Malaria in the Post-Partum Period; a Prospective Cohort Study
Malaria in the Post-Partum Period; a Prospective Cohort Study
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DOI：
10.1371/journal.pone.0057890
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发表时间：
2013-03-13
期刊：
影响因子：
3.7
通讯作者：
Nosten, Francois H.
中科院分区：
文献类型：
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作者：
Boel, Machteld E.;Rijken, Marcus J.;Nosten, Francois H.
背景：多项研究表明，产后对疟疾的易感性会延长或增加。进行了一项配对队列研究，前瞻性评估恶性疟原虫和间日疟原虫流行地区的产后妇女对疟疾的易感性。方法：在泰缅边境季节性疟疾传播低度的地区，将到产前诊所就诊的孕妇与非妊娠、非产后对照进行匹配，并前瞻性随访直至分娩后 12 周。结果：产后妇女 (n = 744)与对照组相比，恶性疟原虫发作次数明显减少（风险比 (HR) 0.39 (95%CI 0.21-0.72) p = 0.003），但间日疟原虫发作次数明显增多（HR 1.34 (1.05-1.72) p = 0.018）。恶性疟疾风险降低是由于接触量减少所致，而妊娠期间间日疟原虫感染史是产后妇女感染间日疟原虫的一个强危险因素（HR 13.98 (9.13-21.41)，p
Background: Several studies have shown a prolonged or increased susceptibility to malaria in the post-partum period. A matched cohort study was conducted to evaluate prospectively the susceptibility to malaria of post-partum women in an area where P.falciparum and P.vivax are prevalent.Methods: In an area of low seasonal malaria transmission on the Thai-Myanmar border pregnant women attending antenatal clinics were matched to a non-pregnant, non-post-partum control and followed up prospectively until 12 weeks after delivery.Results: Post-partum women (n = 744) experienced significantly less P.falciparum episodes than controls (hazard ratio (HR) 0.39 (95%CI 0.21-0.72) p = 0.003) but significantly more P.vivax (HR 1.34 (1.05-1.72) p = 0.018). The reduced risk of falciparum malaria was accounted for by reduced exposure, whereas a history of P.vivax infection during pregnancy was a strong risk factor for P.vivax in post-partum women (HR 13.98 (9.13-21.41), p