Clinical malaria among pregnant women on combined insecticide treated nets (ITNs) and intermittent preventive treatment (IPTp) with sulphadoxine-pyrimethamine in Yaounde, Cameroon.

Clinical malaria among pregnant women on combined insecticide treated nets (ITNs) and intermittent preventive treatment (IPTp) with sulphadoxine-pyrimethamine in Yaounde, Cameroon.
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DOI:
10.1186/1472-6874-14-68
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发表时间:
2014-05-16
期刊:
BMC women's health
影响因子:
--
通讯作者:
Tonye R
Tonye R
中科院分区:
其他
文献类型:
--
作者:
Mbu RE;Takang WA;Fouedjio HJ;Fouelifack FY;Tumasang FN;Tonye R

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疟疾仍然是孕妇和5岁以下儿童的负担。在喀麦隆,用磺胺嘧啶-乙胺嘧啶对孕妇进行间歇性预防性治疗已取代了预防性治疗,并加强了驱虫蚊帐领域的立法。尽管采取了所有这些措施,临床疟疾仍然是一个问题。我们比较了社会产科特征的妇女谁开发的临床疟疾和那些谁没有虽然在同一方案。一项在雅温得三级医院开展的5年嵌套队列研究(2007 - 2011年,含)。自愿接受参与研究的孕妇在预约时入组,并在妊娠18 - 20周、26-28周和32 - 34周之间给予三剂SP。那些发生临床疟疾的人被认为是病例,并与那些没有发生临床疟疾的人进行社会产科特征的比较。从两组妇女中抽取静脉血进行寄生虫密度估计和鉴定,所有临床病例均接受常规治疗。每组有166例病例,许多患临床疟疾的妇女年龄在15至19岁之间(OR 5.5,95%CI 3.9 - 5.3,p < 0.001)。低妊娠率(OR 6.5,95%CI 3.8 - 11.3,p < 0.001)和低产次(OR 4.6,95%CI 2.7 - 7.9,p < 0.001)。病例为单身女性(OR 4.58,95% CI 2.54 - 8.26,p < 0.001),仅受过小学教育(OR 4.6,95% CI 2.8 - 7.9,p < 0.001)。临床疟疾发病年龄在20 ~ 30周之间(OR 6.8,95% CI 4.1 ~ 11.7,p < 0.001)。第一剂和第二剂SP之间的时间在病例中长于10周(OR 5.5,95%CI 3.2 - 9.3,p < 0.001),并且寄生虫密度在病例中也较高(OR 6.9,95%CI 5.9 - 12.1,p < 0.001)。第一剂和第二剂SP之间的长时间间隔似乎是造成这些病例中临床疟疾的原因。
Malaria remains a burden for pregnant women and the under 5. Intermittent preventive treatment of pregnant women (IPTp) for malaria with sulfadoxine – pyrimethamine (SP) has since replaced prophylaxis and legislation has been reinforced in the area of insecticide treated mosquito nets (ITNs) in Cameroon. Clinical malaria despite all these measures remains a problem. We compared the socio-obstetrical characteristics of women who developed clinical malaria and those who did not though in the same regimen. A 5 – year nested cohort study (2007 – 2011 inclusive) at the tertiary level hospitals in Yaounde. Pregnant women who willingly accepted to participate in the study were enrolled at booking and three doses of SP were administered between 18 – 20 weeks of gestation, between 26–28 weeks and between 32 – 34 weeks. Those who developed clinical malaria were considered as cases and were compared for socio – obstetrical characteristics with those who did not. Venous blood was drawn from the women in both arms for parasite density estimation and identification and all the clinical cases were treated conventionally. Each arm had 166 cases and many women who developed clinical malaria were between 15 and 19 years (OR 5.5, 95% CI 3.9 – 5.3, p < 0.001). They were of low gravidity (OR 6.5, 95% CI 3.8 – 11.3, p < 0.001) as well as low parity (OR 4.6, 95% CI 2.7 – 7.9, p < 0.001). The cases were single women (OR 4.58, 95% CI 2.54 – 8.26, p < 0.001) and had attained only primary level of education (OR 4.6, 95% CI 2.8 – 7.9, p < 0.001). Gestational ages were between 20 to 30 weeks during clinical malaria (OR 6.8, 95% CI 4.1 – 11.7, p < 0.001). The time between the first and second dose of SP was longer than ten weeks in the cases (OR 5.5, 95% CI 3.2 – 9.3, p < 0.001) and parasite density was higher also among the cases (OR 6.9, 95% CI 5.9 – 12.1, p < 0.001). Long spacing between the first and second dose of SP seemed to be responsible for clinical malaria in the cases.
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