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萨尔瓦多孕妇患恰加斯病的风险因素。

Risk factors for Chagas disease among pregnant women in El Salvador.

作者信息

Sasagawa Emi, Aiga Hirotsugu, Corado Edith Y, Cuyuch Blanca L, Hernández Marta A, Guevara Ana V, Romero José E, Ramos Hector M, Cedillos Rafael A, Misago Chizuru, Kita Kiyoshi

机构信息

Department of Biomedical Chemistry, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

出版信息

Trop Med Int Health. 2015 Mar;20(3):268-76. doi: 10.1111/tmi.12440. Epub 2014 Dec 12.

Abstract

OBJECTIVES

To determine the seroprevalence of Chagas disease among pregnant women and estimate the risk factors for Chagas disease during pregnancies.

METHODS

Community-based serological tests on Trypanosoma cruzi and structured interviews on socio-demographic and socio-economic status were conducted with pregnant women registered at three health centres in Sonsonate province, El Salvador.

RESULTS

Of 797 pregnant women participating in the study, 29 (3.6%) were infected with Chagas disease. None had clinical symptoms. The results of bivariate analyses showed the significant association between seropositivity and maternal age ≥35 years, anaemia, illiteracy, having no formal school education and having knowledge on Chagas disease (P < 0.05). The results of multivariate analysis indicate that age ≥35 years and anaemia were significantly associated with being infected with Chagas disease among pregnant women (OR = 3.541 and 5.197, respectively).

CONCLUSION

We recommend that the national Chagas disease control programme be better coordinated with the national maternal and child health programme to introduce blood screening for T. cruzi during antenatal visits. If financial constraint allows systematic blood screening to be only partially implemented, resources should be focused on pregnant women ≥35 years and women who have anaemia.

摘要

目的

确定孕妇中恰加斯病的血清阳性率,并评估孕期患恰加斯病的风险因素。

方法

对萨尔瓦多松索纳特省三个保健中心登记的孕妇进行基于社区的克氏锥虫血清学检测,并就社会人口统计学和社会经济状况进行结构化访谈。

结果

参与研究的797名孕妇中,29名(3.6%)感染恰加斯病。均无临床症状。双变量分析结果显示血清阳性与母亲年龄≥35岁、贫血、文盲、未接受正规学校教育以及了解恰加斯病之间存在显著关联(P<0.05)。多变量分析结果表明,年龄≥35岁和贫血与孕妇感染恰加斯病显著相关(比值比分别为3.541和5.197)。

结论

我们建议国家恰加斯病控制项目与国家母婴健康项目更好地协调,以便在产前检查时开展克氏锥虫血液筛查。如果资金限制使系统血液筛查只能部分实施,资源应集中于年龄≥35岁的孕妇和贫血妇女。

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