撒哈拉以南非洲与妊娠有关的疟疾、挑战和前景

I. Aguzie
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引用次数: 10

摘要

在撒哈拉以南非洲,与妊娠有关的疟疾仍然是孕妇、胎儿和婴儿面临的主要风险。恶性疟原虫感染严重影响孕产妇、胎儿和新生儿的健康。产妇贫血、低出生体重、早产、自然流产以及产妇和新生儿死亡是其后果之一。它使母体的免疫反应复杂化,也可能自私地通过经胎盘的通讯抢先了胎儿的免疫反应。因此,其影响可能远远超出怀孕期间和分娩后的直接时期。有效的病例管理和预防继续产生积极成果,但挑战仍然存在,特别是在撒哈拉以南非洲。产前服务提供、妊娠期间遵守磺胺多辛乙胺(IPTp-SP)间歇性预防性治疗、磺胺多辛乙胺广泛耐药以及对杀虫剂处理过的蚊帐和杀虫剂耐药等挑战,继续使撒哈拉以南非洲控制PAM的努力复杂化。希望《2016-2030年全球疟疾技术战略》将全面考虑这些挑战,并改善撒哈拉以南非洲每一位孕妇的前景。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pregnancy-associated Malaria, Challenges and Prospects in Sub-Saharan Africa
Pregnancy-associated malaria remains a major risk to the pregnant woman, her foetus and infants in sub- Saharan Africa. Infection by Plasmodium falciparum significantly affects maternal, foetal and neonatal wellbeing. Maternal anaemia, low birth weight, preterm labour, spontaneous abortion, and maternal and neonatal mortalities are some of its consequences. It complicates maternal immunological response and possibly also selfishly pre-empt foetal immunological response by transplacental communications. Therefore, the impacts may extend well beyond the duration of pregnancy and the immediate period post-delivery. Effective case management and prevention continue to yield positive results, but challenges still remains especially in sub-Saharan Africa. The challenges of antenatal service provision, compliance with intermittent preventive treatment at pregnancy by sulfadoxinepyrimethamine (IPTp-SP), widespread SP resistance, and resistance to insecticide treated nets (ITNs) and insecticides continue to complicate efforts at PAM control in sub-Saharan Africa. Hopefully, the Global Technical Strategy for Malaria 2016–2030 will comprehensively consider these challenges and improve the prospect of every pregnant woman in sub-Saharan Africa.
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