Prevention of anaemia in pregnancy using insecticide-treated bednets and sulfadoxine-pyrimethamine in a highly malarious area of Kenya: a randomized controlled trial
Prevention of anaemia in pregnancy using insecticide-treated bednets and sulfadoxine-pyrimethamine in a highly malarious area of Kenya: a randomized controlled trial
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DOI：
10.1016/s0035-9203(03)90141-6
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发表时间：
2003-05-01
影响因子：
2.2
通讯作者：
Mugo, B
中科院分区：
文献类型：
--
作者：
Njagi, JK;Magnussen, P;Mugo, B
为了比较怀孕中期和晚期使用周效磺胺-乙胺嘧啶（SP）间歇治疗、使用驱虫蚊帐（ITN）或两者结合对怀孕期间血红蛋白（Hb）水平的影响，一项随机、安慰剂对照干预试验于1997年7月至1999年9月在肯尼亚西部疟疾流行地区进行。Primigravidae和secundigravidae被纳入研究，并随机分为4个干预组：（i）ITNs和SP，（ii）ITNs和安慰剂SP，（iii）SP单独，（iv）安慰剂SP。所有组都提供病例管理和铁和叶酸补充剂。752名妇女进行了跟踪，直到分娩（53.2%是经产妇和46.8%的secundigravidae）。在所有组的孕妇中，分娩时的Hb水平（107.6 g/L）与招募时的Hb水平（101.9 g/L）相比有显著改善（P < 0.006），其中ITNs + SP组合组的改善最大。经杀虫剂处理过的蚊帐+ SP对贫血的保护效果为55.8%（95%CI 30.6-71.8），单独使用SP的保护效果为50.9%（95%CI 22.2-69.0），经杀虫剂处理过的蚊帐的保护效果为41.6%（95%CI 9.8-62.3）。在secundigravidae，血红蛋白水平略有下降，在交付相比，招聘（P = 0.03）。得出的结论是，疟疾是孕妇贫血的一个主要原因，但其他原因在secundigravidae中起着更重要的作用，而使用SP或使用驱虫蚊帐的间歇治疗对孕妇的好处大于secundigravidae。
To compare the effects of intermittent treatment with sulfadoxine-pyrimethamine (SP) given during the second and third trimester of pregnancy, the use of insecticide-treated nets (ITN), or the combination of both on haemoglobin (Hb) levels during pregnancy, a randomized, placebo-controlled intervention trial was conducted in a malaria-endemic area of western Kenya from July 1997 to September 1999. Primigravidae and secundigravidae were enrolled into the study and randomized into 4 intervention groups: (i) ITNs and SP, (ii) ITNs and placebo SP, (iii) SP alone, and (iv) placebo SP. All groups were offered case management and iron and folic acid supplementation. Seven hundred and fifty-two women were followed until delivery (53.2% were primigravidae and 46.8% secundigravidae). Among primigravidae in all the groups there was a significant improvement in Hb levels at delivery (107.6 g/L) compared with recruitment (101.9 g/L) (P < 0.006) with the greatest improvement in the combination ITNs + SP group. The protective efficacy of ITNs + SP on anaemia was 55.8% (95% CI 30.6-71.8), of SP alone 50.9% (95% CI 22.2-69.0), and of ITNs 41.6% (95% CI 9.8-62.3). Among secundigravidae, Hb levels were slightly lower at delivery compared with recruitment (P = 0.03). It was concluded that malaria is a major cause of anaemia in primigravidae but that other causes play a more significant role in secundigravidae, and that intermittent treatment with SP or use of ITNs benefits primigravidae more than secundigravidae.