Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellin, Colombia.
School of Medicine, University of Antioquia, Medellin, Colombia.
Sci Rep. 2022 Jun 29;12(1):10944. doi: 10.1038/s41598-022-15011-1.
Research on Gestational Malaria (GM) is scarce in America's. In the few available studies in Colombia, the analysis of immunological or parasitological aspects predominates, with few analyzes of epidemiological aspects. The objectives were to determine the frequency of GM and submicroscopic infections (positive with PCR and negative with thick blood smears), to identify obstetric and malaria history associated with GM, and to describe maternal and neonatal outcomes associated with GM, in northwestern Colombia. A retrospective study with records of 825 pregnant women was conducted. qPCR and thick blood smear were performed. Frequencies were determined with 95% confidence intervals. Comparisons were made with the Chi-square test, Mann-Whitney U test, and prevalence ratios adjusted in a log-binomial model. The frequency of GM was 35.8% (95% CI 32.4-39.1) of submicroscopic infection was 16.2% (95% CI 13.7-18.8). According to the multivariable model, the subgroups with the highest frequency of GM were pregnant women without healthcare coverage (32.3%), in the third trimester of pregnancy (30.5%), nulliparous (35.6%), and with a previous diagnosis of malaria in the current pregnancy (64.0%). GM was associated with more frequency of gestational anemia, infection in neonates, and lower birth weight. The results indicate in a precise and direct way that malaria control in this northwestern region of Colombia is far from adequate, which is even more serious considering the affectations for the mother and the neonate.
美国对妊娠期疟疾(GM)的研究很少。在哥伦比亚为数不多的可用研究中,免疫或寄生虫学方面的分析占主导地位,而对流行病学方面的分析很少。目的是确定 GM 和亚微观感染(PCR 阳性而厚血涂片阴性)的频率,确定与 GM 相关的产科和疟疾史,并描述与 GM 相关的母婴结局,在哥伦比亚西北部进行了一项回顾性研究,记录了 825 名孕妇的情况。进行了 qPCR 和厚血涂片检查。用 95%置信区间确定频率。用卡方检验、Mann-Whitney U 检验和对数二项式模型调整的患病率比进行比较。GM 的频率为 35.8%(95%CI 32.4-39.1),亚微观感染的频率为 16.2%(95%CI 13.7-18.8)。根据多变量模型,GM 频率最高的亚组是没有医疗保健覆盖的孕妇(32.3%)、妊娠晚期(30.5%)、初产妇(35.6%)和当前妊娠中有疟疾既往诊断的孕妇(64.0%)。GM 与妊娠期贫血、新生儿感染和较低的出生体重更频繁相关。结果以精确和直接的方式表明,哥伦比亚西北部地区的疟疾控制远远不够,考虑到对母亲和新生儿的影响,情况更为严重。