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恶性疟原虫和钩虫感染对尼日利亚东南部埃努古农村社区孕妇贫血发生率的影响。

Impact of Plasmodium falciparum and hookworm infections on the frequency of anaemia in pregnant women of rural communities in Enugu, South East Nigeria.

作者信息

Agu Polycarp Uche, Ogboi Johnbull Sonny, Akpoigbe Kesiena, Okeke Tochukwu, Ezugwu Euzebus

机构信息

Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.

出版信息

Pan Afr Med J. 2013;14:27. doi: 10.11604/pamj.2013.14.27.1925. Epub 2013 Jan 18.

Abstract

INTRODUCTION

Malaria and hookworm infections are common in sub-Saharan Africa and they increase the prevalence of anaemia in pregnancy with resultant poor pregnancy outcomes. This study was carried out to assess the impact of Plasmodium falciparum and hookworm infections on the frequency of anaemia among pregnant women in two rural communities in Enugu, South East Nigeria.

METHODS

A cross sectional descriptive study was carried out in a total of 226 women attending antenatal clinics at two rural Primary Health Centres (PHC) from April 2011 to July 2011(each PHC with 113 subjects). Socio-demographic data were collected through a structured questionnaire. Blood and stool samples were evaluated for haemoglobin estimation and malaria parasites, and stool samples examined for parasitic infection in all the women. Data was analyzed using STATA 10 software statistical analysis package. Student t-test was used for comparing mean values and chi square test for comparing categorical variables and level of significance set at p<0.05 and logistic regression was used to identify the risk factors associated with malaria in pregnancy.

RESULTS

The mean age of the women was 27 years with range 18-38 years and SD of 5 years. Most of the women were housewives and over 50% in their second trimester. 53% of them had malaria parasites while 27% had hookworm infection. About 40% of the women were anaemic (haemoglobin<0.001). Similar association was found between hookworm infection and anaemia (p<0.001). Though both malaria and hookworm infections greatly increase the odds for anaemia (AOR 18.06, CI 18.15 -39.99, P<0.001) and (AOR 5.28, CI 2.26-12.38, P<0.001) respectively, the odds for having anaemia in pregnancy was higher for malaria than hookworm infections.

CONCLUSION

Plasmodium falciparum and hookworm infections have significant impact on the high frequency of anaemia in pregnancy in our rural communities. There is need to strengthen the control program that has been in place with an integrated intervention to combat these parasitic infections in our rural communities, with mass distribution of antihelminthics as one of the included relevant methods, among others.

摘要

引言

疟疾和钩虫感染在撒哈拉以南非洲地区很常见,它们会增加孕期贫血的患病率,从而导致不良的妊娠结局。本研究旨在评估恶性疟原虫和钩虫感染对尼日利亚东南部埃努古两个农村社区孕妇贫血发生率的影响。

方法

2011年4月至2011年7月,在两个农村初级卫生保健中心(PHC)共226名参加产前检查的妇女中开展了一项横断面描述性研究(每个PHC有113名受试者)。通过结构化问卷收集社会人口统计学数据。对所有妇女的血液和粪便样本进行血红蛋白估计和疟原虫评估,并对粪便样本进行寄生虫感染检查。使用STATA 10软件统计分析包对数据进行分析。采用学生t检验比较均值,采用卡方检验比较分类变量,显著性水平设定为p<0.05,并使用逻辑回归来确定与孕期疟疾相关的危险因素。

结果

这些妇女的平均年龄为27岁,年龄范围为18 - 38岁,标准差为5岁。大多数妇女是家庭主妇,超过50%处于孕中期。其中53%有疟原虫感染,27%有钩虫感染。约40%的妇女贫血(血红蛋白<0.001)。在钩虫感染和贫血之间也发现了类似的关联(p<0.001)。虽然疟疾和钩虫感染都大大增加了贫血的几率(分别为比值比18.06,置信区间18.15 - 39.99,P<0.001)和(比值比5.28,置信区间2.26 - 12.38,P<0.001),但孕期患贫血的几率疟疾高于钩虫感染。

结论

恶性疟原虫和钩虫感染对我们农村社区孕期贫血的高发生率有重大影响。有必要加强现有的控制项目,通过综合干预措施来对抗我们农村社区的这些寄生虫感染,其中大规模分发抗蠕虫药是其中一项相关方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9008/3597852/76a1961676ea/PAMJ-14-27-g001.jpg

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