Holtz Timothy H, Kachur S Patrick, Roberts Jacquelin M, Marum Lawrence H, Mkandala Christopher, Chizani Nyson, Macheso Allan, Parise Monica E
Malaria Epidemiology Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Trop Med Int Health. 2004 Jan;9(1):77-82. doi: 10.1046/j.1365-3156.2003.01170.x.
Malaria in pregnancy contributes to low birth weight and increased infant mortality. As part of WHO's Roll Back Malaria initiative, African heads of state pledged that by 2005, 60% of pregnant women will receive malaria chemoprophylaxis or intermittent preventive treatment (IPT). We performed a cluster sample survey to study the use of sulfadoxine-pyrimethamine (SP) for IPT among recently pregnant women in February 2000 in Blantyre District, Malawi. Among 391 women in the sample, 98.6% had attended antenatal clinic at least once and 90.2% knew that SP/IPT was recommended during pregnancy. Overall, only 36.8% received the full recommended two-dose regimen of SP/IPT. Using data from 187 women with antenatal clinic cards, we found that residence location, housing type and gender/age/education of the head of household were not associated with failure to receive SP/IPT. Adjusting for education, multigravid women were more likely not to receive the recommended SP/IPT regimen (RR 1.2, 95% CI 1.02-1.5, P=0.03). A substantial effort to improve the delivery and use of SP/IPT in Malawi will be necessary, but the Roll Back Malaria 2005 goal appears achievable.
孕期疟疾会导致低出生体重并增加婴儿死亡率。作为世卫组织“遏制疟疾”倡议的一部分，非洲国家元首承诺，到2005年，60%的孕妇将接受疟疾化学预防或间歇性预防治疗（IPT）。2000年2月，我们在马拉维布兰太尔区对近期怀孕的妇女进行了一项整群抽样调查，以研究使用周效磺胺-乙胺嘧啶（SP）进行IPT的情况。在样本中的391名妇女中，98.6%至少去过一次产前诊所，90.2%知道孕期推荐使用SP/IPT。总体而言，只有36.8%的妇女接受了推荐的完整两剂次SP/IPT治疗方案。利用187名持有产前诊所卡片妇女的数据，我们发现居住地点、住房类型以及户主的性别/年龄/教育程度与未接受SP/IPT无关。在对教育程度进行校正后，经产妇更有可能未接受推荐的SP/IPT治疗方案（相对危险度1.2，95%可信区间1.02 - 1.5，P = 0.03）。在马拉维，有必要做出重大努力来改善SP/IPT的提供和使用情况，但“遏制疟疾”2005年目标似乎是可以实现的。
