Reduction of malaria during pregnancy by permethrin-treated bed nets in an area of intense perennial malaria transmission in western Kenya
Reduction of malaria during pregnancy by permethrin-treated bed nets in an area of intense perennial malaria transmission in western Kenya
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DOI：
10.4269/ajtmh.2003.68.50
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发表时间：
2003-04-01
影响因子：
3.3
通讯作者：
Nahlen, BL
中科院分区：
文献类型：
--
作者：
ter Kuile, FO;Terlouw, DJ;Nahlen, BL
在肯尼亚西部一个常年疟疾传播严重的农村地区，研究了经杀虫剂（氯菊酯）处理的蚊帐对妊娠期疟疾的影响。到1997年1月，79个村庄中有40个村庄的所有家庭都被随机分配到驱虫蚊帐。两年后，在对照村庄分发了驱虫蚊帐。在3，072例分娩中，有2，754例（89.6%）提供了关于出生结果的完整数据。妇女（n = 780）在整个怀孕期间每月在79个村庄的19。在第1-4胎孕妇中，经杀虫剂处理过的蚊帐与妊娠期间疟疾寄生虫血症发病率降低38%（95%置信区间[CI] = 17-54%）和严重疟疾贫血（血红蛋白水平< 8 g/dL伴寄生虫血症）发病率降低47%（95% CI = 6-71%）相关。在ITN村庄，分娩时平均血红蛋白水平高出0.6 g/dL（95% CI = 0.01-1.2 g/dL），胎盘或母体疟疾的患病率降低了35%（95% CI = 20-47%），1-4号孕妇的低出生体重患病率降低了28%（95% CI = 2-47%）。在5次或更高妊娠中未观察到有益影响。在疟疾常年传播严重的地区，用氯菊酯处理过的蚊帐减少了疟疾对怀孕头四个月的不利影响。
The impact of insecticide (permethrin)-treated bed nets (ITNs) on malaria in pregnancy was studied in a rural area in western Kenya with intense perennial malaria transmission. All households in 40 of 79 villages were randomized to receive ITNs by January 1997. The ITNs were distributed in control villages two years later. Complete data on birth outcome were available on 2,754 (89.6%) of 3,072 deliveries. Women (n = 780) were followed monthly throughout pregnancy in 19 of 79 villages. Among gravidae 1-4, ITNs were associated with reductions of 38% (95% confidence interval [CI] = 17-54%) in the incidence of malaria parasitemia and 47% (95% CI = 6-71%) in the incidence of severe malarial anemia (hemoglobin level < 8 g/dL with parasitemia) during pregnancy. At the time of delivery, mean hemoglobin levels were 0.6 g/dL (95% CI = 0.01-1.2 g/dL) higher, the prevalence of placental or maternal malaria was reduced by 35% (95% Cl = 20-47%), and the prevalence of low birth weight was reduced by 28% (95% Cl = 2-47%) in gravidae 1-4 from ITN villages. No beneficial impact was observed in gravidae five or higher. In areas of intense perennial malaria transmission, permethrin-treated bed nets reduce the adverse effect of malaria during the first four pregnancies.