Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK.
PLoS Med. 2010 Jan 26;7(1):e1000221. doi: 10.1371/journal.pmed.1000221.
Comprehensive and contemporary estimates of the number of pregnancies at risk of malaria are not currently available, particularly for endemic areas outside of Africa. We derived global estimates of the number of women who became pregnant in 2007 in areas with Plasmodium falciparum and P. vivax transmission.
A recently published map of the global limits of P. falciparum transmission and an updated map of the limits of P. vivax transmission were combined with gridded population data and growth rates to estimate total populations at risk of malaria in 2007. Country-specific demographic data from the United Nations on age, sex, and total fertility rates were used to estimate the number of women of child-bearing age and the annual rate of live births. Subregional estimates of the number of induced abortions and country-specific stillbirths rates were obtained from recently published reviews. The number of miscarriages was estimated from the number of live births and corrected for induced abortion rates. The number of clinically recognised pregnancies at risk was then calculated as the sum of the number of live births, induced abortions, spontaneous miscarriages, and stillbirths among the population at risk in 2007. In 2007, 125.2 million pregnancies occurred in areas with P. falciparum and/or P. vivax transmission resulting in 82.6 million live births. This included 77.4, 30.3, 13.1, and 4.3 million pregnancies in the countries falling under the World Health Organization (WHO) regional offices for South-East-Asia (SEARO) and the Western-Pacific (WPRO) combined, Africa (AFRO), Europe and the Eastern Mediterranean (EURO/EMRO), and the Americas (AMRO), respectively. Of 85.3 million pregnancies in areas with P. falciparum transmission, 54.7 million occurred in areas with stable transmission and 30.6 million in areas with unstable transmission (clinical incidence <1 per 10,000 population/year); 92.9 million occurred in areas with P. vivax transmission, 53.0 million of which occurred in areas in which P. falciparum and P. vivax co-exist and 39.9 million in temperate regions with P. vivax transmission only.
In 2007, 54.7 million pregnancies occurred in areas with stable P. falciparum malaria and a further 70.5 million in areas with exceptionally low malaria transmission or with P. vivax only. These represent the first contemporary estimates of the global distribution of the number of pregnancies at risk of P. falciparum and P. vivax malaria and provide a first step towards a more informed estimate of the geographical distribution of infection rates and the corresponding disease burden of malaria in pregnancy.
目前尚无疟疾风险妊娠数量的综合和现代估计数，特别是在非洲以外的流行地区。我们对 2007 年在有恶性疟原虫和间日疟原虫传播的地区怀孕的妇女数量进行了全球估计。
最近发表的恶性疟原虫传播全球范围图和更新的间日疟原虫传播范围图与网格化人口数据和增长率相结合，以估计 2007 年疟疾风险总人口。联合国关于年龄、性别和总生育率的特定国家人口统计数据用于估计育龄妇女数量和活产年增长率。最近发表的评论中获得了亚区域人工流产数量和特定国家死产率的估计数。流产数量是根据活产数量估计的，并对人工流产率进行了校正。然后，将风险妊娠的临床确诊妊娠数量计算为 2007 年风险人群中活产、人工流产、自然流产和死产数量的总和。2007 年，在有恶性疟原虫和/或间日疟原虫传播的地区发生了 1.252 亿例妊娠，导致 8260 万例活产。这包括在世界卫生组织（世卫组织）东南亚（SEARO）和西太平洋（WPRO）区域办事处、非洲（AFRO）、欧洲和东地中海（EURO/EMRO）以及美洲（AMRO）管辖的国家中，分别有 7740 万、3030 万、1310 万和 430 万妊娠。在有恶性疟原虫传播的地区，5470 万例妊娠发生在稳定传播地区，3060 万例发生在不稳定传播地区（临床发病率<每年每 10000 人 1 例）；在有间日疟原虫传播的地区，9290 万例妊娠发生，其中 5300 万例发生在恶性疟原虫和间日疟原虫共存的地区，3990 万例发生在间日疟原虫传播的温带地区。
2007 年，稳定的恶性疟原虫疟疾地区发生了 5470 万例妊娠，而疟疾传播率极低或仅有间日疟原虫的地区发生了另外 7050 万例妊娠。这是首次对全球范围内有恶性疟原虫和间日疟原虫风险妊娠数量的现代估计数，也是朝着更准确估计疟疾感染率的地理分布和妊娠疟疾相关疾病负担迈出的第一步。
Zotero 插件
