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刚果民主共和国基桑加尼地区先天性疟疾的流行情况。该地区疟疾传播稳定。

Prevalence of Congenital Malaria in Kisangani, A Stable Malaria Transmission Area in Democratic Republic of the Congo.

机构信息

Obstetrics and Gynecology Department, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo.

Internal Medical Department, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo.

出版信息

Infect Dis Obstet Gynecol. 2020 Feb 25;2020:2176140. doi: 10.1155/2020/2176140. eCollection 2020.

Abstract

BACKGROUND

Gestational malaria is a major public health problem. It produces fetal complications such as low birth weight, perinatal mortality, and congenital malaria. The present study is aimed at determining the prevalence of congenital malaria and its neonatal complications in the city of Kisangani.

METHODS

We conducted a cross-sectional study in Kisangani from 1 January to 30 September 2018. Our study population was composed of 1248 newborns born in our study sites, during the period of our study. Just after their birth, we performed the thick drop smear in the placental print and in umbilical blood smear.

RESULTS

The prevalence of congenital malaria was 13.98%; 69.23% of newborns who contracted congenital malaria were from 18- to 34-year-old mothers, 53.85% from primiparous mothers, 92.31% from mothers who took intermittent preventive treatment in pregnancy with Sulfadoxine-Pyrimethamine, all (100%) from mothers using the insecticide-treated mosquito nets and 7.69% from HIV-positive mothers. Low birth weight and perinatal mortality were recorded in 76.92% and 7.69% of congenital malaria cases, respectively. Intermittent preventive treatment in pregnancy with Sulfadoxine-Pyrimethamine had no effect on congenital malaria (FE = 0.5218; OR: 0.8, 95% CI: 0.1651-3.8769) and on low birth weight (FE = 0.3675; OR: 1.2308, 95% CI: 0.0037-0.1464); however, it seemed to have protective effect against perinatal mortality (FE = 0.0001; OR: 0.0233, 95% CI: 0.0037-0.1464).

CONCLUSION

Congenital malaria remains a major problem in stable malaria transmission area like Kisangani, and it is grafted by major perinatal complications, particularly low birth weight and perinatal mortality. We recommend an extended study to clarify the relationship between the outcome of pregnancy and the intermittent preventive treatment in pregnancy with Sulfadoxine-Pyrimethamine.

摘要

背景

妊娠疟疾是一个重大的公共卫生问题。它会导致胎儿出现并发症,如低出生体重、围产期死亡和先天性疟疾。本研究旨在确定金沙萨市先天性疟疾及其新生儿并发症的患病率。

方法

我们于 2018 年 1 月 1 日至 9 月 30 日在金沙萨进行了一项横断面研究。我们的研究人群由 1248 名在研究地点出生的新生儿组成,均在研究期间出生。在新生儿出生后,我们立即对胎盘印痕和脐血涂片进行厚血滴涂片检查。

结果

先天性疟疾的患病率为 13.98%;69.23%感染先天性疟疾的新生儿母亲年龄在 18 至 34 岁,53.85%为初产妇,92.31%在孕期接受了磺胺多辛-乙胺嘧啶间歇性预防治疗,100%使用了驱虫蚊帐,7.69%的母亲为 HIV 阳性。先天性疟疾病例中分别有 76.92%和 7.69%出现低出生体重和围产期死亡。磺胺多辛-乙胺嘧啶间歇性预防治疗对先天性疟疾(FE = 0.5218;OR:0.8,95%CI:0.1651-3.8769)和低出生体重(FE = 0.3675;OR:1.2308,95%CI:0.0037-0.1464)没有影响,但似乎对围产期死亡有保护作用(FE = 0.0001;OR:0.0233,95%CI:0.0037-0.1464)。

结论

在像金沙萨这样稳定疟疾传播地区,先天性疟疾仍然是一个主要问题,并且伴有重大围产期并发症,特别是低出生体重和围产期死亡。我们建议进行进一步的研究,以阐明妊娠结局与磺胺多辛-乙胺嘧啶间歇性预防治疗之间的关系。

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