Prevalence of malaria infection in pregnant women compared with children for tracking malaria transmission in sub-Saharan Africa: a systematic review and meta-analysis.
Prevalence of malaria infection in pregnant women compared with children for tracking malaria transmission in sub-Saharan Africa: a systematic review and meta-analysis.
复制标题
DOI：
10.1016/s2214-109x(15)00049-2
复制
发表时间：
2015-10
期刊：
影响因子：
--
通讯作者：
ter Kuile FO
中科院分区：
文献类型：
--
作者：
van Eijk AM;Hill J;Noor AM;Snow RW;ter Kuile FO
在疟疾流行地区，孕妇比未怀孕的同龄人更有可能感染可检测到的疟疾，感染的额外风险因怀孕而异。首次到产前诊所就诊的孕妇是跟踪疟疾传播强度的一个潜在的务实的哨点群体;然而，儿童疟疾流行率（估计疟疾流行的标准措施）与孕妇之间的关系从未进行过比较。我们从妊娠期疟疾图书馆（2015年1月）获得了妊娠期疟疾流行率的数据，儿童（0-59个月）的数据来自最近发表的关于非洲寄生虫流行率的工作和妊娠期疟疾图书馆。我们使用随机效应荟萃分析来获得儿童与孕妇（怀孕期间，而不是分娩时）和妊娠期疟疾的合并患病率（PPR），我们使用荟萃回归来评估影响患病率的因素。我们使用了来自18个来源的数据，其中包括57个数据点。孕妇感染率与儿童感染率呈直线相关（r= 0.87，P<0.0001）。儿童的患病率高于所有孕妇（PPR= 1.44，95% CI 1.29 - 1.62; I2= 80%，57项研究）和经产妇（1.94，1.68 - 2.24; I2= 80%，7项研究），略高于经产妇（1.16，1.05 - 1.29; I2= 48%，8项研究）。PPR在传播率较高的地区较高。孕妇疟疾流行率与住户调查获得的儿童疟疾流行率数据密切相关，可以为跟踪非洲疟疾传播趋势的调查战略提供实用的辅助手段。妊娠期疟疾联合会，由比尔和梅林达·盖茨基金会向英国利物浦热带医学院、美国疾病控制和预防中心和英国惠康信托基金会提供赠款。
In malarious areas, pregnant women are more likely to have detectable malaria than are their non-pregnant peers, and the excess risk of infection varies with gravidity. Pregnant women attending antenatal clinic for their first visit are a potential pragmatic sentinel group to track the intensity of malaria transmission; however, the relation between malaria prevalence in children, a standard measure to estimate malaria endemicity, and pregnant women has never been compared. We obtained data on malaria prevalence in pregnancy from the Malaria in Pregnancy Library (January, 2015) and data for children (0–59 months) were obtained from recently published work on parasite prevalence in Africa and the Malaria in Pregnancy Library. We used random effects meta-analysis to obtain a pooled prevalence ratio (PPR) of malaria in children versus pregnant women (during pregnancy, not at delivery) and by gravidity, and we used meta-regression to assess factors affecting the prevalence ratio. We used data from 18 sources that included 57 data points. There was a strong linear relation between the prevalence of malaria infection in pregnant women and children (r=0·87, p<0·0001). Prevalence was higher in children when compared with all gravidae (PPR=1·44, 95% CI 1·29–1·62; I2=80%, 57 studies), and against multigravidae (1·94, 1·68–2·24; I2=80%, 7 studies), and marginally higher against primigravidae (1·16, 1·05–1·29; I2=48%, 8 studies). PPR was higher in areas of higher transmission. Malaria prevalence in pregnant women is strongly correlated with prevalence data in children obtained from household surveys, and could provide a pragmatic adjunct to survey strategies to track trends in malaria transmission in Africa. The Malaria in Pregnancy Consortium, which is funded through a grant from the Bill & Melinda Gates Foundation to the Liverpool School of Tropical Medicine, UK; US Centers for Disease Control and Prevention; and Wellcome Trust, UK.