乌干达北部古卢地区转诊医院孕妇产前护理中与疟疾相关的因素。

Factors associated with malaria in pregnancy among antenatal care mothers at Gulu Regional Referral Hospital in northern Uganda.

机构信息

Medical Student, Faculty of Medicine, Gulu University, Gulu, Uganda.

Department of Reproductive Health, Faculty of Medicine, Gulu University, Gulu, Uganda.

出版信息

Malar J. 2024 Nov 18;23(1):346. doi: 10.1186/s12936-024-05184-7.

DOI:10.1186/s12936-024-05184-7

PMID:39558351

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11575075/

Abstract

BACKGROUND

All pregnant mothers in Uganda are given sulfadoxine-pyrimethamine (SP, Fansidar) for presumptive treatment of malaria in pregnancy from 14 weeks of gestation, every four weeks, until delivery. However, prenatal mothers still fall sick of malaria. This study aimed to assess the factors associated with malaria in pregnancy among antenatal care mothers at Gulu Regional Referral Hospital.

METHODS

This was a cross-sectional study at Gulu Regional Referral Hospital antenatal clinic from July to August 2023. Consecutive sampling was used. An interviewer-administered questionnaire was used to collect sociodemographic characteristics, physical examination findings and blood samples taken for rapid diagnostic test (RDT) for malaria. A positive RDT was taken as the presence of malaria infection in pregnancy. Data was pre-processed in STATA15, and logistic regression analysis was done in RStudio 4.2.2. Variables with p < 0.05 were taken as independently associated with malaria in pregnancy and reported as adjusted risk ratios (aRR).

RESULTS

Three hundred fifty (350) pregnant women were recruited; 96% of them slept under mosquito nets daily, while more than half of them (51.7%) had not yet taken SP (IPTp) during their current pregnancy. Prevalence of anaemia (Hb < 11.0 g/dl) was 46.0%. Twenty-four per cent of the mothers were in the first trimester, 56.3% in the second and 19.7% in the third. The prevalence of malaria in pregnancy was 39.7% (95% CI 34.5-45.1%), equally distributed throughout the trimesters. Anaemia (aRR = 4.99, 95%CI 3.10-8.05, p < 0.001) and tertiary level of education (aRR = 0.29, 95% CI 0.14-0.62, p = 0.001) were significantly associated with malaria in pregnancy. Not sleeping under a mosquito net (aRR = 3.79, 95% CI 0.95-15.16, p = 0.059) may be a factor associated with malaria in pregnancy.

CONCLUSION

Four in every ten mothers had malaria infection, with anaemia being a risk factor, while a tertiary level of education was protective against malaria in pregnancy.

摘要

背景

乌干达的所有孕妇在妊娠 14 周后每四周接受磺胺多辛-乙胺嘧啶（SP， Fansidar）预防性治疗疟疾，直至分娩。然而，孕妇仍会患上疟疾。本研究旨在评估在 Gulu 地区转诊医院进行产前护理的孕妇中与妊娠疟疾相关的因素。

方法

这是 2023 年 7 月至 8 月在 Gulu 地区转诊医院进行的横断面研究。采用连续抽样法。使用访谈者管理的问卷收集社会人口学特征、体格检查结果和用于快速诊断检测（RDT）的血液样本，以检测疟疾。阳性 RDT 被视为妊娠期间存在疟疾感染。数据在 STATA15 中进行预处理，并在 RStudio 4.2.2 中进行逻辑回归分析。p 值<0.05 的变量被视为与妊娠疟疾独立相关，并以调整后的风险比（aRR）报告。

结果

共招募了 350 名孕妇；其中 96%的孕妇每天都睡在蚊帐下，而超过一半（51.7%）的孕妇在本次妊娠中尚未服用 SP（IPT）。贫血（Hb<11.0 g/dl）的患病率为 46.0%。母亲中有 24%处于孕早期，56.3%处于孕中期，19.7%处于孕晚期。妊娠疟疾的患病率为 39.7%（95%CI 34.5-45.1%），在各孕期分布均匀。贫血（aRR=4.99，95%CI 3.10-8.05，p<0.001）和高等教育程度（aRR=0.29，95%CI 0.14-0.62，p=0.001）与妊娠疟疾显著相关。未睡在蚊帐下（aRR=3.79，95%CI 0.95-15.16，p=0.059）可能是妊娠疟疾的一个相关因素。