Mutabingwa T K, Malle L N, Verhave J P, Eling W M, Meuwissen J H, de Geus A
National Institute for Medical Research, Amani, Tanzania.
Trop Geogr Med. 1993;45(4):150-6.
The effect of malaria prophylaxis during pregnancy on the levels of cord blood anti-sporozoite antibodies was investigated in 203 newborns in Muheza, Tanzania. Mothers of 76 newborns had received prophylaxis with proguanil daily (PROG), 66 chloroquine once weekly (CQ), and 61 got a combination of the two drugs (CQ+PROG). Prophylaxis with PROG or CQ+PROG was more efficacious than with CQ. The mean antibody titres were comparable in all three groups, despite titres being significantly low in mothers of the CQ+PROG group. In 93% of 167 paired maternal-cord sera, maternal titres were higher than cord titres. The correlation between maternal and cord titres was low. Parity, placental malaria, and baby maturity showed little influence on titres. Titres of babies delivered by Caesarean section or whose placenta weighed between 0.75 and 1 kg were comparatively low. The first occurrence of a malaria parasitaemia in infants was independent of the levels of cord titres at birth. The results suggested that chemoprophylaxis as effective as PROG or CQ+PROG in holoendemic areas, insignificantly affects maternal-foetal transfer of anti-sporozoite antibodies, and that levels of these antibodies at birth do not modulate the first occurrence of infancy malaria parasitaemia. Interference with the maternal-foetal transfer of this antibody and possibly other component antibodies of passive immunity should not limit the selection of PROG or CQ+PROG for chemoprophylaxis.
在坦桑尼亚穆赫扎，对203名新生儿进行了研究，以调查孕期疟疾预防措施对脐带血抗子孢子抗体水平的影响。76名新生儿的母亲每日接受了氯胍预防（PROG），66名母亲每周接受一次氯喹预防（CQ），61名母亲接受了两种药物的联合预防（CQ+PROG）。使用PROG或CQ+PROG进行预防比使用CQ更有效。尽管CQ+PROG组母亲的抗体滴度显著较低，但三组的平均抗体滴度相当。在167对母婴配对血清中，93%母亲的抗体滴度高于脐带血中的滴度。母亲和脐带血抗体滴度之间的相关性较低。产次、胎盘疟疾和婴儿成熟度对抗体滴度影响不大。剖宫产分娩的婴儿或胎盘重量在0.75至1千克之间的婴儿的抗体滴度相对较低。婴儿首次出现疟原虫血症与出生时脐带血抗体滴度水平无关。结果表明，在高度流行地区，与PROG或CQ+PROG一样有效的化学预防措施对母婴抗子孢子抗体的转移影响不大，且出生时这些抗体的水平不会调节婴儿期疟原虫血症的首次出现。对这种抗体以及可能的其他被动免疫成分抗体的母婴转移进行干预，不应限制选择PROG或CQ+PROG进行化学预防。
