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疟疾和土源性蠕虫感染对加纳库马西地区出生结局的影响。

Effect of Malaria and Geohelminth Infection on Birth Outcomes in Kumasi, Ghana.

作者信息

Asundep Ntui N, Jolly Pauline E, Carson April P, Turpin Cornelius A, Zhang Kui, Wilson Nana O, Stiles Jonathan K, Tameru Berhanu

机构信息

Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA.

Komfo Anokye Teaching Hospital, Kumasi, Ghana.

出版信息

Int J Trop Dis Health. 2014;4(5):582-594. doi: 10.9734/IJTDH/2014/7573.

Abstract

AIM

In 2005, the Ghana Health Service mandated malaria and helminths chemoprophylaxis during antenatal care visits. The aim of this study was to investigate the prevalence of malaria and helminth infections and their relationship with adverse birth outcomes (low birth weight, stillbirth, and preterm) following the implementation of these treatments.

STUDY DESIGN

A quantitative cross-sectional study.

METHOD

The study was conducted on 630 women presenting for delivery in the Komfo Anokye Teaching Hospital and the Manhyia District Hospital from July to November 2011. Socio-demographic information and medical and obstetric history were collected. Laboratory analyses for the presence of malaria and helminths were performed. Association of malaria and helminths with birth outcomes was assessed using logistic regression to obtain odds ratios (ORs) and 95% confidence intervals.

RESULTS

The prevalence of malaria, helminths and adverse birth outcomes was 9.0%, 5.0% and 22.2%, respectively. Compared with women who received malaria prophylaxis, women without malaria prophylaxis were two times more likely to have malaria infection (aOR = 2.1; 95% CI = 1.06-4.17). Women who were not screened for helminths were twice as likely to be infected with helminths (aOR = 2.4; 95% CI = 1.15-5.12) than women who were screened for helminths. For women infected with hookworm or , the odds of having an adverse birth outcome (aOR = 3.9; 95% CI = 1.09-14.20) and stillbirth (aOR = 7.7; 95% CI = 1.21-36.38) were greater than for women who were not infected.

CONCLUSION

The prevalence of malaria, helminths and adverse birth outcomes was lower than previously reported 9.0% vs. 36.3, 5.0% vs. 25.7 and 22.2% vs. 44.6, respectively. Helminth but not malaria infection was found to be significantly associated with adverse birth outcomes.

摘要

目的

2005年,加纳卫生服务局规定在产前检查时进行疟疾和蠕虫化学预防。本研究的目的是调查在实施这些治疗后疟疾和蠕虫感染的患病率及其与不良出生结局(低出生体重、死产和早产)的关系。

研究设计

定量横断面研究。

方法

2011年7月至11月,对在Komfo Anokye教学医院和曼希亚区医院分娩的630名妇女进行了研究。收集了社会人口统计学信息以及医疗和产科病史。对疟疾和蠕虫的存在进行了实验室分析。使用逻辑回归评估疟疾和蠕虫与出生结局的关联,以获得比值比(OR)和95%置信区间。

结果

疟疾、蠕虫和不良出生结局的患病率分别为9.0%、5.0%和22.2%。与接受疟疾预防的妇女相比,未接受疟疾预防的妇女感染疟疾的可能性高出两倍(调整后OR = 2.1;95%置信区间 = 1.06 - 4.17)。未接受蠕虫筛查的妇女感染蠕虫的可能性是接受蠕虫筛查妇女的两倍(调整后OR = 2.4;95%置信区间 = 1.15 - 5.12)。对于感染钩虫或[此处原文可能缺失信息]的妇女,出现不良出生结局(调整后OR = 3.9;95%置信区间 = 1.09 - 14.20)和死产(调整后OR = 7.7;95%置信区间 = 1.21 - 36.38)的几率高于未感染的妇女。

结论

疟疾、蠕虫和不良出生结局的患病率低于先前报告,分别为9.0%对36.3%、5.0%对25.7%和22.2%对44.6%。发现蠕虫感染而非疟疾感染与不良出生结局显著相关。

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