Ndyomugyenyi R, Magnussen P
Ministry of Health, Vector Control Division, Kampala, Uganda.
Ann Trop Med Parasitol. 2000 Dec;94(8):759-68; discussion 769-70. doi: 10.1080/00034980020015189.
A randomized, double-blind, placebo-controlled trial, which compared the effects of three interventions (weekly chloroquine prophylaxis, daily iron and weekly folic-acid supplementation, and case management of malaria) on congenital malaria, maternal haemoglobin (Hb) and foetal outcome, was conducted among primigravidae resident in Hoima district, Uganda. Among 473 babies examined at birth or within 7 days of birth, 198 (42%) were parasitaemic, the level of parasitaemia in an infant being strongly correlated with those of placental (P< 0.01) and maternal, peripheral parasitaemia (P < 0.01). However, 33 (17%) of the parasitaemic babies were born to mothers who had placental but not peripheral parasitaemia, 22 (11%) to mothers who had peripheral but not placental parasitaemia, and 12 (6%) to mothers with neither peripheral nor placental parasitaemia. Overall, 163 babies were each examined for malarial parasites at birth and 1 month later. Of the 76 (47%) found to have parasitaemia at birth, 37 (23%) appeared aparasitaemic at the 1-month follow-up but 28 (17%) were still parasitaemic at that time. Among the babies born to the mothers who only received case management of malaria during pregnancy, parasitaemia at birth was associated with infant anaemia at birth (i.e. < 140 g Hb/litre; P = 0.03). Infants found to be parasitaemic at the 1-month follow-up had lower mean concentrations of Hb at that time than their aparasitaemic counterparts (P= 0.03). Parasitaemia at birth was not significantly associated with low birthweight, in any of three intervention groups. The intervention given to the mother had no significant effect on the parasitaemia of her baby, either at birth or at the age of 1 month. Congenital malaria per se may have little influence on birthweight but may have an impact on infant anaemia. In conclusion, congenital parasitaemia was not associated with birthweight, but was related to anaemia at birth in infants born to women who had only received active case management during their pregnancies.
在乌干达霍伊马区居住的初产妇中进行了一项随机、双盲、安慰剂对照试验，比较了三种干预措施（每周氯喹预防、每日铁剂和每周叶酸补充以及疟疾病例管理）对先天性疟疾、孕产妇血红蛋白（Hb）和胎儿结局的影响。在473名出生时或出生后7天内接受检查的婴儿中，198名（42%）有寄生虫血症，婴儿的寄生虫血症水平与胎盘（P<0.01）和母亲外周血寄生虫血症水平（P<0.01）密切相关。然而，33名（17%）有寄生虫血症的婴儿的母亲有胎盘寄生虫血症但外周血无寄生虫血症，22名（11%）婴儿的母亲外周血有寄生虫血症但胎盘无寄生虫血症，12名（6%）婴儿的母亲外周血和胎盘均无寄生虫血症。总体而言，163名婴儿在出生时和1个月后分别接受了疟原虫检查。在出生时发现有寄生虫血症的76名（47%）婴儿中，37名（23%）在1个月随访时似乎无寄生虫血症，但仍有28名（17%）在那时仍有寄生虫血症。在孕期仅接受疟疾病例管理的母亲所生的婴儿中，出生时的寄生虫血症与出生时婴儿贫血相关（即Hb<140g/升；P=0.03）。在1个月随访时发现有寄生虫血症的婴儿，其当时的Hb平均浓度低于无寄生虫血症的婴儿（P=0.03）。在三个干预组中的任何一组中，出生时的寄生虫血症与低出生体重均无显著关联。给予母亲的干预措施对其婴儿出生时或1个月龄时的寄生虫血症均无显著影响。先天性疟疾本身可能对出生体重影响不大，但可能对婴儿贫血有影响。总之，先天性寄生虫血症与出生体重无关，但与孕期仅接受积极病例管理的妇女所生婴儿的出生时贫血有关。
