Wanyonyi Wekesa Antony, Mulambalah Chrispinus Siteti, Mulama David H, Omukunda Elizabeth, Siteti Darwin Injete
Department of Biological Sciences, Masinde Muliro University of Science and Technology, P.O. Box 190, Kakamega, Kenya.
Department of Medical Microbiology & Parasitology, College of Health Sciences, Moi University, P.O. Box 4606, Eldoret, Kenya.
J Parasitol Res. 2018 Nov 29;2018:2613484. doi: 10.1155/2018/2613484. eCollection 2018.
Geohelminthiasis and malaria coinfections in pregnancy are common in sub-Saharan Africa. The consequences of the disease combination on maternal health and birth outcomes are poorly understood. For a better understanding of this coinfection in expectant mothers, a cross-sectional study was carried out to evaluate the effect of the coinfection on maternal health and birth outcomes in expectant mothers in Bungoma County, Kenya. To collect data on malaria and maternal haematological parameters, blood samples were obtained from 750 participants aged 18-49 years and analyzed. Haemoglobin and eosinophils levels were determined by coulter counter while malaria parasitemia levels and red blood cell morphology were assessed by preparing and observing blood smears under the microscope. Fresh stool samples were collected and processed for identification and quantification of geohelminths species using Kato-Katz. Harada Mori technique was used to increase chances of detecting hookworms and infections. Neonate's health was evaluated based on the appearance, pulse, grimace, activity, and respiration (APGAR) scale. Parasites identified were and . The prevalence of geohelminths, malaria parasites, and coinfection was 24.7%, 21.6%, and 6.8%, respectively. Those coinfected with geohelminths and malaria parasites were four times likely to have anaemia (OR 4.137; 95% CI 2.088-8.195; P=0.001) compared with those infected with geohelminths or malaria parasites alone (OR 0.505; 95% CI 0.360-0.709; P=0.001 and OR 0.274; 95%CI 0.187-0.402 P=0.001, respectively). The odds of having preterm deliveries (OR 6.896; 95% CI 1.755-27.101; P=0.006) and still births (OR 3.701; 95% CI 1.008-13.579 P< 0.048) were greater in those coinfected than in those infected with either geohelminths or malaria parasites. Geohelminths and malaria coinfections were prevalent among study participants; consequently the risk of maternal anaemia, preterm deliveries, and still births were high. Routine screening and prompt treatment during antenatal visits should be encouraged to mitigate the adverse consequences associated with the coinfections.
在撒哈拉以南非洲地区，孕期土源性蠕虫感染与疟疾共感染的情况很常见。人们对这种疾病组合对孕产妇健康和分娩结局的影响知之甚少。为了更好地了解准妈妈中的这种共感染情况，开展了一项横断面研究，以评估共感染对肯尼亚邦戈马县准妈妈的孕产妇健康和分娩结局的影响。为了收集有关疟疾和孕产妇血液学参数的数据，从750名年龄在18至49岁的参与者中采集了血样并进行分析。血红蛋白和嗜酸性粒细胞水平通过库尔特计数器测定，而疟原虫血症水平和红细胞形态则通过制备和在显微镜下观察血涂片来评估。采集新鲜粪便样本并使用加藤厚涂片法进行处理，以鉴定和定量土源性蠕虫种类。采用原田-森氏技术增加检测钩虫和感染的机会。根据外观、脉搏、 grimace、活动和呼吸（APGAR）评分来评估新生儿的健康状况。鉴定出的寄生虫为 和 。土源性蠕虫、疟原虫和共感染的患病率分别为24.7%、21.6%和6.8%。与仅感染土源性蠕虫或疟原虫的人相比，同时感染土源性蠕虫和疟原虫的人患贫血的可能性高出四倍（比值比4.137；95%置信区间2.088 - 8.195；P = 0.001）（仅感染土源性蠕虫的比值比0.505；95%置信区间0.360 - 0.709；P = 0.001，仅感染疟原虫的比值比0.274；95%置信区间0.187 - 0.402，P = 0.001）。共感染人群发生早产（比值比6.896；95%置信区间1.755 - 27.101；P = 0.006）和死产（比值比3.701；95%置信区间1.008 - 13.579，P < 0.048）的几率高于仅感染土源性蠕虫或疟原虫的人群。土源性蠕虫和疟疾共感染在研究参与者中很普遍；因此，孕产妇贫血、早产和死产的风险很高。应鼓励在产前检查期间进行常规筛查和及时治疗，以减轻与共感染相关的不良后果。
