Effectiveness of intermittent preventive treatment with sulphadoxine-pyrimethamine for control of malaria in pregnancy in western Kenya: a hospital-based study
Effectiveness of intermittent preventive treatment with sulphadoxine-pyrimethamine for control of malaria in pregnancy in western Kenya: a hospital-based study
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DOI：
10.1111/j.1365-3156.2004.01196.x
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发表时间：
2004-03-01
影响因子：
3.3
通讯作者：
Nahlen, BL
中科院分区：
文献类型：
--
作者：
van Eijk, AM;Ayisi, JG;Nahlen, BL
目的监测间歇性预防性治疗（IPT）的有效性与磺胺嘧啶乙胺嘧啶（SP）控制疟疾在分娩时，在基苏穆，肯尼亚省医院，并评估IPT的影响，在参与者在队列study.METHODS在1999年6月和2000年6月之间，IPT和出生结果的信息收集在2302连续分娩。一组889名妇女，谁被招募在一个队列中，以评估疟疾和艾滋病毒之间的相互作用，分别进行了分析，因为入学标准和不同的访问到healthcare.RESULTS胎盘疟疾的患病率为13.8%，低出生体重（LBW）为12.2%。在多变量分析中，IPT（大于或等于1剂SP）与胎盘疟疾和LBW的减少相关[校正的比值比（OR）分别为0.56，95%置信区间（CI）0.39-0.83和0.65，95% CI 0.45-0.95]。对于SP给药次数的每次增加（大于或等于2次给药），观察到出生体重校正后平均增加61 g（95% CI 22-101 g）。IPT与HIV血清阴性女性的胎盘疟疾减少相关（OR 0.49，95%CI 0.28-0.86），但在HIV血清阳性女性中不显著（OR 0.45，95%CI 0.20-1.05）。一个显着的影响，对出生体重的参与者中无法检测到HIV-cohol.CONCLUSIONS这项评估证实，IPT与SP是有效的，减少胎盘疟疾和LBW。必须扩大因特网预防和治疗的覆盖面，并将因特网预防和治疗扩大到城市周边和农村地区的产前诊所。
OBJECTIVE To monitor the effectiveness of intermittent preventive treatment (IPT) with sulphadoxine-pyrimethamine (SP) for the control of malaria in pregnancy at delivery in the Provincial Hospital in Kisumu, Kenya, and to assess the effect of IPT in participants in a cohort study.METHODS Between June 1999 and June 2000, information on IPT and birth outcome was collected in 2302 consecutive deliveries. A group of 889 women, who were enrolled in a cohort to assess the interaction between malaria and HIV, were analysed separately because of the enrolment criteria and different access to health care.RESULTS The prevalence of placental malaria was 13.8% and of low birthweight (LBW) was 12.2%. In multivariable analysis, IPT (greater than or equal to1 dose of SP) was associated with a reduction in placental malaria and LBW [adjusted odds ratio (OR) 0.56, 95% confidence interval (CI) 0.39-0.83 and OR 0.65, 95% CI 0.45-0.95, respectively]. An adjusted mean increase in birthweight of 61 g was seen (95% CI 22-101 g) for each increment in number of SP doses (greater than or equal to2 doses grouped together). IPT was associated with a reduction in placental malaria in HIV-seronegative women (OR 0.49, 95% CI 0.28-0.86) but this was not significant among HIV-seropositive women (OR 0.45, 95% CI 0.20-1.05). A significant effect on birthweight could not be detected among participants in the HIV-cohort.CONCLUSIONS This evaluation confirms that IPT with SP is effective in reducing placental malaria and LBW. It will be important to increase coverage of IPT and to extend IPT to antenatal clinics in peri-urban and rural areas.