Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
J Infect Dis. 2011 Dec 1;204(11):1762-71. doi: 10.1093/infdis/jir625. Epub 2011 Oct 11.
Pregnancy-associated malaria (PAM) produces poor birth outcomes, but its prevalence is commonly estimated in convenience samples.
We assessed the prevalence of malaria using real-time polymerase chain reaction (PCR) and estimated the consequences of infection on birth outcomes, using specimens from a nationally representative sample of 4570 women of childbearing age (WOCBA) responding to the 2007 Demographic and Health Survey in Democratic Republic of the Congo (DRC).
Overall, 31.2% (95% confidence interval [CI], 29.2-33.1) of WOCBA were parasitemic, which was significantly more common in pregnant (37.2% [31.0-43.5]) than nonpregnant women (30.4% [CI, 28.4-32.5], prevalence ratio [PR] 1.22 [1.02-1.47]). Plasmodium falciparum was highest among pregnant women (36.6% vs 28.8%, PR 1.27 [1.05-1.53]). By contrast, P malariae was less common in pregnant (0.6%) compared with nonpregnant women (2.7%, PR 0.23 [0.09-0.56]). Extrapolation of the prevalence estimate to the population at risk of malaria in DRC suggests 1.015 million births are affected by P falciparum infection annually, and that adherence to preventive measures could prevent up to 549 000 episodes of pregnancy-associated malaria and 47 000 low-birth-weight births.
Pregnancy-associated malaria and its consequences are highly prevalent in the DRC. Increasing the uptake of malaria preventive measures represents a significant opportunity to improve birth outcomes and neonatal health.
妊娠相关疟疾(PAM)会导致不良的生育结局,但它的流行率通常是通过便利样本进行估计的。
我们使用实时聚合酶链反应(PCR)评估疟疾的流行率,并使用来自刚果民主共和国(DRC)全国代表性的 4570 名育龄妇女(WOCBA)对 2007 年人口与健康调查的回应样本,估计感染对生育结局的影响。
总体而言,31.2%(95%置信区间[CI],29.2-33.1)的 WOCBA 存在寄生虫血症,孕妇(37.2%[31.0-43.5])比非孕妇(30.4%[CI,28.4-32.5])更为常见,患病率比(PR)为 1.22(1.02-1.47)。孕妇中恶性疟原虫的比例最高(36.6%比 28.8%,PR 为 1.27[1.05-1.53])。相比之下,孕妇中间日疟原虫的比例较低(0.6%比非孕妇的 2.7%,PR 为 0.23[0.09-0.56])。将流行率估计值外推到 DRC 疟疾高危人群中,表明每年有 101.5 万例新生儿受到恶性疟原虫感染的影响,而采取预防措施可以预防多达 54.9 万例妊娠相关疟疾和 4.7 万例低出生体重儿。
妊娠相关疟疾及其后果在 DRC 非常普遍。增加疟疾预防措施的采用率是改善生育结局和新生儿健康的重要机会。