坦桑尼亚接受复方新诺明预防治疗的感染艾滋病毒孕妇中疟疾和贫血症的患病率：基农多尼市的一项横断面研究
Prevalence of malaria and anaemia among HIV infected pregnant women receiving co-trimoxazole prophylaxis in Tanzania: a cross sectional study in Kinondoni Municipality.
作者信息
Manyanga Vicent P, Minzi Omary, Ngasala Billy
机构信息
Unit of Pharmacology and Therapeutics, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania.
出版信息
BMC Pharmacol Toxicol. 2014 Apr 24;15:24. doi: 10.1186/2050-6511-15-24.
BACKGROUND
HIV-infected pregnant women are particularly more susceptible to the deleterious effects of malaria infection particularly anaemia. In order to prevent opportunistic infections and malaria, a policy of daily co-trimoxazole prophylaxis without the standard Suphadoxine-Pyrimethamine intermittent preventive treatment (SP-IPT) was introduced to all HIV infected pregnant women in the year 2011. However, there is limited information about the effectiveness of this policy.
METHODS
This was a cross sectional study conducted among HIV-infected pregnant women receiving co-trimoxazole prophylaxis in eight public health facilities in Kinondoni Municipality from February to April 2013. Blood was tested for malaria infection and anaemia (haemoglobin <11 g/dl). Data were collected on the adherence to co-trimoxazole prophylaxis and other risk factors for malaria infection and anaemia. Pearson chi-square test, Fischer's exact test and multivariate logistic regression were used in the statistical analysis.
RESULTS
This study enrolled 420 HIV infected pregnant women. The prevalence of malaria infection was 4.5%, while that of anaemia was 54%. The proportion of subjects with poor adherence to co-trimoxazole was 50.5%. As compared to HIV infected pregnant women with good adherence to co-trimoxazole prophylaxis, the poor adherents were more likely to have a malaria infection (Adjusted Odds Ratio, AOR = 6.81, 95% CI = 1.35-34.43, P = 0.02) or anaemia (AOR = 1.75, 95% CI = 1.03-2.98, P = 0.039). Other risk factors associated with anaemia were advanced WHO clinical stages, current malaria infection and history of episodes of malaria illness during the index pregnancy.
CONCLUSION
The prevalence of malaria was low; however, a significant proportion of subjects had anaemia. Good adherence to co-trimoxazole prophylaxis was associated with reduction of both malaria infection and anaemia among HIV infected pregnant women.
背景
感染艾滋病毒的孕妇尤其更容易受到疟疾感染尤其是贫血的有害影响。为预防机会性感染和疟疾，2011年对所有感染艾滋病毒的孕妇推行了每日服用复方新诺明预防治疗的政策，而未采用标准的磺胺多辛-乙胺嘧啶间歇性预防治疗（SP-IPT）。然而，关于该政策有效性的信息有限。
方法
这是一项横断面研究，于2013年2月至4月在基农多尼市的八家公共卫生机构中对接受复方新诺明预防治疗的感染艾滋病毒的孕妇开展。检测血液中的疟疾感染和贫血情况（血红蛋白<11克/分升）。收集关于复方新诺明预防治疗依从性以及疟疾感染和贫血的其他风险因素的数据。统计分析采用Pearson卡方检验、费舍尔精确检验和多因素逻辑回归。
结果
本研究纳入了420名感染艾滋病毒的孕妇。疟疾感染患病率为4.5%，贫血患病率为54%。复方新诺明依从性差的受试者比例为50.5%。与复方新诺明预防治疗依从性良好的感染艾滋病毒孕妇相比，依从性差的孕妇更有可能感染疟疾（调整优势比，AOR = 6.81，95%置信区间 = 1.35 - 34.43，P = 0.02）或患贫血（AOR = 1.75，95%置信区间 = 1.03 - 2.98，P = 0.039）。与贫血相关的其他风险因素包括世界卫生组织临床分期较晚、当前疟疾感染以及本次妊娠期间疟疾发病史。
结论
疟疾患病率较低；然而，相当一部分受试者患有贫血。良好的复方新诺明预防治疗依从性与感染艾滋病毒孕妇中疟疾感染和贫血的减少相关。
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