Faculty of Medicine, Kassala University, Sudan.
Parasit Vectors. 2011 May 23;4:88. doi: 10.1186/1756-3305-4-88.
Pregnant women are more susceptible to severe Plasmodium falciparum malaria, which can lead to poor maternal and fetal outcomes. Few data exist on the epidemiology of severe P. falciparum malaria in pregnant women.A hospital-based study was carried out to assess the pattern of severe P. falciparum malaria among pregnant women at the Kassala and Medani maternity hospitals, which are located in areas of unstable malaria transmission, in eastern and central Sudan, respectively. Pre-tested questionnaires were used to gather socio-demographic, clinical and obstetrical data. Suitable tests were performed for clinical and biochemical investigations.
Among 222 pregnant women diagnosed with malaria at the two hospitals, 40 (18.0%) women at mean (SD) gestational age of 29.3 (6.7) weeks fulfilled one or more of the WHO criteria for severe P. falciparum malaria. These were hypoglycaemia (14; 35.5%), severe anaemia (12; 30%), hypotension (10; 25%), jaundice (9; 22.5%), cerebral malaria (6; 15%), repeated convulsions (4; 10%), hyperparasitaemia (4; 10.0%) and more than one manifestation (9; 22.5%). While the mean (SD) presenting temperature was significantly lower for women presenting with hypoglycaemia [38.2(0.6) versus 38.8(0.7) °C, P = 0.04], other clinical and biochemical characteristics were not significantly different among women with different manifestations of severe P. falciparum malaria.
Preventive measures for pregnant women such as insecticide-treated bednets and chemoprophylaxis may be beneficial in areas of unstable malaria transmission. Early detection and prompt treatment of severe malaria, especially in pregnant women with hypoglycaemia, are needed.
孕妇更容易感染严重的恶性疟原虫疟疾，这可能导致母婴不良结局。关于孕妇严重恶性疟原虫疟疾的流行病学数据很少。本研究在苏丹东部和中部不稳定疟疾传播地区的卡萨拉和麦丹尼妇产医院进行了一项基于医院的研究，以评估孕妇严重恶性疟原虫疟疾的模式。使用预先测试的问卷收集社会人口统计学、临床和产科数据。进行了适当的检测以进行临床和生化研究。
在这两家医院诊断患有疟疾的 222 名孕妇中，40 名（18.0%）妊娠周数平均（标准差）为 29.3（6.7）周的孕妇符合世界卫生组织（WHO）一项或多项严重恶性疟原虫疟疾标准。这些标准包括低血糖（14 例；35.5%）、严重贫血（12 例；30%）、低血压（10 例；25%）、黄疸（9 例；22.5%）、脑型疟疾（6 例；15%）、反复惊厥（4 例；10%）、高寄生虫血症（4 例；10.0%）和一种以上表现（9 例；22.5%）。虽然低血糖症孕妇的体温平均值（标准差）明显较低[38.2（0.6）℃与 38.8（0.7）℃，P=0.04]，但不同严重恶性疟原虫疟疾表现的孕妇的其他临床和生化特征没有显著差异。
在不稳定疟疾传播地区，孕妇预防性措施如经杀虫剂处理的蚊帐和化学预防可能有益。需要早期发现和及时治疗严重疟疾，特别是在低血糖症孕妇中。
