Non-falciparum malaria infections in pregnant women in West Africa.
Non-falciparum malaria infections in pregnant women in West Africa.
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DOI：
10.1186/s12936-016-1092-1
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发表时间：
2016-01-29
期刊：
影响因子：
3
通讯作者：
Chandramohan D
中科院分区：
文献类型：
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作者：
Williams J;Njie F;Cairns M;Bojang K;Coulibaly SO;Kayentao K;Abubakar I;Akor F;Mohammed K;Bationo R;Dabira E;Soulama A;Djimdé M;Guirou E;Awine T;Quaye SL;Ordi J;Doumbo O;Hodgson A;Oduro A;Magnussen P;Ter Kuile FO;Woukeu A;Milligan P;Tagbor H;Greenwood B;Chandramohan D
非恶性疟原虫疟疾感染在撒哈拉以南非洲的许多地区都有发现，但人们对其在怀孕中的重要性知之甚少。在布基纳法索、冈比亚、加纳和马里进行的妊娠期疟疾间歇性筛查和治疗（ISTp）与间歇性预防性治疗（IPTp）试验中，从2526名妇女首次产前门诊就诊时采集血样。从血斑中提取DNA，并使用巢式PCR试验检测恶性疟原虫、间日疟原虫、三日疟原虫和卵形疟原虫。对非恶性疟疾感染的危险因素进行了调查，并确定了这些感染对妊娠结局的影响。经常检测到恶性疟原虫感染（PCR法总体患病率：38.8%，[95% CI 37.0，40.8]），患病率范围从冈比亚的10.8%到加纳的56.1%。非恶性疟疾感染很少发现（总患病率1.39%[95%CI 1.00，1.92]），范围从冈比亚的0.17%到马里的3.81%。发现10例非恶性疟单一感染和25例恶性疟和非恶性疟混合感染，三日疟原虫是最常见的非恶性疟感染，间日疟原虫仅在马里发现。通过显微镜或快速诊断测试，仅检测到四例非恶性疟原虫单一感染。雨季后期招募和社会经济地位低下与非恶性疟疾和恶性疟疾风险增加有关。妊娠结局在非恶性疟疾感染的妇女和首次产前护理时未感染疟疾的妇女之间没有差异。非恶性疟原虫感染在所研究的人群中并不常见，当作为单一感染存在时很少被检测到，并且由于感染非恶性疟原虫寄生虫的妇女人数很少，因此不太可能对所研究社区的妊娠结局产生重要影响。
Non-Plasmodium falciparum malaria infections are found in many parts of sub-Saharan Africa but little is known about their importance in pregnancy. Blood samples were collected at first antenatal clinic attendance from 2526 women enrolled in a trial of intermittent screening and treatment of malaria in pregnancy (ISTp) versus intermittent preventive treatment (IPTp) conducted in Burkina Faso, The Gambia, Ghana and Mali. DNA was extracted from blood spots and tested for P. falciparum, Plasmodium vivax, Plasmodium malariae and Plasmodium ovale using a nested PCR test. Risk factors for a non-falciparum malaria infection were investigated and the influence of these infections on the outcome of pregnancy was determined. P. falciparum infection was detected frequently (overall prevalence by PCR: 38.8 %, [95 % CI 37.0, 40.8]), with a prevalence ranging from 10.8 % in The Gambia to 56.1 % in Ghana. Non-falciparum malaria infections were found only rarely (overall prevalence 1.39 % [95 % CI 1.00, 1.92]), ranging from 0.17 % in the Gambia to 3.81 % in Mali. Ten non-falciparum mono-infections and 25 mixed falciparum and non-falciparum infections were found. P. malariae was the most frequent non-falciparum infection identified; P. vivax was detected only in Mali. Only four of the non-falciparum mono-infections were detected by microscopy or rapid diagnostic test. Recruitment during the late rainy season and low socio-economic status were associated with an increased risk of non-falciparum malaria as well as falciparum malaria. The outcome of pregnancy did not differ between women with a non-falciparum malaria infection and those who were not infected with malaria at first ANC attendance. Non-falciparum infections were infrequent in the populations studied, rarely detected when present as a mono-infection and unlikely to have had an important impact on the outcome of pregnancy in the communities studied due to the small number of women infected with non-falciparum parasites.