Asa O O, Onayade A A, Fatusi A O, Ijadunola K T, Abiona T C
Department of Community Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
Matern Child Health J. 2008 Nov;12(6):692-8. doi: 10.1007/s10995-008-0319-3. Epub 2008 Feb 15.
To evaluate the efficacy of intermittent preventive treatment of malaria using sulphadoxine-pyrimethamine (SP) in the prevention of anaemia in women of low parity in a low socio-economic, malaria endemic setting.
The study design was an open randomized control trial comparing anaemia incidence among pregnant women on intermittent presumptive treatment of malaria with SP with those on chloroquine (CQ). A total of 352 primigravid and secondigravid women between 16 and 30 weeks gestation receiving antenatal care at the Primary Health Care Center, Enuwa in Ile-Ife, Osun State, Nigeria were serially recruited and randomly allocated into experimental and control groups of 176 each. The experimental group received SP (to a maximum of three doses depending on the gestational age at enrollment into the study) while the control group had treatment doses of CQ at recruitment and subsequently only if they had symptoms suggestive of malaria. The primary outcome measure was anaemia (haematocrit<30) at 34 weeks of gestation.
At recruitment and 34 weeks gestation, there was no statistically significant difference between the experimental and control group in terms of socio-demographic characteristics and past medical history. Thirty-three (22.6%) and 52 (37.1%) women in the study and control groups, respectively, had anaemia (protective efficacy 49.5%, p=0.01). With multivariate analysis, controlling for the possible confounding effects of education, parity, haemoglobin level at booking and malaria parasitaemia in peripheral blood, the difference in the incidence of anaemia in the two groups remained significant (p=0.01; odds ratio=0.5; 95% confidence interval=0.29-0.85).
The IPT regime with sulphadoxine-pyrimethamine is an effective, practicable strategy to decrease risk of anaemia in women of low parity residing in areas endemic for malaria.
评估在社会经济水平较低、疟疾流行地区，使用周效磺胺 - 乙胺嘧啶（SP）进行疟疾间歇性预防治疗对低生育次数女性贫血的预防效果。
本研究设计为开放性随机对照试验，比较接受SP间歇性疟疾推定治疗的孕妇与接受氯喹（CQ）治疗的孕妇的贫血发生率。在尼日利亚奥孙州伊费市埃努瓦初级卫生保健中心接受产前护理的16至30周妊娠的352名初产妇和经产妇被连续招募，并随机分为实验组和对照组，每组各176名。实验组接受SP治疗（根据入组时的孕周最多服用三剂），而对照组在招募时接受CQ治疗剂量，随后仅在出现疟疾症状时进行治疗。主要结局指标为妊娠34周时的贫血（血细胞比容<30）。
在招募时和妊娠34周时，实验组和对照组在社会人口学特征和既往病史方面无统计学显著差异。研究组和对照组分别有33名（22.6%）和52名（37.1%）女性患有贫血（保护效力为49.5%，p = 0.01）。通过多变量分析，控制教育程度、生育次数、登记时的血红蛋白水平和外周血疟疾寄生虫血症的可能混杂效应后，两组贫血发生率的差异仍然显著（p = 0.01；优势比 = 0.5；95%置信区间 = 0.29 - 0.85）。
使用周效磺胺 - 乙胺嘧啶的间歇性预防治疗方案是降低疟疾流行地区低生育次数女性贫血风险的有效、可行策略。
