Brabin B J, Ginny M, Alpers M, Brabin L, Eggelte T, Van der Kaay H J
Institute of Medical Research, Madang, Papua New Guinea.
Ann Trop Med Parasitol. 1990 Feb;84(1):1-9. doi: 10.1080/00034983.1990.11812428.
Six hundred and twenty pregnant women, living under conditions of year-round transmission of malaria in a rural coastal area of Madang, Papua New Guinea (PNG), were followed while attending mobile antenatal clinics and receiving chloroquine prophylaxis (300 mg base weekly). Whole blood chloroquine concentrations measured by ELISA from samples collected at delivery indicated a high level of drug compliance in regular attenders. Susceptibility is increased in primigravidae to Plasmodium falciparum but not to other malaria species, with the peak prevalence occurring at nine to 16 weeks gestation. The incidence of P. falciparum infection per person-month was 20% for primigravidae, 25% for those gravida 2, 17% for those gravida 3 or greater, and 14% for non-pregnant nulliparae. Some 8.7% of primigravidae and 9.5% of those gravida 2 had persistent infections. Prophylactic chloroquine is required in this pregnant population because of altered host immunity during pregnancy, but is reduced in efficacy because of chloroquine resistance. Despite this, a missed clinic attendance resulted in a two-fold increase in incidence for all pregnant women, indicating that chloroquine was having some effect.
在巴布亚新几内亚（PNG）马当省农村沿海地区，620名孕妇常年生活在疟疾传播环境中，她们在前往流动产前诊所并接受氯喹预防（每周300毫克碱）时接受了跟踪观察。通过酶联免疫吸附测定法（ELISA）对分娩时采集的样本进行检测，发现定期就诊者的全血氯喹浓度显示出较高的药物依从性。初产妇对恶性疟原虫的易感性增加，但对其他疟原虫种类则不然，其患病率高峰出现在妊娠9至16周。初产妇每人每月的恶性疟原虫感染率为20%，二胎孕妇为25%，三胎及以上孕妇为17%，未孕未产妇为14%。约8.7%的初产妇和9.5%的二胎孕妇有持续性感染。由于孕期宿主免疫力发生改变，该孕妇群体需要进行氯喹预防，但由于氯喹耐药性，其疗效有所降低。尽管如此，错过一次诊所就诊会导致所有孕妇的感染率增加两倍，这表明氯喹仍有一定效果。
