Malaria in pregnancy in rural Gabon: a cross-sectional survey on the impact of seasonality in high-risk groups.
Malaria in pregnancy in rural Gabon: a cross-sectional survey on the impact of seasonality in high-risk groups.
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DOI：
10.1186/1475-2875-12-412
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发表时间：
2013-11-13
期刊：
影响因子：
3
通讯作者：
Ramharter M
中科院分区：
文献类型：
--
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
疟疾仍然是撒哈拉以南非洲怀孕期间最重要的传染病之一。虽然季节性疟疾化学预防被提倡作为对某些高度季节性疟疾传播地区儿童的公共卫生干预措施，但在赤道非洲稳定的高流行传播环境中，尚未调查季节性对怀孕期间疟疾的影响。本研究的目的是调查季节性对加蓬妊娠期疟疾流行的影响。这项研究于2008年1月至2011年12月在加蓬的一家农村地区医院进行。在第一次产前检查时，记录了孕妇的人口统计数据、胎次、年龄和胎龄，并进行了浓血涂片以诊断疟疾。在单因素和多因素分析中评估季节性和已确定的危险因素与恶性疟原虫感染的关系。1661名孕妇参加了这项研究。与低传播季节相比，在高传播季节出现的参与者感染恶性疟原虫的风险明显更高（调整优势比[AOR] 1.91, 95%可信区间[CI] 1.39-2.63, p < 0.001）。已确定的危险因素包括胎次（多胎与少胎的AOR为0.45，CI为0.30-0.69,p < 0.001）和年龄（13-17岁、18-22岁、23-27岁和≥28岁女性的AOR、CI和p值分别为：AOR为0.59,CI 0.40-0.88； AOR为0.57,CI 0.34-0.97； AOR为0.51,CI 0.29-0.91）是恶性疟原虫感染的重要危险因素。高危人群，包括初产妇和初产妇以及年龄在13-17岁的年轻妇女，在高传播季节的疟疾风险分别从低传播期和高传播期的17%增加到64%。在疟疾传播稳定和高度流行的中非地区，季节变化导致妊娠期恶性疟原虫感染风险存在重大差异。怀孕期间疟疾的季节性增加在由年轻和少产妇女构成的高危群体中最为明显。因此，有必要对这些高危人群量身定制的季节性预防策略进行评估。
Malaria remains one of the most important infectious diseases in pregnancy in sub-Saharan Africa. Whereas seasonal malaria chemoprevention is advocated as public health intervention for children in certain areas of highly seasonal malaria transmission, the impact of seasonality on malaria in pregnancy has not yet been investigated for stable, hyper-endemic transmission settings of Equatorial Africa. The aim of this study was to investigate the influence of seasonality on the prevalence of malaria in pregnancy in Gabon. The study was conducted at a rural district hospital in Gabon between January 2008 and December 2011. At first antenatal care visits demographic data, parity, age, and gestational age of pregnant women were documented and thick blood smears were performed for the diagnosis of malaria. Seasonality and established risk factors were evaluated in univariate and multivariate analysis for their association with Plasmodium falciparum infection. 1,661 pregnant women were enrolled in this study. Participants presenting during high transmission seasons were at significantly higher risk for P. falciparum infection compared to low transmission seasons (adjusted odds ratio [AOR] 1.91, 95% confidence interval [CI] 1.39-2.63, p < 0.001). Established risk factors including parity (AOR 0.45, CI 0.30-0.69, p < 0.001 for multipara versus paucipara) and age (AOR, CI and p-value for women aged 13–17, 18–22, 23–27 and ≥28 years, respectively: AOR 0.59, CI 0.40-0.88; AOR 0.57, CI 0.34-0.97; AOR 0.51, CI 0.29-0.91) were significant risk factors for P. falciparum infection. High-risk groups including nulli- and primipara and younger women aged 13–17 years showed a disproportionately increased risk for malaria in high transmission seasons from 17% to 64% prevalence in low and high transmission periods, respectively. Seasonal variations lead to important differences in the risk for P. falciparum infection in pregnancy in the setting of central African regions with stable and hyper-endemic malaria transmission. The seasonal increase in malaria in pregnancy is most pronounced in high-risk groups constituted by young and pauciparous women. The evaluation of tailored seasonal prevention strategies for these high-risk populations may, therefore, be warranted.
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影响因子：
168.9
作者：
Alloueche, A;Bailey, W;Winstanley, PA
通讯作者：
Winstanley, PA
DOI：
10.4269/ajtmh.2001.65.599
发表时间：
2001-11-01
影响因子：
3.3
作者：
Planche, T;Krishna, S;Kremsner, PG
通讯作者：
Kremsner, PG
DOI：
10.4269/ajtmh.1996.55.33
发表时间：
1996-01-01
影响因子：
3.3
作者：
Steketee, RW;Wirima, JJ;Breman, JG
通讯作者：
Breman, JG
DOI：
10.4269/ajtmh.2007.77.418
发表时间：
2007-09-01
影响因子：
3.3
作者：
Ramharter, Michael;Schuster, Katharina;Kremsner, Peter G.
通讯作者：
Kremsner, Peter G.
DOI：
10.1016/0035-9203(91)90205-d
发表时间：
1991-07-01
影响因子：
2.2
作者：
NOSTEN, F;TERKUILE, F;WHITE, NJ
通讯作者：
WHITE, NJ