Epidemiology of congenital malaria in Nigeria: a multi-centre study
Epidemiology of congenital malaria in Nigeria: a multi-centre study
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DOI：
10.1111/j.1365-3156.2007.01931.x
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发表时间：
2007-11-01
影响因子：
3.3
通讯作者：
Callahan, Michael V.
中科院分区：
文献类型：
--
作者：
Falade, Catherine;Mokuolu, Olugbenga;Callahan, Michael V.
目的了解尼日利亚新生儿先天性疟疾负担情况。方法在一项前瞻性多中心研究中，1875对连续12个月的母婴配对被纳入研究。从母亲、新生儿、胎盘抽吸物和分娩后4小时内的脐带血中制备血涂片。结局变量为母亲、胎盘、脐带和新生儿的显性寄生虫血症，以及母亲和新生儿的红细胞压积。结果95例新生儿中检出明显寄生虫血症，占5.1%。在不同的研究中心发生的情况有所不同，但在所有的研究地点全年都有发现。受感染新生儿的平均寄生虫密度较低（每亩48个无性虫，范围在8-200个/亩）。母体和胎盘寄生血症是新生儿显性寄生血症最重要的危险因素（P < 0.0001）。62.1%的新生儿在第2天前自发清除寄生虫血症。33.7%在出生3天内出现症状。结论先天性疟疾通常无症状，可自行清除，不需要治疗。然而，在疟疾流行地区，出现不明原因发热和拒绝进食的新生儿应接受疟疾检测。
OBJECTIVE To determine the burden of congenital malaria in newborns in Nigeria.METHODS In a prospective multi-centre study, 1875 consecutive mother-baby pairs were enrolled over a continuous 12-month period. Blood smears were prepared from mothers, neonates, placental aspirates and cord blood within 4 h of delivery. Outcome variables were patent parasitaemia in the mother, placenta, cord and neonate in addition to maternal and neonatal haematocrit.RESULTS Patent parasitaemia was detected in 95 neonates (5.1%). The occurrence varied between study centres, but was found year round in all sites. The mean parasite density among infected neonates was low (48 asexual forms per mu l, range 8-200/mu l). Maternal and placental parasitaemia were the most important risk factors for patent neonatal parasitaemia (P < 0.0001). Spontaneous clearance of parasitaemia occurred in 62.1% of neonates before day 2. 33.7% were symptomatic within 3 days of birth.CONCLUSION Congenital malaria is often asymptomatic, clears spontaneously and may not warrant treatment. However, newborns with unexplained fever and refusal to feed in malaria endemic areas should be tested for malaria.