Obebe Oluwasola Olaiya, Olajuyigbe Olaitan Olubunmi, Falohun Olufarati Oludunsin
Department of Veterinary Parasitology and Entomology, Faculty of Veterinary Medicine, University of Ibadan, 200284 Ibadan, Oyo State, Nigeria.
Nigerian Institute for Oceanography and Marine Research, Victoria Island, Lagos, Nigeria.
Ann Parasitol. 2020;66(3):283-294. doi: 10.17420/ap6603.266.
Asymptomatic Plasmodium falciparum infection during pregnancy is a major cause of foetal and maternal morbidity and mortality. The current study estimated the prevalence of asymptomatic P. falciparum infection among pregnant women in Nigeria. We systematically searched the PubMed, Web of Science, Google Scholar and AJOL databases for studies that estimated the prevalence of asymptomatic P. falciparum infection in pregnant women up to December, 2019, and identified additional studies from reference lists. Twenty-seven studies which fulfilled eligibility criteria were included in final systematic review and meta-analysis. The prevalence of asymptomatic P. falciparum infection of individual study varied from 2.1% to 95.4%. Most surveys were performed in the southern parts of Nigeria. We observed a high degree of heterogeneity in most pooled estimates (I2 > 75%; p < 0.01). The pooled estimate of asymptomatic P. falciparum infection prevalence across studies for the entire period was 34.3% (95% CI: 24.0-46.3), ranging from 34.7% (95% CI: 22.8-48.9) in primigravida to 28.5% (95% CI: 15.8-45.8%) in the first trimester. Studies conducted from 2000-2009 (51.3%; 95% CI: 29.1-73.0), southern Nigeria (41.8%; 95% CI: 28.2-56.7), rural areas (52.1%; 95% CI: 19.4-83.0), and median sample size ≥ 246 (41.5; 95% CI: 25.9-58.9), had the highest pooled prevalence. Asymptomatic P. falciparum infection is considered high in pregnant women in Nigeria. This results, therefore, emphasize the need to actively diagnose and treat asymptomatic malaria infection during all antenatal care visits.
孕期无症状恶性疟原虫感染是导致胎儿和孕产妇发病及死亡的主要原因。本研究估算了尼日利亚孕妇中无症状恶性疟原虫感染的患病率。我们系统检索了PubMed、科学网、谷歌学术和AJOL数据库，查找截至2019年12月估算孕妇无症状恶性疟原虫感染患病率的研究，并从参考文献列表中识别出其他研究。27项符合纳入标准的研究被纳入最终的系统评价和荟萃分析。各研究中无症状恶性疟原虫感染的患病率从2.1%至95.4%不等。大多数调查在尼日利亚南部进行。我们观察到大多数合并估计值存在高度异质性（I2>75%；p<0.01）。整个时期内各研究中无症状恶性疟原虫感染患病率的合并估计值为34.3%（95%置信区间：24.0 - 46.3），初产妇为34.7%（95%置信区间：22.8 - 48.9），孕早期为28.5%（95%置信区间：15.8 - 45.8%）。2000 - 2009年开展的研究（51.3%；95%置信区间：29.1 - 73.0）、尼日利亚南部（41.8%；95%置信区间：28.2 - 56.7）、农村地区（52.1%；95%置信区间：19.4 - 83.0）以及样本量中位数≥246的研究（41.5；95%置信区间：25.9 - 58.9），其合并患病率最高。尼日利亚孕妇中无症状恶性疟原虫感染被认为较为普遍。因此，这些结果强调了在所有产前检查中积极诊断和治疗无症状疟疾感染的必要性。
