Bouyou-Akotet Marielle K, Ionete-Collard Denisa E, Mabika-Manfoumbi Modeste, Kendjo Eric, Matsiegui Pierre-Blaise, Mavoungou Elie, Kombila Maryvonne
Département de Parasitologie, Mycologie, Médecine Tropicale, Université des Sciences de la Santé, Libreville, Gabon.
Malar J. 2003 Jun 25;2:18. doi: 10.1186/1475-2875-2-18.
In areas where malaria is endemic, pregnancy is associated with increased susceptibility to malaria. It is generally agreed that this risk ends with delivery and decreases with the number of pregnancies. Our study aimed to demonstrate relationships between malarial parasitaemia and age, gravidity and anaemia in pregnant women in Libreville, the capital city of Gabon.
Peripheral blood was collected from 311 primigravidae and women in their second pregnancy. Thick blood smears were checked, as were the results of haemoglobin electrophoresis. We also looked for the presence of anaemia, fever, and checked whether the volunteers had had chemoprophylaxis. The study was performed in Gabon where malaria transmission is intense and perennial.
A total of 177 women (57%) had microscopic parasitaemia; 139 (64%)of them were primigravidae, 38 (40%) in their second pregnancy and 180 (64%) were teenagers. The parasites densities were also higher in primigravidae and teenagers. The prevalence of anaemia was 71% and was associated with microscopic Plasmodium falciparum parasitaemia: women with moderate or severe anaemia had higher parasite prevalences and densities. However, the sickle cell trait, fever and the use of chemoprophylaxis did not have a significant association with the presence of P. falciparum.
These results suggest that the prevalence of malaria and the prevalence of anaemia, whether associated with malaria or not, are higher in pregnant women in Gabon. Primigravidae and young pregnant women are the most susceptible to infection. It is, therefore, urgent to design an effective regimen of malaria prophylaxis for this high risk population.
在疟疾流行地区，妊娠与疟疾易感性增加有关。人们普遍认为这种风险在分娩后结束，且随着妊娠次数的增加而降低。我们的研究旨在证明加蓬首都利伯维尔孕妇的疟原虫血症与年龄、妊娠次数和贫血之间的关系。
采集了311名初产妇和经产妇的外周血。检查了厚血涂片以及血红蛋白电泳结果。我们还检查了是否存在贫血、发热情况，并询问志愿者是否进行过化学预防。该研究在疟疾传播强烈且常年存在的加蓬进行。
共有177名女性（57%）有镜检疟原虫血症；其中139名（64%）为初产妇，38名（40%）为经产妇，180名（64%）为青少年。初产妇和青少年的寄生虫密度也更高。贫血患病率为71%，且与镜检恶性疟原虫血症相关：中度或重度贫血的女性寄生虫患病率和密度更高。然而，镰状细胞性状、发热和化学预防的使用与恶性疟原虫的存在没有显著关联。
这些结果表明，加蓬孕妇中疟疾患病率以及贫血患病率（无论是否与疟疾相关）都较高。初产妇和年轻孕妇最易感染。因此，迫切需要为这一高危人群设计一种有效的疟疾预防方案。
