U.S. President's Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA.
Jhpiego, Dar es Salaam, Tanzania.
Int J Infect Dis. 2023 Nov;136:57-63. doi: 10.1016/j.ijid.2023.08.007. Epub 2023 Aug 10.
Estimates of malaria burden and intervention uptake in Africa are primarily based on household surveys. However, their expense and infrequency limit their utility. We investigated whether data collected during antenatal care (ANC) can provide relevant information for decision-makers.
Malaria test positivity rates and questionnaire data from ANC attendees at 39 health facilities were compared to questionnaire data and positivity rates among children from two cross-sectional surveys in the facilities' corresponding catchment areas.
Trends in parasitemia among ANC attendees were predictive of trends in parasitemia among children at the council level (mean absolute error 6.0%). Primigravid ANC attendees had the lowest rates of net ownership (modeled odds ratio [OR] 0.28, 95% CI 0.19-0.40) and use (OR 0.58, 95% CI 0.42-0.79). ANC attendees reported higher levels of care-seeking (OR 1.78, 95% CI 1.48-2.14), malaria testing (OR 4.16, 95% CI 3.44-5.04), and treatment for children with fever (OR 7.66, 95% CI 4.89-11.98) compared to women surveyed in households, raising concerns about social desirability bias disproportionately impacting ANC surveys.
ANC surveillance is an effective strategy for tracking trends in malaria burden. More work is required to elucidate the value of administering questionnaires to ANC attendees.
非洲疟疾负担和干预措施采用率的估算主要基于家庭调查。然而，这些调查费用高昂且频率有限，因此其应用受到限制。我们研究了在产前保健（ANC）期间收集的数据是否可以为决策者提供相关信息。
将 39 个卫生设施 ANC 参与者的疟疾检测阳性率和问卷调查数据与同一地区的两个横断面调查中儿童的问卷调查数据和阳性率进行比较。
ANC 参与者中的寄生虫血症趋势与理事会层面儿童中的寄生虫血症趋势具有预测性（平均绝对误差为 6.0%）。初次妊娠的 ANC 参与者拥有蚊帐的比例最低（模型比值比 [OR] 0.28，95%置信区间 [CI] 0.19-0.40），使用率也最低（OR 0.58，95% CI 0.42-0.79）。ANC 参与者报告了更高水平的寻求治疗（OR 1.78，95% CI 1.48-2.14）、疟疾检测（OR 4.16，95% CI 3.44-5.04）和儿童发热治疗（OR 7.66，95% CI 4.89-11.98），与家庭调查中的妇女相比，这引发了对社会期望偏差不成比例地影响 ANC 调查的担忧。
ANC 监测是跟踪疟疾负担趋势的有效策略。需要进一步研究来阐明向 ANC 参与者发放问卷的价值。
