Graduate School of Health Sciences, St Louis University Institute, Douala, Cameroon.
Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.
BMC Pregnancy Childbirth. 2024 Aug 28;24(1):560. doi: 10.1186/s12884-024-06769-5.
Malaria during pregnancy continues to be a significant cause of morbidity and mortality for both infants and mothers, particularly in sub-Saharan African (SSA) countries, despite increased efforts to control it. The utilization of long-lasting insecticide-treated nets (LLINs) during pregnancy is a well-established strategy to reduce the prevalence of malaria. Nonetheless, inadequate adherence remains a persistent challenge in certain regions with high malaria endemicity. This research aimed to assess the effectiveness of long-lasting insecticidal nets in preventing asymptomatic malaria infections among pregnant women attending antenatal care at the Bonassama District Hospital in the Littoral Region of Cameroon.
A hospital-based cross-sectional study was conducted from March to June 2022. Data on sociodemographic characteristics and LLIN usage were collected through a structured questionnaire, while asymptomatic malaria infections were identified using a PfHRP2/pLDH malaria qualitative rapid diagnostic kit. The relationship between categorical variables was analyzed using the chi-square test and logistic regression at a significance level of 5%.
Out of the 411 pregnant women included in the study, 35.4% were diagnosed with malaria. The LLIN utilization rate was 65.1%. The risk of malaria infection was 2.7 times higher (AOR = 2.75, 95% CI = 1.83-4.14, p < 0.001) among women who did not consistently use LLINs compared to those who did. Pregnant women in their first trimester (AOR = 3.40, 95% CI = 1.24-4.64, p = 0.010) and second trimester (AOR = 1.90, 95%CI = 0.99-3.62, p = 0.055) were more likely to sleep under net when compared to those in the third trimester. Younger women 20-29 years (71.4%), those in the first trimester (69.6%) and those who had the nets before pregnancy (68.9%) were amongst those who frequently used use the nets. Among the reasons reported for not frequently using LLINs were heat (55.2%), suffocation (13.6%) and the smell of nets (8.4%).
The use of LLIN was moderately high among the participants in this study, though still below national target. Age group, religion and gestation period were the major factors determining the use of LLINs. Considering the proven effectiveness of LLINs in reducing malaria morbidity and mortality, it is imperative for the National Malaria Control Programme (NMCP) to remain focused in promoting both LLIN ownership and utilization to achieve the national target of 100% and 80%, respectively.
尽管在控制疟疾方面做出了更多努力，但孕妇疟疾仍然是撒哈拉以南非洲（SSA）国家婴儿和母亲发病率和死亡率的一个重要原因。在怀孕期间使用长效驱虫蚊帐（LLINs）是减少疟疾流行的既定策略。然而，在疟疾高度流行的某些地区，仍然存在着坚持使用不足的问题。本研究旨在评估在喀麦隆滨海大区博纳萨马区医院接受产前护理的孕妇使用长效驱虫蚊帐预防无症状疟疾感染的效果。
这是一项 2022 年 3 月至 6 月期间在医院进行的横断面研究。通过结构化问卷收集社会人口学特征和 LLIN 使用情况的数据，同时使用 PfHRP2/pLDH 疟疾定性快速诊断试剂盒确定无症状疟疾感染。使用卡方检验和逻辑回归在 5%的显著性水平上分析分类变量之间的关系。
在纳入研究的 411 名孕妇中，35.4%被诊断患有疟疾。LLIN 的使用率为 65.1%。与经常使用 LLINs 的孕妇相比，不经常使用 LLINs 的孕妇感染疟疾的风险高 2.7 倍（AOR=2.75，95%CI=1.83-4.14，p<0.001）。与孕晚期相比，孕早期（AOR=3.40，95%CI=1.24-4.64，p=0.010）和孕中期（AOR=1.90，95%CI=0.99-3.62，p=0.055）的孕妇更有可能在睡觉时使用蚊帐。较年轻的 20-29 岁女性（71.4%）、孕早期（69.6%）和怀孕前有蚊帐的女性（68.9%）是经常使用蚊帐的人群之一。报告的不经常使用 LLINs 的原因包括热（55.2%）、窒息（13.6%）和蚊帐气味（8.4%）。
在这项研究中，参与者使用 LLIN 的比例适中，但仍低于国家目标。年龄组、宗教和妊娠周期是决定使用 LLIN 的主要因素。考虑到 LLIN 在降低疟疾发病率和死亡率方面的有效性，国家疟疾控制规划（NMCP）必须继续专注于促进 LLIN 的拥有和使用，以分别实现 100%和 80%的国家目标。
