Quantifying the Number of Pregnancies at Risk of Malaria in 2007: A Demographic Study
Quantifying the Number of Pregnancies at Risk of Malaria in 2007: A Demographic Study
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DOI：
10.1371/journal.pmed.1000221
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发表时间：
2010-01-01
期刊：
影响因子：
15.8
通讯作者：
ter Kuile, Feiko O.
中科院分区：
文献类型：
--
作者：
Dellicour, Stephanie;Tatem, Andrew J.;ter Kuile, Feiko O.
背景：目前无法对面临疟疾风险的怀孕人数进行全面和当代的估计，特别是对于非洲以外的流行地区。我们对 2007 年恶性疟原虫和间日疟传播地区怀孕妇女人数进行了估计。方法和结果：最近出版的恶性疟原虫传播全球限制图和更新的间日疟原虫传播限制图与网格人口数据和增长率相结合，估计了 2007 年面临疟疾风险的总人口。来自联合国的具体国家人口数据 使用年龄、性别和总生育率来估计育龄妇女人数和年活产率。对人工流产数量和特定国家死产率的次区域估计是从最近发表的评论中获得的。流产数量是根据活产数量估算的，并根据人工流产率进行校正。然后，将临床认可的高危妊娠人数计算为 2007 年高危人群中活产数、人工流产数、自然流产数和死产数的总和。2007 年，恶性疟原虫和/或间日疟原虫传播地区发生了 1.252 亿人怀孕，导致 8260 万人活产。其中包括世界卫生组织 (WHO) 东南亚 (SEARO) 和西太平洋 (WPRO) 区域办事处、非洲 (AFRO)、欧洲和东地中海 (EURO/EMRO) 以及美洲 (AMRO) 区域办事处所属国家的怀孕人数分别为 77.4、30.3、13.1 和 430 万。在恶性疟原虫传播地区的 8530 万人中，5470 万人发生在传播稳定地区，3060 万人发生在传播不稳定地区（临床发病率，每 10,000 人中有 1 人/年）； 9 290 万人发生在有间日疟传播的地区，其中 5 300 万人发生在恶性疟和间日疟共存的地区，3 990 万人发生在仅有间日疟传播的温带地区。结论：2007 年，恶性疟原虫疟疾稳定地区发生了 5 470 万人怀孕，另有 7 050 万人发生在疟疾极低地区。疟疾传播或间日疟原虫传播 仅有的。这些代表了对面临恶性疟和间日疟疾风险的妊娠数量全球分布的首次当代估计，并为更明智地估计妊娠期疟疾感染率的地理分布和相应的疾病负担提供了第一步。
Background: Comprehensive and contemporary estimates of the number of pregnancies at risk of malaria are not currently available, particularly for endemic areas outside of Africa. We derived global estimates of the number of women who became pregnant in 2007 in areas with Plasmodium falciparum and P. vivax transmission.Methods and Findings: A recently published map of the global limits of P. falciparum transmission and an updated map of the limits of P. vivax transmission were combined with gridded population data and growth rates to estimate total populations at risk of malaria in 2007. Country-specific demographic data from the United Nations on age, sex, and total fertility rates were used to estimate the number of women of child-bearing age and the annual rate of live births. Subregional estimates of the number of induced abortions and country-specific stillbirths rates were obtained from recently published reviews. The number of miscarriages was estimated from the number of live births and corrected for induced abortion rates. The number of clinically recognised pregnancies at risk was then calculated as the sum of the number of live births, induced abortions, spontaneous miscarriages, and stillbirths among the population at risk in 2007. In 2007, 125.2 million pregnancies occurred in areas with P. falciparum and/or P. vivax transmission resulting in 82.6 million live births. This included 77.4, 30.3, 13.1, and 4.3 million pregnancies in the countries falling under the World Health Organization (WHO) regional offices for South-East-Asia (SEARO) and the Western-Pacific (WPRO) combined, Africa (AFRO), Europe and the Eastern Mediterranean (EURO/EMRO), and the Americas (AMRO), respectively. Of 85.3 million pregnancies in areas with P. falciparum transmission, 54.7 million occurred in areas with stable transmission and 30.6 million in areas with unstable transmission (clinical incidence,1 per 10,000 population/year); 92.9 million occurred in areas with P. vivax transmission, 53.0 million of which occurred in areas in which P. falciparum and P. vivax co-exist and 39.9 million in temperate regions with P. vivax transmission only.Conclusions: In 2007, 54.7 million pregnancies occurred in areas with stable P. falciparum malaria and a further 70.5 million in areas with exceptionally low malaria transmission or with P. vivax only. These represent the first contemporary estimates of the global distribution of the number of pregnancies at risk of P. falciparum and P. vivax malaria and provide a first step towards a more informed estimate of the geographical distribution of infection rates and the corresponding disease burden of malaria in pregnancy.