Unit of Evolution, Epidemiology and Parasitic Resistances (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), B.P. 769, Franceville, Gabon.
Département d'Epidémiologie Biostatistique et Informatique Médicale, Université des Sciences de la Santé, Libreville, Gabon.
Malar J. 2022 Nov 4;21(1):315. doi: 10.1186/s12936-022-04305-4.
Evaluating malaria control strategies for pregnant women is essential. The objective of this study was to determine the factors influencing antenatal care (ANC) visit attendance, complete intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) and its impact on the health of pregnant women and their newborn babies living in semi-urban and rural areas of southeastern Gabon.
This transversal study was performed at the Centre Hospitalier Régional Paul Moukambi de Koula-Moutou (CHRPMK). Information regarding age, frequency of prenatal consultations, obstetric history, use of malaria control measures, use of IPTp-SP, malaria diagnostic of women and their newborns, were collected: (i): from birth registers from 1 January, 2018 to 31 December, 2019 and, (ii): a questionnaire from January to April 2020.
In total, 1,851 and 323 pregnant women were included during the first and the second sub-set of study, respectively. In the first sub-set of data, the mean age was 26.18 ± 7.02 years and 96.54% (1,787/1,851) of pregnant women had attended ANC service but 54.45% had complete ANC visit attendance (at least 4 ANC). The complete ANC visit was linked with age (p < 0.001) and profession (p < 0.001). The complete IPTp-SP (at least 3 doses) was 58.87%. Complete IPTp-SP was linked to profession (aOR = 1.49, 95% CI [1.04-2.18], p < 0.001), ANC visit (aOR = 0.176, 95% CI [0.14-0.22], p < 0.034) and age (p = 0.03). Birth weight was higher for babies whose mothers had received complete IPTp-SP (p < 0,001) but the Apgar score was not influenced by the use of IPTp-SP (p = 0.71). In the second sub-set of data, the prevalence of plasmodial infection was 3.10% (95% IC [1.21-5]) and Plasmodium falciparum was responsible for 100% of infections. The prevalence of plasmodial infection was the same for all age groups (p = 0.69), gravidity (p = 0.13) and domestic control measures (p > 0.05). A low birth weight was statistically linked to the mother's plasmodial infection (p < 0.01). Furthermore, plasmodial infection was statistically linked to premature birth (p < 0.001).
It was observed that attendance of women to ANC service and a complete IPTp-SP course is insufficient.
评估针对孕妇的疟疾控制策略至关重要。本研究旨在确定影响产前护理（ANC）就诊、完成磺胺多辛-乙胺嘧啶间歇性预防治疗（IPTp-SP）的因素及其对居住在加蓬东南部半城市和农村地区的孕妇及其新生儿健康的影响。
本横断面研究在保罗·穆卡姆比·库拉-穆图地区中心医院（CHRPMK）进行。从 2018 年 1 月 1 日至 2019 年 12 月 31 日，收集了年龄、产前咨询频率、产科史、疟疾控制措施使用、IPTp-SP 使用、妇女及其新生儿疟疾诊断的信息：（i）来自出生登记册，（ii）2020 年 1 月至 4 月的问卷。
在第一和第二部分数据中，分别纳入了 1851 名和 323 名孕妇。在第一部分数据中，平均年龄为 26.18 ± 7.02 岁，96.54%（1787/1851）的孕妇接受了 ANC 服务，但仅有 54.45%的孕妇完成了 ANC 就诊（至少 4 次 ANC）。完成 ANC 就诊与年龄（p < 0.001）和职业（p < 0.001）有关。完全的 IPTp-SP（至少 3 剂）为 58.87%。完全的 IPTp-SP 与职业（aOR = 1.49，95%CI [1.04-2.18]，p < 0.001）、ANC 就诊（aOR = 0.176，95%CI [0.14-0.22]，p < 0.034）和年龄（p = 0.03）有关。接受完全 IPTp-SP 的婴儿出生体重较高（p < 0.001），但 Apgar 评分不受 IPTp-SP 使用的影响（p = 0.71）。在第二部分数据中，疟原虫感染的患病率为 3.10%（95%IC [1.21-5]），且全部由恶性疟原虫引起。所有年龄组（p = 0.69）、孕次（p = 0.13）和家庭控制措施（p > 0.05）的疟原虫感染患病率相同。低出生体重与母亲疟原虫感染有统计学关联（p < 0.01）。此外，疟原虫感染与早产有统计学关联（p < 0.001）。
我们发现，妇女参加 ANC 服务和完成完整的 IPTp-SP 疗程的情况并不理想。
