Intermittent preventive treatment in pregnant women is associated with increased risk of severe malaria in their offspring.
Intermittent preventive treatment in pregnant women is associated with increased risk of severe malaria in their offspring.
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DOI：
10.1371/journal.pone.0056183
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Duffy PE
中科院分区：
文献类型：
--
作者：
Harrington WE;Morrison R;Fried M;Duffy PE
在磺胺类耐药广泛的地区，孕期间歇治疗(IPTp)无法预防胎盘疟疾(PM)，并可能加剧耐药感染。因为PM预测婴儿对寄生虫血症的易感性增加，我们假设IPTp也会增加子代对疟疾感染和疾病的易感性。在坦桑尼亚东北部的一个出生队列中，我们评估了母体使用IPTp与子代寄生虫血症和严重疟疾风险之间的关系。使用COX比例风险模型和广义估计方程，我们评估了IPTp对整个队列和按分娩时PM状态分层的子组的影响。接受IPTP治疗的PM+妇女的后代首次寄生虫血症的时间呈剂量依赖性减少(AHR = 2.13，p = 0.04[95%CI：1.04，4.38])。在所有子代中，IPTp与较早的首次严重疟疾发病相关(AHR = 2.32，p = 0.0 2[95%CI：1.12，4.78])，并增加了严重疟疾的总体风险(AOR = 2.31，p = 0.0 3[95%CI：1.0 9，4.88])。IPTp方案的成本效益分析除了考虑妊娠结局外，还应考虑对后代的长期影响。
In areas of widespread sulfadoxine-pyrimethamine resistance, intermittent treatment in pregnancy (IPTp) fails to prevent placental malaria (PM) and may exacerbate drug resistant infections. Because PM predicts increased susceptibility to parasitemia during infancy, we hypothesized that IPTp would also increase susceptibility to malaria infection and disease in the offspring. In a birth cohort from NE Tanzania, we evaluated the association between maternal IPTp use and risk of parasitemia and severe malaria in the offspring. Using Cox Proportional Hazards Models as well as Generalized Estimating Equations, we evaluated the effects of IPTp on the entire cohort and on subgroups stratified by PM status at delivery. Offspring of PM+ women who received IPTp had a dose-dependent decrease in time to first parasitemia (AHR = 2.13, p = 0.04 [95%CI: 1.04, 4.38]). Among all offspring, IPTp was associated with earlier first severe malaria episode (AHR = 2.32, p = 0.02 [95%CI: 1.12, 4.78]) as well as increased overall odds of severe malaria (AOR = 2.31, p = 0.03 [95%CI: 1.09, 4.88]). Cost-benefit analyses of IPTp regimens should consider the long term effects on offspring in addition to pregnancy outcomes.
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影响因子：
56.9
作者：
Fried, M;Duffy, PE
通讯作者：
Duffy, PE
影响因子：
15.8
作者：
Muehlenbachs, Atis;Mutabingwa, Theonest K.;Duffy, Patrick E.
通讯作者：
Duffy, Patrick E.
影响因子：
3.1
作者：
Staalsoe, T;Shulman, CE;Hviid, L
通讯作者：
Hviid, L
DOI：
10.1073/pnas.0901415106
发表时间：
2009-06-02
影响因子：
11.1
作者：
Harrington, W. E.;Mutabingwa, T. K.;Duffy, P. E.
通讯作者：
Duffy, P. E.
DOI：
10.1186/cc2183
发表时间：
2003-08
期刊：
Critical care (London, England)
影响因子：
--
作者：
Trampuz A;Jereb M;Muzlovic I;Prabhu RM
通讯作者：
Prabhu RM