Shoklo Malaria Research Unit, Mae Sot, Tak, Thailand.
Lancet Infect Dis. 2012 Jan;12(1):75-88. doi: 10.1016/S1473-3099(11)70315-2.
Most pregnant women at risk of for infection with Plasmodium vivax live in the Asia-Pacific region. However, malaria in pregnancy is not recognised as a priority by many governments, policy makers, and donors in this region. Robust data for the true burden of malaria throughout pregnancy are scarce. Nevertheless, when women have little immunity, each infection is potentially fatal to the mother, fetus, or both. WHO recommendations for the control of malaria in pregnancy are largely based on the situation in Africa, but strategies in the Asia-Pacific region are complicated by heterogeneous transmission settings, coexistence of multidrug-resistant Plasmodium falciparum and Plasmodium vivax parasites, and different vectors. Most knowledge of the epidemiology, effect, treatment, and prevention of malaria in pregnancy in the Asia-Pacific region comes from India, Papua New Guinea, and Thailand. Improved estimates of the morbidity and mortality of malaria in pregnancy are urgently needed. When malaria in pregnancy cannot be prevented, accurate diagnosis and prompt treatment are needed to avert dangerous symptomatic disease and to reduce effects on fetuses.
大多数有感染间日疟原虫风险的孕妇生活在亚太地区。然而,该地区的许多政府、政策制定者和捐助者并未将妊娠合并疟疾视为优先事项。整个孕期疟疾真实负担的可靠数据十分匮乏。然而,当孕妇免疫力较弱时,每次感染都可能对母亲、胎儿或两者都有致命危险。世卫组织关于妊娠合并疟疾控制的建议主要基于非洲的情况,但亚太地区的策略因传播环境的异质性、耐多药恶性疟原虫和间日疟原虫寄生虫的共存以及不同的传播媒介而变得复杂。关于妊娠合并疟疾的流行病学、影响、治疗和预防,大多数知识来自印度、巴布亚新几内亚和泰国。迫切需要改进对妊娠合并疟疾发病率和死亡率的估计。如果无法预防妊娠合并疟疾,就需要准确诊断和及时治疗,以避免出现危险的有症状疾病,并减少对胎儿的影响。