Omer Samia A, Noureldein Ali N, Eisa Hadeel, Abdelrahim Mutasim, Idress Hagir E, Abdelrazig Abdelrahim M, Adam Ishag
Department of Immunology and Molecular Biology, Tropical Medicine Research Institute, National Centre for Research, Khartoum, Sudan.
Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
J Trop Med. 2019 Aug 7;2019:3162378. doi: 10.1155/2019/3162378. eCollection 2019.
The aim of the present study was to investigate the prevalence of submicroscopic infections and to assess its impact on maternal anaemia and low birth weight. A cross-sectional study was carried out with 1149 consented pregnant women who delivered at 3 main hospitals in the Blue Nile State, between January 2012 and December 2015. From a matched maternal peripheral, placental maternal side, and cord blood sample, blood films and dried spots were prepared for microscopic examination and nested polymerase chain reaction (n-PCR), respectively. 107 out of 447 negative blood films were found to have submicroscopic infection detected using n-PCR in any of the three compartments. Placental samples had a significantly higher prevalence (142) of submicroscopic infections compared with the peripheral (6.5%) and cord (8.1%) samples. The mean (SD) of the maternal haemoglobin (Hb) was significantly lower in cases with submicroscopic parasitaemia (10.9 (0.8) vs. 12.1 (0.7) g/dl, < 0.001) compared with those who had no submicroscopic parasitaemia. Submicroscopic malaria infection was associated with anaemia (OR 19.7, (95% CI, 10.3-37.8)). Thirty-eight babies born to women with submicroscopic infections were low birth weight (LBW) and was significantly lower in submicroscopic parasitaemia (2.663 (0.235) vs. 2.926 (0.341) kg, < 0.001). Submicroscopic malaria infection was associated with LBW (OR = 2.7, (95% CI, 1.2-5.6)). There is a high incidence of submicroscopic infections in any of the three compartments regardless of age or parity. Submicroscopic infection is a risk of maternal anaemia and low birth weight in women in this area of high seasonal malaria transmission.
本研究的目的是调查亚显微感染的患病率，并评估其对孕产妇贫血和低出生体重的影响。2012年1月至2015年12月期间，对在青尼罗州3家主要医院分娩的1149名同意参与研究的孕妇进行了一项横断面研究。从匹配的孕产妇外周血、胎盘母体侧和脐带血样本中，分别制备血涂片和干血斑用于显微镜检查和巢式聚合酶链反应（n-PCR）。在447份阴性血涂片中，有107份在三个样本区室中的任何一个通过n-PCR检测出亚显微感染。与外周血（6.5%）和脐带血（8.1%）样本相比，胎盘样本中亚显微感染的患病率显著更高（14.2%）。与无亚显微疟原虫血症的孕妇相比，有亚显微疟原虫血症的孕妇的平均（标准差）血红蛋白（Hb）水平显著更低（10.9（0.8）对12.1（0.7）g/dl，P<0.001）。亚显微疟疾感染与贫血相关（比值比19.7，（95%置信区间，10.3 - 37.8））。38名亚显微感染孕妇所生的婴儿为低出生体重儿，且有亚显微疟原虫血症的婴儿出生体重显著更低（2.663（0.235）对2.926（0.341）kg，P<0.001）。亚显微疟疾感染与低出生体重相关（比值比 = 2.7，（95%置信区间，1.2 - 5.6））。无论年龄或胎次如何，三个样本区室中的任何一个亚显微感染的发生率都很高。在这个季节性疟疾传播高发地区，亚显微感染是孕妇发生贫血和低出生体重的一个危险因素。
