Department of Zoology, University of Oxford, Oxford OX1 3PS, UK.
Malar J. 2009 Oct 28;8:245. doi: 10.1186/1475-2875-8-245.
The clinical presentation of pregnancy-associated malaria, or PAM, depends crucially on the particular epidemiological settings. This can potentially lead to an underestimation of its overall burden on the female population, especially in regions prone to epidemic outbreaks and where malaria transmission is generally low.
Here, by re-examining historical data, it is demonstrated how excess female mortality can be used to evaluate the burden of PAM. A simple mathematical model is then developed to highlight the contrasting signatures of PAM within the endemicity spectrum and to show how PAM is influenced by the intensity and stability of transmission.
Both the data and the model show that maternal malaria has a huge impact on the female population. This is particularly pronounced in low-transmission settings during epidemic outbreaks where excess female mortality/morbidity can by far exceed that of a similar endemic setting.
The results presented here call for active intervention measures not only in highly endemic regions but also, or in particular, in areas where malaria transmission is low and seasonal.
妊娠相关疟疾（PAM）的临床表现主要取决于特定的流行病学环境。这可能导致其对女性人群总体负担的低估，特别是在容易发生流行爆发和疟疾传播普遍较低的地区。
在这里，通过重新检查历史数据，证明了如何利用女性超额死亡率来评估 PAM 的负担。然后，开发了一个简单的数学模型，以突出 PAM 在流行范围中的对比特征，并展示 PAM 如何受到传播强度和稳定性的影响。
数据和模型都表明，母体疟疾对女性人口有巨大影响。在低传播环境中，特别是在流行爆发期间，这种影响更为明显，此时女性超额死亡率/发病率远远超过类似的流行环境。
这里提出的结果不仅呼吁在高度流行地区采取积极的干预措施，而且还呼吁在疟疾传播低且季节性的地区采取干预措施。
