Ezeoke Uchechukwu, Ndu Anne, Omotowo Babatunde, Okoye Micheal, Mbachu Chinyere, Agwu-Umahi Olanike
Department of Community Medicine, College of Medicine, University of Nigeria, Enugu Campus.
Malawi Med J. 2018 Dec;30(4):256-261. doi: 10.4314/mmj.v30i4.8.
Globally, malaria in pregnancy is a public health challenge. Malaria and HIV are among the two most important diseases contributing to the global health burden of our time. HIV positive pregnant women are at increased risk of all the adverse outcomes of malaria in pregnancy.
The objective of this study was to compare malaria parasitaemia between HIV positive and HIV negative pregnant women attending antenatal clinics offering Preventing Maternal to Child Transmission (PMTCT) services in Enugu metropolis, south-eastern Nigeria.
A descriptive cross sectional study was conducted among 200 HIV positive and 200 HIV negative pregnant women attending antenatal clinics in Enugu. Two out of five hospitals that provide PMTCT services were selected through balloting. Finger pricked blood samples were collected and thick blood films were examined for malaria parasite using giemsa expert microscopy. A structured interviewer administered questionnaire was used for data collection. Data was analysed using SPSS version 22.
The HIV positive pregnant women (152) (76%) and HIV negative women (137) (68.5%) studied were mostly in the age range of 25-34 years. Mean gestational age of HIV positive and HIV negative participants were 23.4±10.7 and 23.2±10.1 weeks respectively (P=0.001). The prevalence of malaria infection among HIV positive pregnant mothers was 81% (162/200) and 75% (150/200) among HIV negative pregnant women (P < 0.001). The HIV positive mothers had more moderate parasitaemia (86/200: 53.1%) compared to 43/200: 28.7% in HIV negative mothers (P<0.001). Even though more HIV positive mothers (54.5%) used insecticide treated nets ITNs during pregnancy compared to 41.5% in HIV negative mothers, moderate malaria parasitaemia was higher in HIV positive mothers. HIV positive nulliparous pregnant women had the highest rate of malaria parasitaemia (32/36: 88.9%).
Moderate malaria parasitaemia was higher among HIV positive pregnant women. All malaria preventive strategies should be intensified in pregnancy as ITNs provided little protection.
在全球范围内，妊娠疟疾是一项公共卫生挑战。疟疾和艾滋病毒是造成我们这个时代全球健康负担的两个最重要疾病。感染艾滋病毒的孕妇出现妊娠疟疾所有不良后果的风险增加。
本研究的目的是比较在尼日利亚东南部埃努古市提供预防母婴传播（PMTCT）服务的产前诊所就诊的感染艾滋病毒和未感染艾滋病毒的孕妇之间的疟原虫血症情况。
对在埃努古产前诊所就诊的200名感染艾滋病毒和200名未感染艾滋病毒的孕妇进行了描述性横断面研究。通过抽签从提供PMTCT服务的五家医院中选出两家。采集手指刺破的血样，并用吉姆萨专家显微镜检查厚血膜中的疟原虫。使用结构化访谈问卷进行数据收集。数据使用SPSS 22版进行分析。
所研究的感染艾滋病毒的孕妇（152名）（76%）和未感染艾滋病毒的孕妇（137名）（68.5%）大多年龄在25 - 34岁之间。感染艾滋病毒和未感染艾滋病毒参与者的平均孕周分别为23.4±10.7周和23.2±10.1周（P = 0.001）。感染艾滋病毒的孕妇中疟疾感染率为81%（162/200），未感染艾滋病毒的孕妇中为75%（150/200）（P < 0.001）。与未感染艾滋病毒的孕妇中43/200（28.7%）相比，感染艾滋病毒的母亲中中度疟原虫血症的比例更高（86/200:53.1%）（P<0.001）。尽管孕期使用经杀虫剂处理蚊帐（ITNs）的感染艾滋病毒的母亲比例更高（54.5%），而未感染艾滋病毒的母亲中这一比例为41.5%，但感染艾滋病毒的母亲中中度疟疾疟原虫血症的比例更高。感染艾滋病毒的初产妇孕妇的疟原虫血症发生率最高（32/36:88.9%）。
感染艾滋病毒的孕妇中中度疟疾疟原虫血症的比例更高。由于ITNs提供的保护作用很小，孕期应加强所有疟疾预防策略。
