Muhangi Lawrence, Woodburn Patrick, Omara Mildred, Omoding Nicholas, Kizito Dennison, Mpairwe Harriet, Nabulime Juliet, Ameke Christine, Morison Linda A, Elliott Alison M
MRC/UVRI Uganda Research Unit on AIDS, Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda.
Trans R Soc Trop Med Hyg. 2007 Sep;101(9):899-907. doi: 10.1016/j.trstmh.2007.03.017. Epub 2007 Jun 6.
It is suggested that helminths, particularly hookworm and schistosomiasis, may be important causes of anaemia in pregnancy. We assessed the associations between mild-to-moderate anaemia (haemoglobin >8.0 g/dl and <11.2 g/dl) and helminths, malaria and HIV among 2507 otherwise healthy pregnant women at enrolment to a trial of deworming in pregnancy in Entebbe, Uganda. The prevalence of anaemia was 39.7%. The prevalence of hookworm was 44.5%, Mansonella perstans 21.3%, Schistosoma mansoni 18.3%, Strongyloides 12.3%, Trichuris 9.1%, Ascaris 2.3%, asymptomatic Plasmodium falciparum parasitaemia 10.9% and HIV 11.9%. Anaemia showed little association with the presence of any helminth, but showed a strong association with malaria (adjusted odds ratio (AOR) 3.22, 95% CI 2.43-4.26) and HIV (AOR 2.46, 95% CI 1.90-3.19). There was a weak association between anaemia and increasing hookworm infection intensity. Thus, although highly prevalent, helminths showed little association with mild-to-moderate anaemia in this population, but HIV and malaria both showed a strong association. This result may relate to relatively good nutrition and low helminth infection intensity. These findings are pertinent to estimating the disease burden of helminths and other infections in pregnancy. [Clinical Trial No. ISRCTN32849447].
有人认为,蠕虫,尤其是钩虫和血吸虫病,可能是妊娠期贫血的重要原因。我们在乌干达恩德培进行的一项妊娠期驱虫试验中,对2507名其他方面健康的孕妇进行了入组时的评估,以研究轻度至中度贫血(血红蛋白>8.0 g/dl且<11.2 g/dl)与蠕虫、疟疾和艾滋病毒之间的关联。贫血患病率为39.7%。钩虫患病率为44.5%,常现曼森线虫为21.3%,曼氏血吸虫为18.3%,粪类圆线虫为12.3%,鞭虫为9.1%,蛔虫为2.3%,无症状恶性疟原虫血症为10.9%,艾滋病毒为11.9%。贫血与任何蠕虫的存在几乎没有关联,但与疟疾(校正比值比(AOR)3.22,95%可信区间2.43 - 4.26)和艾滋病毒(AOR 2.46,95%可信区间1.90 - 3.19)有很强的关联。贫血与钩虫感染强度增加之间存在弱关联。因此,尽管蠕虫感染率很高,但在该人群中,蠕虫与轻度至中度贫血几乎没有关联,而艾滋病毒和疟疾均显示出很强的关联。这一结果可能与相对良好的营养状况和较低的蠕虫感染强度有关。这些发现对于估计妊娠期蠕虫和其他感染的疾病负担具有重要意义。[临床试验编号:ISRCTN32849447]