Departments of Pediatrics and Molecular Virology and Microbiology, National School of Tropical Medicine at Baylor College of Medicine, and the Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development, Houston, Texas; and Virginia Tech Carilion School of Medicine, Roanoke, Virginia.
Obstet Gynecol. 2014 Jan;123(1):155-160. doi: 10.1097/AOG.0000000000000025.
Emerging evidence over the past decade has implicated helminth infections as important yet stealth causes of adverse pregnancy outcomes and impaired women's reproductive health. The two most important helminth infections affecting women living in poverty in Africa and elsewhere in the developing world are hookworm infection and schistosomiasis. In Africa alone, almost 40 million women of childbearing age are infected with hookworms, including almost 7 million pregnant women who are at greater risk of severe anemia, higher mortality, and experiencing poor neonatal outcome (reduced birth weight and increased infant mortality). Possibly, tens of millions of women in Africa also suffer from female genital schistosomiasis associated with genital itching and pain, stress incontinence, dyspareunia, and infertility and experience social stigma and depression. Female genital schistosomiasis also is linked to horizontal transmission of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) and it may represent one of Africa's major cofactors in its AIDS epidemic. There is urgency to expand mass drug administration efforts for hookworm and schistosomiasis to include women of reproductive age and to shape new policies and advocacy initiatives for women's global health to include helminth control. In parallel is a requirement to better link global health programs for HIV and AIDS and malaria with helminth control and to simultaneously launch initiatives for research and development.
在过去十年中，越来越多的证据表明，寄生虫感染是导致不良妊娠结局和女性生殖健康受损的重要但隐蔽的原因。在非洲和发展中国家其他地区生活的贫困妇女中，两种最重要的寄生虫感染是钩虫感染和血吸虫病。仅在非洲，就有近 4000 万育龄妇女感染钩虫，其中近 700 万孕妇面临严重贫血、更高死亡率和不良新生儿结局（出生体重降低和婴儿死亡率升高）的风险更大。可能还有数千万非洲妇女患有与生殖器瘙痒和疼痛、压力性尿失禁、性交困难和不孕有关的女性生殖器血吸虫病，并面临社会耻辱和抑郁。女性生殖器血吸虫病也与人类免疫缺陷病毒（HIV）和获得性免疫缺陷综合征（AIDS）的水平传播有关，它可能是非洲艾滋病流行的主要因素之一。迫切需要扩大钩虫和血吸虫病的大规模药物治疗努力，将育龄妇女包括在内，并制定新的妇女全球健康政策和宣传倡议，将寄生虫控制纳入其中。与此同时，还需要更好地将艾滋病毒和艾滋病以及疟疾的全球卫生方案与寄生虫控制联系起来，并同时启动研究和开发倡议。
