The risk of malaria in Ghanaian infants born to women managed in pregnancy with intermittent screening and treatment for malaria or intermittent preventive treatment with sulfadoxine/pyrimethamine.
The risk of malaria in Ghanaian infants born to women managed in pregnancy with intermittent screening and treatment for malaria or intermittent preventive treatment with sulfadoxine/pyrimethamine.
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DOI：
10.1186/s12936-016-1094-z
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发表时间：
2016-01-28
期刊：
影响因子：
3
通讯作者：
Williams JE
中科院分区：
文献类型：
--
作者：
Awine T;Belko MM;Oduro AR;Oyakhirome S;Tagbor H;Chandramohan D;Milligan P;Cairns M;Greenwood B;Williams JE
几项研究报告了胎盘疟疾感染与幼儿在出生后第一年患疟疾的风险之间的关联，但尚不清楚这是因果关系，还是受到怀孕期间疟疾控制措施的影响。本文比较了母亲在怀孕期间接受磺胺甲基嘧啶/乙胺嘧啶（IPTp-SP）间歇性预防性治疗或蒿甲醚-苯芴醇（ISTP-AL）快速诊断检测和治疗筛查的婴儿疟疾发病率。从2011年7月至2013年4月，在加纳北方的Kassena-Nankana地区，988名妇女的婴儿参加了一项IPTp-SP与ISTp-AL试验，并进行了随访，以确定婴儿早期患临床疟疾的风险，以及他们在6个月和12个月大时患寄生虫病和贫血的风险。此外，还比较了母亲感染胎盘疟疾的婴儿与未感染胎盘疟疾的妇女所生婴儿的临床疟疾发病率。在母亲接受ISTP-AL或IPTP-SP的婴儿中，临床疟疾发病率分别为0.237和0.211次/儿童年。校正后的发病率比和校正后的率差分别为0.94（95% CI 0.68，1.33）和0.029（95% CI-0.053，0.110）例/儿童年风险。患有胎盘疟疾的妇女所生婴儿的临床疟疾发病率（0.195次/儿童年）与无胎盘疟疾的妇女所生婴儿的临床疟疾发病率（0.224次/儿童年）相似（率比= 0.86 [95% CI 0.54，1.37]）。与接受IPTP-SP的妇女相比，妊娠期间接受ISTP-AL治疗的妇女所生的婴儿患疟疾的风险并没有显著增加。无论其母亲是否患有胎盘疟疾，婴儿的疟疾发病率相似。本文的在线版本（doi：10.1186/s12936-016-1094-z）包含补充材料，可供授权用户使用。
Several studies have reported an association between malaria infection of the placenta and the risk of malaria in young children in the first year of life, but it is not known if this is causal, or influenced by malaria control measures during pregnancy. This paper compares the incidence of malaria in infants born to mothers who received either intermittent preventive treatment with sulfadoxine/pyrimethamine (IPTp-SP) or screening with a rapid diagnostic test and treatment with artemether–lumefantrine (ISTp-AL) during their pregnancy. From July 2011 to April 2013, 988 infants of women enrolled in a trial of IPTp-SP versus ISTp-AL in the Kassena-Nankana districts of northern Ghana were followed to determine the risk of clinical malaria during early life, and their risk of parasitaemia and anaemia at 6 and 12 months of age. In addition, the incidence of clinical malaria in infants whose mothers had malaria infection of the placenta was compared with that in infants born to women free of placental malaria. The incidence of clinical malaria was 0.237 and 0.211 episodes per child year in infants whose mothers had received ISTp-AL or IPTp-SP, respectively. The adjusted incidence rate ratio and the adjusted rate difference were 0.94 (95 % CI 0.68, 1.33) and 0.029 (95 % CI −0.053, 0.110) cases per child year at risk respectively. The incidence of clinical malaria was similar in infants born to women with placental malaria (0.195 episodes per child year) and in infants of women without placental malaria (0.224 episodes per child year) (rate ratio = 0.86 [95 % CI 0.54, 1.37]). Infants born to women managed with ISTp-AL during pregnancy were not at greatly increased risk of malaria compared with infants born to women who had received IPTp-SP. The incidence of malaria in infants was similar whether or not their mother had had placental malaria. The online version of this article (doi:10.1186/s12936-016-1094-z) contains supplementary material, which is available to authorized users.