孕期疟疾预防：评估通过贝宁国家政策实施 IPTp 分布的效果。
Prevention of malaria during pregnancy: assessing the effect of the distribution of IPTp through the national policy in Benin.
机构信息
Institut de Recherche pour le Développement (IRD), UMR216, Mère et Enfant Face aux Infections Tropicales, Paris, France.
出版信息
Am J Trop Med Hyg. 2011 Feb;84(2):270-5. doi: 10.4269/ajtmh.2011.10-0319.
Abstract
The efficiency of malaria prevention during pregnancy was compared between three studies in Benin for malaria infection of the placenta (MIP) and low birth weight (LBW). The first was carried out when chloroquine prophylaxis was still recommended, the second was an intermittent preventive treatment in pregnancy (IPTp) clinical trial comparing sulfadoxine pyrimetamine (SP) versus mefloquine, and the third was an observational study after SP-IPTp national implementation. We showed an association between the use of IPTp and the reduction of LBW (10% with national IPTp and 8.7% in IPTp trial versus 15.7% in pre-trial study). The effect on MIP was better in the trial (2.9% versus 11.2% and 16.7% for national IPTp and pre-trial studies, respectively). In spite of a good overall compliance with the national IPTp (with 84% of women taking at least one dose of SP), there are still failures in adherence to the directly observed therapy (DOT) scheme and needs for better training of health staff.
摘要
本研究比较了贝宁的三项研究在预防孕妇疟疾方面的效率，以评估胎盘疟疾感染（MIP）和低出生体重（LBW）的预防效果。第一项研究是在氯喹预防仍被推荐使用时进行的，第二项是比较磺胺多辛-乙胺嘧啶（SP）与甲氟喹的间歇性预防治疗在妊娠期间的临床试验（IPTp），第三项是 SP-IPTp 国家实施后的观察性研究。我们发现 IPTp 的使用与 LBW 减少之间存在关联（全国性 IPTp 组为 10%，IPTp 试验组为 8.7%，而预试验组为 15.7%）。试验中 MIP 的效果更好（全国性 IPTp 组为 2.9%，预试验组为 11.2%和 16.7%）。尽管全国性 IPTp 的总体依从性良好（84%的妇女至少接受了一次 SP 治疗），但在直接观察治疗（DOT）方案的依从性方面仍存在失败，需要更好地培训卫生工作人员。
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