Investigate Morbidity Patterns and Nutritional Challenges among Pregnant Adolescent Girls in Sierra Leone: A District-Level Analysis

Abstract

Background: Pregnant adolescents in Sierra Leone face intersecting morbidity and nutritional challenges that may vary across geographic settings. Aim: The study investigates morbidity patterns and nutritional challenges among pregnant adolescent girls in Sierra Leone at the district level (Freetown, Kambia, and Moyamba). Methodology: The study used a mixed-methods approach integrating quantitative and qualitative research designs, in which 502 pregnant adolescent girls aged 13–19 years were randomly selected. Data were collected using two primary instruments: a structured questionnaire and anthropometric measurement tools. Qualitative methods, including in-depth interviews and focus group discussions, were also employed. Descriptive statistics, frequencies, and percentages were used in the analysis, and the data were presented in tabular form. Results: The results revealed that malaria represents a major maternal health challenge with significant implications for pregnancy outcomes. Freetown and Moyamba reported the highest malaria transmission, while Kambia reported the lowest among pregnant adolescent girls. Typhoid fever affects nearly one-quarter of pregnant adolescents, representing a major but often overlooked maternal health burden. Kambia has the highest typhoid prevalence, contrasting with its lowest malaria prevalence. Moyamba has the highest prevalence of anaemia among the districts studied, while Freetown reports a moderate prevalence. The chi-square test indicates a statistically significant association between disease condition and study location (χ² = 36.23, df = 4, p < 0.001). This means that the distribution of abdominal pain, malaria, and typhoid was not the same across Freetown, Kambia, and Moyamba. Financial constraints emerged as the most significant barrier, particularly in Kambia, where nearly seven in ten respondents reported affordability issues. Knowledge gaps about nutrition were most pronounced in Moyamba, highlighting the need for targeted education and awareness campaigns. Cultural and religious dietary restrictions were more evident in Freetown, illustrating the influence of social practices on food consumption. Food taboos restricting nutrient-rich foods such as eggs, meat, and fish have been reported among pregnant girls, with pregnant adolescent girls in Kambia and Moyamba reporting greater difficulties than those in Freetown. Conclusion: Pregnant adolescents face compounded health risks from infectious diseases, nutritional deficiencies, and pregnancy-related vulnerabilities. Malaria and typhoid remain major threats, while abdominal pain may signal undiagnosed conditions.