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坦桑尼亚北部一家三级医院分娩妇女的胎盘寄生虫感染与妊娠结局

Placental Parasitic Infections and Pregnancy Outcomes Among Women Delivering at a Tertiary Hospital in Northern Tanzania.

作者信息

Felician Eustadius Kamugisha, Ngoda Octavian Aron, Jahanpour Ola Farid, Kahima Jackson, Msuya Sia Emmanuel, Lukambagire Abdul Hamid

机构信息

Department of Epidemiology & Biostatistics, Institute of Public Health, KCMUCo, Moshi-Tanzania.

Bukoba Regional Referral Hospital, Bukoba-Tanzania.

出版信息

East Afr Health Res J. 2022;6(2):141-146. doi: 10.24248/eahrj.v6i2.695. Epub 2022 Nov 30.

Abstract

BACKGROUND

Placental parasitic infections continue to be a public health problem despite numerous interventions put in place. Placental parasitic infections reported are Toxoplasma, Trypanosome, Borrelia, Schistosoma, Hookworm and Plasmodia. The infections persist to cause poor pregnancy outcomes such as maternal anaemia, low birth weight and stillbirth. This study aimed to determine the prevalence and pregnancy outcomes associated with placental parasitic infections at a tertiary hospital in northern Tanzania.

METHODS

A cross sectional study was conducted at Kilimanjaro Christian Medical Centre between June and July 2016. Pregnant women were interviewed before delivery and additional information obtained from their medical files. Blood samples as well as placental material were collected from each mother. Malaria was tested using a malaria rapid diagnostic test (mRDT). A total of 80 placental slide sections were made following histological protocols. After staining, slide sections were examined for the presence of parasites microscopically. Pearson's Chi-square and Fisher's exact tests were used to test for differences between groups.

RESULTS

Placental malaria parasites were found on histological examination of 8(10%) mothers' placental sections, none of whom had a positive mRDT. Education status was significantly associated with placental malaria (=0.035). Stillbirth, maternal anaemia and pre-eclampsia were significantly associated with placenta malaria (<0.05).

CONCLUSION

Placental malaria was found to be prevalent in the studied population and was associated with stillbirth, maternal anaemia and pre-eclampsia. Efforts for developing malaria tests that will detect subclinical infections are needed in order to identify infections early and offer prompt treatment to prevent poor pregnant outcomes.

摘要

背景

尽管已采取了诸多干预措施,但胎盘寄生虫感染仍是一个公共卫生问题。报告的胎盘寄生虫感染有弓形虫、锥虫、疏螺旋体、血吸虫、钩虫和疟原虫。这些感染持续导致不良妊娠结局,如孕产妇贫血、低出生体重和死产。本研究旨在确定坦桑尼亚北部一家三级医院胎盘寄生虫感染的患病率及其与妊娠结局的关联。

方法

2016年6月至7月在乞力马扎罗基督教医疗中心开展了一项横断面研究。在分娩前对孕妇进行访谈,并从其病历中获取更多信息。从每位母亲采集血液样本和胎盘组织。使用疟疾快速诊断检测(mRDT)检测疟疾。按照组织学方案制作了总共80个胎盘切片。染色后,在显微镜下检查切片中是否存在寄生虫。使用Pearson卡方检验和Fisher精确检验来检验组间差异。

结果

在8名(10%)母亲的胎盘切片组织学检查中发现了胎盘疟原虫,其中无一mRDT检测呈阳性。教育程度与胎盘疟疾显著相关(P=0.035)。死产、孕产妇贫血和子痫前期与胎盘疟疾显著相关(P<0.05)。

结论

在所研究人群中发现胎盘疟疾很普遍,且与死产、孕产妇贫血和子痫前期有关。需要努力开发能够检测亚临床感染的疟疾检测方法,以便早期识别感染并及时提供治疗,以预防不良妊娠结局。

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