Dionne-Odom Jodie, Westfall Andrew O, Apinjoh Tobias O, Anchang-Kimbi Judith, Achidi Eric A, Tita Alan T N
Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, 908 20th Street South, Room 325A, Birmingham, AL, 35294-2050, USA.
Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Malar J. 2017 Mar 27;16(1):132. doi: 10.1186/s12936-017-1786-z.
Malaria in pregnancy is common in sub-Saharan Africa where it contributes to perinatal morbidity and mortality. Use of insecticide-treated bed nets and intermittent preventive therapy with sulfadoxine-pyrimethamine during pregnancy are effective but underutilized interventions to prevent infection. Factors associated with bed net ownership and usage, and use of prophylaxis among recently pregnant women in Cameroon were investigated.
National data from the 2011 Cameroon Demographic Health Survey was used to identify women with a pregnancy within the previous 5 years. Logistic regression models were created to assess for independent predictors of reported bed net ownership, bed net usage, and the use of malaria prophylaxis medications during pregnancy.
Nearly one in two women surveyed had a recent pregnancy (n = 7647). In this group, bed net ownership and usage rates were low (33.7 and 16.9%, respectively); 61.6% used medication for malaria prophylaxis during pregnancy. Bed net ownership and usage were associated with maternal literacy (aOR 1.4 for net usage, 95% CI 1.1-1.8) and the presence of children under age 5 in the home (aOR 2.3 for net usage, 95% CI 1.6-3.3). The use of malaria prophylaxis medication was associated with measures of healthcare access (aOR 17.8, 95% CI 13-24.5 for ≥4 antenatal care visits), higher maternal education (aOR 1.5, 95% CI 1.1-2.1) and maternal literacy (aOR 1.4, 95% CI 1.1-1.7).
Women in Cameroon and their antenatal providers missed many opportunities to prevent malaria in pregnancy. Efforts toward ensuring universal bed net provision, consistent antenatal care and the education of girls are likely to improve birth outcomes attributable to malaria infection.
妊娠疟疾在撒哈拉以南非洲地区很常见，它会导致围产期发病和死亡。使用经杀虫剂处理的蚊帐以及在孕期进行磺胺多辛-乙胺嘧啶间歇性预防治疗是有效的预防感染措施，但未得到充分利用。本研究调查了喀麦隆近期怀孕妇女中与蚊帐拥有和使用以及预防用药相关的因素。
利用2011年喀麦隆人口与健康调查的全国数据，确定过去5年内怀孕的妇女。建立逻辑回归模型，以评估报告的蚊帐拥有、蚊帐使用以及孕期疟疾预防药物使用的独立预测因素。
近二分之一接受调查的妇女近期怀孕（n = 7647）。在这组人群中，蚊帐拥有率和使用率较低（分别为33.7%和16.9%）；61.6%的妇女在孕期使用药物预防疟疾。蚊帐拥有和使用与母亲识字率（蚊帐使用率的调整后比值比为1.4，95%置信区间为1.1 - 1.8）以及家中有5岁以下儿童有关（蚊帐使用率的调整后比值比为2.3，95%置信区间为1.6 - 3.3）。疟疾预防药物的使用与医疗保健可及性指标相关（产前检查≥4次时，调整后比值比为17.8，95%置信区间为13 - 24.5）、母亲教育程度较高（调整后比值比为1.5，95%置信区间为1.1 - 2.1）以及母亲识字率（调整后比值比为1.4，95%置信区间为1.1 - 1.7）。
喀麦隆的妇女及其产前保健提供者错失了许多预防妊娠疟疾的机会。努力确保普遍提供蚊帐、持续进行产前保健以及女童教育，可能会改善因疟疾感染导致的出生结局。
