Kintampo Health Research Centre, Ghana Health Service, PO Box 200, Kintampo, Ghana.
Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
Malar J. 2020 Oct 23;19(1):381. doi: 10.1186/s12936-020-03457-5.
Malaria during pregnancy may result in unfavourable outcomes in both mothers and their foetuses. This study sought to document the current burden and factors associated with malaria and anaemia among pregnant women attending their first antenatal clinic visit in an area of Ghana with perennial malaria transmission.
A total of 1655 pregnant women aged 18 years and above with a gestational age of 13-22 weeks, who attended an antenatal care (ANC) clinic for the first time, were consented and enrolled into the study. A structured questionnaire was used to collect socio-demographic and obstetric data and information on use of malaria preventive measures. Venous blood (2 mL) was collected before sulfadoxine-pyrimethamine administration. Malaria parasitaemia and haemoglobin concentration were determined using microscopy and an automated haematology analyser, respectively. Data analysis was carried out using Stata 14.
Mean age (SD) and gestational age (SD) of women at enrolment were 27.4 (6.2) years and 16.7 (4.3) weeks, respectively. Overall malaria parasite prevalence was 20.4% (95% CI 18.5-22.4%). Geometric mean parasite density was 442 parasites/µL (95% CI 380-515). Among women with parasitaemia, the proportion of very low (1-199 parasites/µL), low (200-999 parasites/µL), medium (1000-9999 parasites/µL) and high (≥ 10,000 parasites/µL) parasite density were 31.1, 47.0, 18.9, and 3.0%, respectively. Age ≥ 25 years (OR 0.57, 95% CI 0.41-0.79), multigravid (OR 0.50, 95% CI 0.33-0.74), educated to high school level or above (OR 0.53, 95% CI 0.33-0.83) and in household with higher socio-economic status (OR 0.34, 95% CI 0.21-0.54) were associated with a lower risk of malaria parasitaemia. The prevalence of anaemia (< 11.0 g/dL) was 56.0%, and the mean haemoglobin concentration in women with or without parasitaemia was 9.9 g/dL or 10.9 g/dL, respectively.
One out of five pregnant women attending their first ANC clinic visit in an area of perennial malaria transmission in the middle belt of Ghana had Plasmodium falciparum infection. Majority of the infections were below 1000 parasites/µL and with associated anaemia. There is a need to strengthen existing malaria prevention strategies to prevent unfavourable maternal and fetal birth outcomes in this population.
孕妇疟疾可能导致母婴双方不良结局。本研究旨在记录加纳一个疟疾常年传播地区孕妇在首次产前检查时疟疾和贫血的现状及其相关因素。
共纳入 1655 名年龄在 18 岁及以上、妊娠 13-22 周的首次接受产前保健的孕妇。使用结构化问卷收集社会人口学和产科数据以及疟疾预防措施使用情况信息。在给予磺胺多辛-乙胺嘧啶之前采集 2ml 静脉血。使用显微镜和自动化血液分析仪分别检测疟原虫寄生虫血症和血红蛋白浓度。使用 Stata 14 进行数据分析。
女性入组时的平均年龄（标准差）和妊娠周数（标准差）分别为 27.4（6.2）岁和 16.7（4.3）周。总体疟疾寄生虫患病率为 20.4%（95%CI 18.5-22.4%）。几何平均寄生虫密度为 442 个/μL（95%CI 380-515）。在寄生虫血症患者中，极低密度（1-199 个/μL）、低密度（200-999 个/μL）、中密度（1000-9999 个/μL）和高密度（≥10,000 个/μL）寄生虫密度的比例分别为 31.1%、47.0%、18.9%和 3.0%。年龄≥25 岁（OR 0.57，95%CI 0.41-0.79）、多胎（OR 0.50，95%CI 0.33-0.74）、接受过高中或以上教育（OR 0.53，95%CI 0.33-0.83）和家庭社会经济地位较高（OR 0.34，95%CI 0.21-0.54）与疟疾寄生虫血症风险降低相关。贫血（＜11.0g/dL）的患病率为 56.0%，有或无寄生虫血症的妇女的平均血红蛋白浓度分别为 9.9g/dL 和 10.9g/dL。
在加纳中地带一个疟疾常年传播地区，每五个首次接受产前检查的孕妇中就有一个患有恶性疟原虫感染。大多数感染低于 1000 个/μL，且伴有贫血。需要加强现有的疟疾预防策略，以防止该人群出现不良的母婴出生结局。
