Heterogeneity in the prevalence of subclinical malaria, other co-infections and anemia among pregnant women in rural areas of Myanmar: a community-based longitudinal study.

IF 3.6 Q1 TROPICAL MEDICINE
Poe Poe Aung, Kay Thwe Han, Wim Groot, Regien Biesma, Zaw Win Thein, Thura Htay, Zaw Lin, Kyin Hla Aye, Matthew Adams, Milena Pavlova
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引用次数: 0

Abstract

Background: Due to the low prevalence of clinically suspected malaria among pregnant women in Myanmar, little is known about its impact on mothers and newborns. Helminth and Human Immuno-deficiency Virus (HIV) co-infections cause anemia in pregnant women. This study assessed the prevalence of subclinical malaria and co-infections among pregnant women, and its association with adverse outcomes of pregnancy in the presence of infection.

Methods: A prospective longitudinal study was conducted in 12 villages in two townships in Myanmar between 2013 to 2015. A total of 752 pregnant women, with a mean age of 27 years, were enrolled and followed up once a month until six weeks after childbirth. Prevalence ratio was calculated in the multivariable analysis.

Results: The prevalence of subclinical malaria as measured by nested PCR was 5.7% for either P. falciparum or P. vivax, 2.7% prevalence of P. falciparum and 2.8% prevalence of P. vivax. Helminth infections were prevalent in 17% of women, and one woman with an HIV infection was found in our study. The burden of anemia was high, with an overall prevalence of 37% with or without helminth infection, 42% of the women were malaria positive and 43% had dual infections (both malaria and helminth). Only 11 abnormal pregnancy outcomes (7 stillbirths, 2 premature, 2 twins) were identified. Poisson regression showed that women in their first trimester had a 2.9 times higher rate of subclinical malaria compared to women in the third trimester (PR:2.9, 95%CI 1.19, 7.31, p = 0.019), women who were enrolled during the wet season were 2.5 times more likely to be malaria positive than the women enrolled in the dry season (PR: 2.5, 95%CI 1.27, 4.88, p = 0.008), and the malaria positivity rate decreased by 5% when increased in one year of woman's age (PR:0.95, 95%CI 0.91, 0.99, p = 0.02). In the multivariable regression, the age of respondents was the only significant factor associated with subclinical malaria in pregnancy.

Conclusions: A comprehensive approach of integrating interventions for malaria, anemia, and helminths should be delivered during antenatal care services for pregnant women in rural areas of Myanmar.

缅甸农村地区孕妇亚临床疟疾、其他合并感染和贫血患病率的异质性:一项基于社区的纵向研究。
背景:由于缅甸孕妇中临床疑似疟疾的发病率较低,人们对疟疾对母亲和新生儿的影响知之甚少。螺旋体和人类免疫缺陷病毒(HIV)合并感染会导致孕妇贫血。这项研究评估了亚临床疟疾和合并感染在孕妇中的流行情况,以及感染与妊娠不良后果之间的关系:方法:2013 年至 2015 年期间,在缅甸两个乡镇的 12 个村庄开展了一项前瞻性纵向研究。共登记了 752 名孕妇,平均年龄为 27 岁,每月随访一次,直至产后六周。在多变量分析中计算了患病率:结果:通过巢式 PCR 测定的亚临床疟疾流行率为:恶性疟原虫或间日疟原虫 5.7%,恶性疟原虫 2.7%,间日疟原虫 2.8%。17%的妇女患有螺旋体感染,在我们的研究中还发现了一名感染艾滋病毒的妇女。贫血的发病率很高,感染或未感染螺旋体的总发病率为 37%,42% 的妇女为疟疾阳性,43% 的妇女有双重感染(疟疾和螺旋体)。仅发现了 11 例异常妊娠结果(7 例死胎、2 例早产、2 例双胞胎)。泊松回归显示,与怀孕三个月的妇女相比,怀孕头三个月的妇女亚临床疟疾感染率高出 2.9 倍(PR:2.9, 95%CI 1.19, 7.31, p = 0.019),在雨季入学的妇女感染疟疾的几率是雨季妇女的 2.5 倍(PR:2.9, 95%CI 1.19, 7.31, p = 0.019)。疟疾阳性率是旱季妇女的 2.5 倍(PR:2.5, 95%CI 1.27, 4.88, p = 0.008),妇女年龄每增加一岁,疟疾阳性率降低 5%(PR:0.95, 95%CI 0.91, 0.99, p = 0.02)。在多变量回归中,受访者的年龄是与孕期亚临床疟疾相关的唯一重要因素:结论:缅甸农村地区的孕妇在接受产前保健服务时应采取综合措施,对疟疾、贫血和蠕虫病进行干预。
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来源期刊
Tropical Medicine and Health
Tropical Medicine and Health TROPICAL MEDICINE-
CiteScore
7.00
自引率
2.20%
发文量
90
审稿时长
11 weeks
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