在科特迪瓦农村高疟疾传播地区，胎盘疟疾及相关低出生体重的风险因素。

Risk factors for placental malaria and associated low birth weight in a rural high malaria transmission setting of Cote d'Ivoire.

作者信息

Toure Offianan Andre, C Konan Carole B, Kouame Valery N, Gbessi Eric A, Soumahoro Adama, Bassinka Issiaka, Jambou Ronan

机构信息

Department of Malariology, Pasteur Institute of Côte d'Ivoire, Côte d'Ivoire, Côte d'Ivoire.

Pediatric Department, General Hospital of Ayame Catholic Mission, Cote d'Ivoire.

出版信息

Trop Parasitol. 2020 Jul-Dec;10(2):102-108. doi: 10.4103/tp.TP_58_19. Epub 2021 Jan 25.

DOI:10.4103/tp.TP_58_19

PMID:33747876

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7951072/

Abstract

BACKGROUND

Placental malaria (PM) is associated with increased risk of both maternal and neonatal adverse outcomes. The objective of this study was to assess risks factors associated with PM including intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP).

METHODS

A cross-sectional study was conducted at Ayame hospital in the southern region of Cote d'Ivoire between August 2016 and March 2017. Sociodemographic baseline characteristic and antenatal data were obtained from the mother's antenatal card and included timing and number of IPTp-SP doses. Newborn characteristics were recorded.Peripheral blood as well as placental and cord blood were used to prepare thick and thin blood films. In addition, pieces of placental tissues were used to prepare impression smears. Regression logistics were used to study factors associated with PM and low birth weight (LBW) (<2.500 g).

RESULTS

Three hundred delivered women were enrolled in the study. The mean age of the participants was 25 ± 6.5 years and most participants were multigravida (52.8%). The coverage rate of IPTp-SP with the full three doses recommended was 27.8%. Overall, 7.3% (22/300) of women examined had PM detected by microscopy using impression smear (22/300). Multivariate analysis showed that significant risks factors of PM were maternal peripheral parasitemia at delivery ( < 0.0001), residence ( = 0.03), and not sleeping under long-lasting insecticide treated nets (LLINs) ( = 0.006). LBW infants were born to 22.7% (5/22) of women with PM and 13.3% (37/278) of women without PM ( = 0.47). Only primiparous was associated with LBW in the multivariable analysis ( = 0.04).

CONCLUSION

The prevalence of PM was 7.3%. Low parity, residence and not using LLINs and maternal peripheral parasitemia were identified as risks factors. PM was associated with LBW. Implementation of IPTp-SP should be improved by the National Malaria Control Program in rural settings.

摘要

背景

胎盘疟疾（PM）与孕产妇和新生儿不良结局风险增加相关。本研究的目的是评估与胎盘疟疾相关的风险因素，包括磺胺多辛 - 乙胺嘧啶间歇性预防性治疗（IPTp - SP）。

方法

2016年8月至2017年3月在科特迪瓦南部地区的阿亚梅医院进行了一项横断面研究。社会人口统计学基线特征和产前数据从母亲的产前卡片中获取，包括IPTp - SP剂量的时间和数量。记录新生儿特征。外周血以及胎盘血和脐带血用于制备厚血膜和薄血膜。此外，胎盘组织块用于制备印片。采用逻辑回归研究与胎盘疟疾和低出生体重（LBW）（<2500克）相关的因素。

结果

300名分娩妇女纳入研究。参与者的平均年龄为25±6.5岁，大多数参与者为经产妇（52.8%）。推荐的三剂完整IPTp - SP的覆盖率为27.8%。总体而言，通过印片显微镜检查，7.3%（22/300）的受检妇女被检测出患有胎盘疟疾。多变量分析显示，胎盘疟疾的显著风险因素是分娩时母亲外周血寄生虫血症（<0.0001）、居住地（=0.03）以及未使用长效驱虫蚊帐（LLINs）（=0.006）。患有胎盘疟疾的妇女中22.7%（5/22）的婴儿为低出生体重儿，未患胎盘疟疾的妇女中13.3%（37/278）的婴儿为低出生体重儿（=0.47）。在多变量分析中，只有初产与低出生体重相关（=0.04）。