Epidemiology of malaria among pregnant women during their first antenatal clinic visit in the middle belt of Ghana: a cross sectional study.
Epidemiology of malaria among pregnant women during their first antenatal clinic visit in the middle belt of Ghana: a cross sectional study.
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DOI：
10.1186/s12936-020-03457-5
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发表时间：
2020-10-23
期刊：
影响因子：
3
通讯作者：
Owusu-Agyei S
中科院分区：
文献类型：
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作者：
Dosoo DK;Chandramohan D;Atibilla D;Oppong FB;Ankrah L;Kayan K;Agyemang V;Adu-Gyasi D;Twumasi M;Amenga-Etego S;Bruce J;Asante KP;Greenwood B;Owusu-Agyei S
孕期疟疾可能会对母亲及其胎儿造成不利后果。这项研究试图记录在加纳疟疾常年传播地区第一次产前门诊就诊的孕妇目前的负担和与疟疾和贫血有关的因素。共有1655名年龄在18岁及以上、胎龄13-22周、首次到产前护理(ANC)诊所就诊的孕妇同意并纳入研究。使用结构化问卷收集关于疟疾预防措施使用情况的社会人口和产科数据和信息。在磺胺多辛-乙胺嘧啶给药前采集静脉血2ml。疟疾寄生虫血症和血红蛋白浓度分别使用显微镜和自动血液学分析仪进行测定。使用STATA 14进行数据分析。登记时妇女的平均年龄(SD)和胎龄(SD)分别为27.4(6.2)岁和16.7(4.3)周。总体疟疾寄生虫流行率为20.4%(95%可信区间为18.5-22.4%)。几何平均寄生虫密度为442只/µL(95%可信区间380~515)。在寄生虫血症妇女中，极低(1~199个寄生虫/µL)、低(200~999个寄生虫/µL)、中等(1000~9999个寄生虫/µL)和高(≥ 10,000个/µL)寄生虫密度的比例分别为31.1%、47.0%、18.9%和3.0%。年龄25岁(OR 0.57，95%CI 0.41~0.79)、多胎(OR 0.50，95%CI 0.33~0.74)、高中及以上文化程度(OR 0.53，95%CI 0.33~0.83)、社会经济地位较高的家庭(OR 0.34，95%CI 0.21~0.54)与疟疾原虫血症的风险较低相关。 ≥ 年龄25岁(OR 0.57，95%CI 0.41~0.79)、多胎(OR 0.50，95%CI 0.33~0.74)、高中以上文化程度(OR 0.53，95%CI 0.33~0.83)、社会经济地位较高的家庭(OR 0.34，95%CI 0.21~0.54)与疟疾原虫血症的风险相关。贫血患病率( 11.0g/dL)为56.0%，有无寄生虫血症妇女的平均血红蛋白浓度分别为9.9g/dL和10.9g/dL。在加纳中部地带疟疾常年传播区第一次到非国大诊所就诊的孕妇中，每五名孕妇中就有一名感染了恶性疟原虫。大多数感染者的寄生虫数在1,000只/微克L以下，并伴有贫血。有必要加强现有的疟疾预防战略，以防止在这一人群中产生不利的孕产妇和胎儿出生结果。
Malaria during pregnancy may result in unfavourable outcomes in both mothers and their foetuses. This study sought to document the current burden and factors associated with malaria and anaemia among pregnant women attending their first antenatal clinic visit in an area of Ghana with perennial malaria transmission. A total of 1655 pregnant women aged 18 years and above with a gestational age of 13–22 weeks, who attended an antenatal care (ANC) clinic for the first time, were consented and enrolled into the study. A structured questionnaire was used to collect socio-demographic and obstetric data and information on use of malaria preventive measures. Venous blood (2 mL) was collected before sulfadoxine-pyrimethamine administration. Malaria parasitaemia and haemoglobin concentration were determined using microscopy and an automated haematology analyser, respectively. Data analysis was carried out using Stata 14. Mean age (SD) and gestational age (SD) of women at enrolment were 27.4 (6.2) years and 16.7 (4.3) weeks, respectively. Overall malaria parasite prevalence was 20.4% (95% CI 18.5–22.4%). Geometric mean parasite density was 442 parasites/µL (95% CI 380–515). Among women with parasitaemia, the proportion of very low (1–199 parasites/µL), low (200–999 parasites/µL), medium (1000–9999 parasites/µL) and high (≥ 10,000 parasites/µL) parasite density were 31.1, 47.0, 18.9, and 3.0%, respectively. Age ≥ 25 years (OR 0.57, 95% CI 0.41–0.79), multigravid (OR 0.50, 95% CI 0.33–0.74), educated to high school level or above (OR 0.53, 95% CI 0.33–0.83) and in household with higher socio-economic status (OR 0.34, 95% CI 0.21–0.54) were associated with a lower risk of malaria parasitaemia. The prevalence of anaemia (< 11.0 g/dL) was 56.0%, and the mean haemoglobin concentration in women with or without parasitaemia was 9.9 g/dL or 10.9 g/dL, respectively. One out of five pregnant women attending their first ANC clinic visit in an area of perennial malaria transmission in the middle belt of Ghana had Plasmodium falciparum infection. Majority of the infections were below 1000 parasites/µL and with associated anaemia. There is a need to strengthen existing malaria prevention strategies to prevent unfavourable maternal and fetal birth outcomes in this population.
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DOI：
10.4269/ajtmh.17-0620
发表时间：
2018-03
期刊：
The American journal of tropical medicine and hygiene
影响因子：
--
作者：
Berry I;Walker P;Tagbor H;Bojang K;Coulibaly SO;Kayentao K;Williams J;Oduro A;Milligan P;Chandramohan D;Greenwood B;Cairns M
通讯作者：
Cairns M
影响因子：
3
作者：
Jäckle MJ;Blumentrath CG;Zoleko RM;Akerey-Diop D;Mackanga JR;Adegnika AA;Lell B;Matsiegui PB;Kremsner PG;Mombo-Ngoma G;Ramharter M
通讯作者：
Ramharter M
影响因子：
3
作者：
Noone C;Parkinson M;Dowling DJ;Aldridge A;Kirwan P;Molloy SF;Asaolu SO;Holland C;O'Neill SM
通讯作者：
O'Neill SM
影响因子：
3
作者：
Chaponda, Enesia Banda;Chandramohan, Daniel;Chico, R. Matthew
通讯作者：
Chico, R. Matthew
影响因子：
--
作者：
Jeremiah, Zaccheaus Awortu;Uko, Emmanuel Kufre
通讯作者：
Uko, Emmanuel Kufre