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孕妇中的疟疾和可治愈的性传播感染:布基纳法索农村地区的一项为期两年的观察性研究。

Malaria and curable sexually transmitted infections in pregnant women: A two-years observational study in rural Burkina Faso.

机构信息

Pôle d'Epidémiologie et biostatistique, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain (UCLouvain), Brussels, Belgique.

Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Bobo-Dioulasso, Burkina Faso.

出版信息

PLoS One. 2020 Nov 16;15(11):e0242368. doi: 10.1371/journal.pone.0242368. eCollection 2020.

Abstract

BACKGROUND

Malaria and curable sexually transmitted infections (STI) are the most common curable infections known to have a severe impact on pregnancy outcomes in sub-Saharan Africa. This study aims to assess the marginal and joint prevalence of symptomatic cases of malaria and STI in pregnant women living in rural settings of Burkina Faso and their associated factors, after more than a decade of the introduction of intermittent preventive treatment (IPT-SP).

METHODS

We carried out an observational study in two health districts in rural Burkina, namely Nanoro and Yako. Routine data were collected during antenatal and delivery visits for all women who delivered in the year 2016 and 2017. Logistic regression models were used to assess factors associated with infections.

RESULTS

We collected data from 31639 pregnant women attending health facilities. Malaria, curable STI and their coinfections were diagnosed in 7747 (24.5%; 95%CI: 24.0-25.0%), 1269 (4.0%; 95%CI: 3.8-4.2%) and 388 (1.2%; 95%CI: 1.1-1.4%) women, respectively. In multivariate logistic regression, malaria occurrence was significantly higher in pregnant women < 20 years (Adjusted OR = 2.36; 95% CI: 2.07-2.69) than in women ≥30 years. The prevalence of curable STI was also significantly higher in students (Adjusted OR = 1.93; 95% CI: 1.26-2.95) and compensated workers (Adjusted OR = 1.52; 95% CI: 1.01-2.17) than in uncompensated workers. Women who received no IPT-SP had higher prevalence of malaria (Adjusted OR = 3.33; 95%CI: 3.00-3.70), curable STI (Adjusted OR = 1.96 95%CI: 1.60-2.39) and coinfections (Adjusted OR = 2.11; 95% CI: 1.50-2.95) compared to women who received SP.

CONCLUSION

Malaria and curable STI remain highly prevalent in rural settings of Burkina Faso, with young pregnant women and women who received no IPT-SP being the most affected. Prevention must be reinforced to improve maternal and infant health.

摘要

背景

疟疾和可治愈性性传播感染(STI)是已知对撒哈拉以南非洲的妊娠结局有严重影响的最常见的可治愈感染。本研究旨在评估在布基纳法索农村地区,经过十多年间歇性预防治疗(IPT-SP)的引入后,妊娠妇女中症状性疟疾和 STI 的边际和联合流行率及其相关因素。

方法

我们在布基纳法索的两个农村卫生区(Nanoro 和 Yako)进行了一项观察性研究。为 2016 年和 2017 年分娩的所有妇女在产前和分娩期间收集常规数据。使用逻辑回归模型评估与感染相关的因素。

结果

我们收集了 31639 名在卫生机构就诊的孕妇的数据。诊断出 7747 例(24.5%;95%CI:24.0-25.0%)疟疾、1269 例(4.0%;95%CI:3.8-4.2%)可治愈性 STI 和 388 例(1.2%;95%CI:1.1-1.4%)的合并感染。在多变量逻辑回归中,20 岁以下的孕妇患疟疾的发生率明显高于 30 岁以上的孕妇(调整后的比值比[OR] = 2.36;95%CI:2.07-2.69)。学生(调整后的 OR = 1.93;95%CI:1.26-2.95)和有酬工人(调整后的 OR = 1.52;95%CI:1.01-2.17)比无酬工人更易患可治愈性 STI。未接受 IPT-SP 的妇女患疟疾(调整后的 OR = 3.33;95%CI:3.00-3.70)、可治愈性 STI(调整后的 OR = 1.96;95%CI:1.60-2.39)和合并感染(调整后的 OR = 2.11;95%CI:1.50-2.95)的患病率均高于接受 SP 的妇女。

结论

疟疾和可治愈性 STI 在布基纳法索农村地区仍然高度流行,年轻孕妇和未接受 IPT-SP 的妇女受影响最大。必须加强预防措施,以改善母婴健康。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc4c/7668607/f226d74da40b/pone.0242368.g001.jpg

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