Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon.
Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.
Trop Med Int Health. 2021 Aug;26(8):973-981. doi: 10.1111/tmi.13591. Epub 2021 May 4.
To report the prevalence of polyparasitism during pregnancy in the Lambaréné region of Gabon and its association with newborn birth weight.
Pregnant women in their third trimester were recruited in a prospective study between November 2011 and March 2015. Parasite infection status was assessed microscopically in stool, urine and blood samples. Maternal demographic and obstetrical characteristics and newborns anthropometric data were collected. Multivariable logistic regression was used to assess the association between low birth weight and polyparasitism.
678 of 927 pregnant women were included for analysis with mean age (SD) of 25 (6.8) years. The analysis showed that 69% (468/678) were infected with at least one parasite (Plasmodium spp., Schistosoma spp., soil-transmitted helminths, filarial infections). This comprised of 38% with monoparasitism and 31% polyparasitism. The proportion of newborn babies with a weight below 2500 g (LBW) in our study was 21% (142/678). Compared to pregnant women without infection, women with monoparasitic infection had adjusted Odds Ratio confidence interval 95% CI (aOR [95%CI]) of 1.6 [0.95-2.73], those with two parasites had aOR 95%CI of 2.63 [1.51-4.62], and those with more than two parasites had aOR of 5.08 [2.5-10.38] for delivering a newborn with low birth weight.
In Lambaréné, an endemic area for multiple parasite infections, there is a high prevalence of polyparasitism in pregnant women. Polyparasitism is associated with low birth weight. Therefore, there is an urgent need for active screening and treatment of parasite infections in pregnant women to assess the potential public health benefit of such interventions.
报告加蓬兰巴雷内地区妊娠期间的寄生虫感染率及其与新生儿出生体重的关系。
2011 年 11 月至 2015 年 3 月，对处于妊娠晚期的孕妇进行前瞻性研究。通过显微镜检查粪便、尿液和血液样本评估寄生虫感染状况。收集产妇人口统计学和产科特征以及新生儿人体测量数据。采用多变量逻辑回归评估低出生体重与寄生虫感染的关系。
在 927 名孕妇中，有 678 名被纳入分析，平均年龄（标准差）为 25（6.8）岁。分析显示，69%（468/678）感染了至少一种寄生虫（疟原虫、血吸虫、土壤传播的蠕虫、丝虫感染）。其中 38%为单寄生虫感染，31%为多寄生虫感染。本研究中体重低于 2500 克（LBW）的新生儿比例为 21%（142/678）。与未感染的孕妇相比，单寄生虫感染孕妇的校正优势比置信区间 95%CI（aOR [95%CI]）为 1.6 [0.95-2.73]，感染两种寄生虫的孕妇 aOR 95%CI 为 2.63 [1.51-4.62]，感染两种以上寄生虫的孕妇 aOR 为 5.08 [2.5-10.38]，新生儿出生体重低。
在兰巴雷内这个多种寄生虫感染的流行地区，孕妇中普遍存在寄生虫感染。寄生虫感染与低出生体重有关。因此，迫切需要对孕妇进行寄生虫感染的主动筛查和治疗，以评估此类干预措施的潜在公共卫生效益。
