Ouma Peter, van Eijk Anna M, Hamel Mary J, Parise Monica, Ayisi John G, Otieno Kephas, Kager Piet A, Slutsker Laurence
Centre for Vector Biology and Control Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.
Trop Med Int Health. 2007 Dec;12(12):1515-23. doi: 10.1111/j.1365-3156.2007.01960.x.
To determine the prevalence of malaria and anaemia among urban and peri-urban women attending their first antenatal clinic (ANC) in an area of perennial malaria transmission.
Between November 2003 and May 2004 we screened first ANC attenders for malaria and anaemia in a large urban hospital in Kisumu (western Kenya) and interviewed them to obtain demographic and medical information.
Among the 685 study participants, prevalence of malaria parasitaemia was 18.0%, prevalence of any anaemia (haemoglobin < 11 g/dl) was 69.1% and prevalence of moderate anaemia was (haemoglobin < 8 g/dl) 11.8%. Sixteen women were hospitalized during pregnancy, eight because of malaria. In multivariate analysis, young age, living in a house with mud walls, a visit to rural area, peri-urban residence, second trimester of pregnancy and Luo ethnicity were significant risk factors for malaria parasitaemia. Malaria was an important risk factor for any and moderate anaemia; use of an insecticide-treated net (ITN) was a protective factor for any anaemia. Married women with a higher level of education, better-quality housing and full-time employment were more likely to use an ITN.
Malaria and anaemia are established problems by the time of the first ANC visit. Mechanisms to deliver ITNs to women of child-bearing age before they become pregnant need to be explored. Early ANC visits are warranted in order for women to benefit from policies aimed at reducing the burden of malaria and anaemia.
确定在常年有疟疾传播的地区，首次前往产前诊所（ANC）就诊的城市及城郊孕妇中疟疾和贫血的患病率。
2003年11月至2004年5月期间，我们在基苏木（肯尼亚西部）的一家大型城市医院对首次前来ANC就诊的孕妇进行疟疾和贫血筛查，并对她们进行访谈以获取人口统计学和医学信息。
在685名研究参与者中，疟原虫血症患病率为18.0%，任何贫血（血红蛋白<11 g/dl）的患病率为69.1%，中度贫血（血红蛋白<8 g/dl）的患病率为11.8%。16名女性在孕期住院，其中8名是因为疟疾。多因素分析显示，年轻、居住在泥墙房屋、去过农村地区、城郊居住、妊娠中期以及卢奥族是疟原虫血症的重要危险因素。疟疾是导致任何贫血和中度贫血的重要危险因素；使用经杀虫剂处理的蚊帐（ITN）是预防任何贫血的保护因素。受教育程度较高、住房条件较好且全职工作的已婚女性更有可能使用ITN。
在首次进行ANC就诊时，疟疾和贫血已是既定问题。需要探索在育龄妇女怀孕前为其提供ITN的机制。有必要尽早进行ANC就诊，以便妇女能够受益于旨在减轻疟疾和贫血负担的政策。
