyses, pregnant women with only a primary education had significantly higher odds of elevated HRP2 levels (AOR = 33.38, p = 0.013). Urban residence (AOR = 4.51, p = 0.021) and middle-income status (AOR = 3.60, p = 0.040) were also independently associated with malaria. Compared with malaria-negative controls, pregnant women with malaria had significantly elevated levels of acute-phase proteins (AGP and CRP) and the malaria-specific biomarker HRP2, as well as indicators of reduced iron status (p < 0.05). The infection was also associated with a significantly lower red blood cell count (p = 0.013) and hematocrit (p = 0.021). IDA was significantly linked to elevated CRP levels (p = 0.044), suggesting an acute inflammatory response. Conclusion The study reveals a high prevalence of malaria and anaemia, and their frequent co-occurrence, among pregnant women in northern Ghana. Malaria was associated with altered iron status and adverse immunohaematological changes. These findings underscore the potential value of integrated strategies that address both malaria and anaemia in antenatal care programs in this region.