2011年坦桑尼亚产前检查门诊孕妇中艾滋病毒和梅毒感染率
Prevalence of HIV and syphilis infections among pregnant women attending antenatal clinics in Tanzania, 2011.
作者信息
Manyahi Joel, Jullu Boniphace S, Abuya Mathias I, Juma James, Ndayongeje Joel, Kilama Bonita, Sambu Veryeh, Nondi Josef, Rabiel Bernard, Somi Geoffrey, Matee Mecky I
机构信息
Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
St. Francis University College of Health and Allied Sciences, Ifakara, Tanzania.
出版信息
BMC Public Health. 2015 May 22;15:501. doi: 10.1186/s12889-015-1848-5.
BACKGROUND
The occurrence of HIV-1 and syphilis infections during pregnancy poses major health risks to the foetus due to mother-to-child transmission. We conducted surveillance of HIV and syphilis infections among pregnant women attending antenatal clinics (ANCs) in Mainland Tanzania in 2011.
METHODS
This surveillance was carried out in 133 ANCs selected from 21 regions in Tanzania. In each region, six ANC sites were selected, with urban, semi-urban, and rural areas contributing two each. All pregnant women who were attending selected sentinel ANC sites for the first time at any pregnancy between September and December 2011 were enrolled. Serial ELISA assays were performed to detect HIV infection in an unlinked anonymous manner using dried blood spot (DBS) after routine syphilis testing. Data analysis was conducted using Stata v.12 software.
RESULTS
A total of 39,698 pregnant women representing 2.4 % of all pregnant women (1.68 million) attending ANCs in the Mainland Tanzania were enrolled. The overall HIV prevalence was found to be 5.6 % (95 % CI: 5.4-5.8 %). The risk for HIV infection was significantly higher among women aged 25-34 (cOR = 1.97, 95 % CI: 1.79-2.16; p < 0.05), older than 35 years (cOR = 1.88, 95 % CI: 1.62-2.17; p < 0.05) and those having 1-2 and 3-4 previous pregnancies. HIV infection was less prevalent among women attending rural ANC clinics (cOR = 0.46, 95 % CI 0.4-0.52; p < 0.05). The overall syphilis prevalence was 2.5 % (95 % CI: 2.3, 3.6). The risk for syphilis infection was significantly higher among women attending semi-urban and rural clinics and those having 3-4, and 5 previous pregnancies (p < 0.05). Marital status and level of education were not statistically significant with either of the two infections. HIV and syphilis co-infections occurred in 109 of 38,928 (0.3 %).
CONCLUSION
The overall prevalence of HIV infection (5.6 %) and syphilis (2.5 %) found among pregnant women attending ANC clinics in Tanzania calls for further strengthening of current intervention measures, which include scaling up the integration of prevention of mother to child transmission (PMTCT) services in Reproductive and Child Health (RCH) clinics.
背景
孕期感染艾滋病毒-1和梅毒会因母婴传播给胎儿带来重大健康风险。2011年，我们对坦桑尼亚大陆产前诊所（ANC）的孕妇进行了艾滋病毒和梅毒感染监测。
方法
该监测在从坦桑尼亚21个地区选取的133家产前诊所开展。在每个地区，选取6个产前诊所地点，城市、半城市和农村地区各占两个。纳入了2011年9月至12月期间在选定的定点产前诊所首次就诊的所有孕妇。在进行常规梅毒检测后，采用干血斑（DBS）以不关联匿名方式进行系列酶联免疫吸附测定（ELISA）检测艾滋病毒感染。使用Stata v.12软件进行数据分析。
结果
共纳入39698名孕妇，占坦桑尼亚大陆产前诊所所有孕妇（168万）的2.4%。艾滋病毒总体患病率为5.6%（95%置信区间：5.4 - 5.8%）。25 - 34岁女性（校正比值比[cOR]=1.97，95%置信区间：1.79 - 2.16；p<0.05）、35岁以上女性（cOR = 1.88，95%置信区间：1.62 - 2.17；p<0.05）以及有过1 - 2次和3 - 4次既往妊娠的女性感染艾滋病毒的风险显著更高。在农村产前诊所就诊的女性中艾滋病毒感染率较低（cOR = 0.46，95%置信区间0.4 - 0.52；p<0.05）。梅毒总体患病率为2.5%（95%置信区间：2.3，3.6）。在半城市和农村诊所就诊的女性以及有过3 - 4次和5次既往妊娠的女性中梅毒感染风险显著更高（p<0.05）。婚姻状况和教育水平与这两种感染中的任何一种均无统计学显著关联。在38928名孕妇中有109名（0.3%）同时感染了艾滋病毒和梅毒。
结论
在坦桑尼亚产前诊所就诊的孕妇中发现的艾滋病毒感染总体患病率（5.6%）和梅毒患病率（2.5%）表明需要进一步加强当前的干预措施，包括在生殖与儿童健康（RCH）诊所扩大预防母婴传播（PMTCT）服务的整合。
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