What is the burden of submicroscopic malaria in pregnancy in central India?
What is the burden of submicroscopic malaria in pregnancy in central India?
复制标题
DOI：
10.1179/2047773215y.0000000002
复制
发表时间：
2015-02-01
影响因子：
3.4
通讯作者：
Wylie, Blair J.
中科院分区：
文献类型：
--
作者：
Singh, Neeru;Bharti, Praveen K.;Wylie, Blair J.
背景资料：与使用聚合酶链反应（PCR）为基础的方法进行分子诊断相比，传统的显微镜检查低估了疟疾感染的负担。低密度的寄生虫血症是感染的宿主。我们评估了亚显微感染的患病率在一个地区的不稳定的疟疾传播在印度，并确定这些感染是否会对产妇或胎儿outcomes.Methods产生负面影响：本横断面研究（2007-2008年）进行了两个地区的恰蒂斯加尔，招募妇女从产前诊所（ANC）和交付单位（DU）。对于ANC/DU受试者，外周/胎盘血，分别获得常规显微镜和收集到滤纸上进行PCR analysis.Results：有3425名孕妇，包括2477 ANC受试者和948 DU受试者谁有显微镜和PCR样本。聚合酶链反应检测到的疟原虫感染比传统的光学显微镜显着更多的外周血（3.4比1.2%; OR 2.9，95%置信区间（CI）1.9-4.5）和胎盘（4.2比1.7%; OR 2.5，95% CI 1.4-4.8）的血液样本。在ANC或DU参与者中，亚显微感染与贫血或重度母体贫血无关，在DU参与者中与低出生体重（LBW）无关。与此相反，显微镜下检测到的感染与严重贫血和LBW.Conclusions：在这方面的不稳定的疟疾传播从印度，亚显微感染并没有确定一组孕妇贫血或LBW的风险增加。在PCR技术变得便宜得多并可作为现场环境的即时检测之前，其在疟疾检测中的使用将受到限制。
Background: Conventional microscopy underestimates the burden of malarial infection when compared with molecular diagnosis using polymerase chain reaction (PCR)-based methods. Lower density parasitemias serve as a reservoir for infection. We evaluated the prevalence of submicroscopic infections in an area of unstable malarial transmission in India and determined whether these infections negatively impacted maternal or fetal outcomes.Methods: This cross-sectional study (2007-2008) was undertaken in two districts of Chhattisgarh, recruiting women from both antenatal clinics (ANCs) and delivery units (DUs). For ANC/DU subjects, peripheral/placental blood, respectively, was obtained for conventional microscopy and collected onto filter paper for PCR analysis.Results: There were 3425 pregnant women, including 2477 ANC subjects and 948 DU subjects who had both microscopic and PCR samples available. Polymerase chain reaction detected significantly more Plasmodium infections than traditional light microscopy both from peripheral (3.4 vs 1.2%; OR 2.9, 95% confidence intervals (CIs) 1.9-4.5) and placental (4.2 vs 1.7%; OR 2.5, 95% CIs 1.4-4.8) blood samples. Submicroscopic infections were not associated with anemia or severe maternal anemia among ANC or DU participants and were not associated with low birth weight (LBW) among DU participants. In contrast, microscopically detected infections were associated with severe anemia and LBW.Conclusions: In this area of unstable malarial transmission from India, submicroscopic infections did not identify a set of pregnant women at increased risk for anemia or LBW. Until PCR techniques become much less expensive and available as a point of care test for the field setting, its use will be limited for malarial detection.