PDF(Pubmed)
Abstract：
BACKGROUND: Pregnancy Associated Malaria (PAM) include malaria in pregnancy (MiP), placental malaria (PM), and congenital malaria (CM). The evidence available in Colombia on PAM focuses on one of the presentations (MiP, PM or CM), and no study longitudinally analyses the infection from the pregnant woman, passing through the placenta, until culminating in the newborn. This study determined the frequency of MiP, PM, and CM caused by Plasmodium vivax, Plasmodium falciparum, or mixed infections, according to Thick Blood Smear (TBS) and quantitative Polymerase Chain Reaction (qPCR). Identifying associated factors of PAM and clinical-epidemiological outcomes in northwestern Colombia.
METHODS: Prospective study of 431 pregnant women, their placenta, and newborns registered in the data bank of the research Group \"Salud y Comunidad César Uribe Piedrahíta\" which collected information between 2014 and 2020 in endemic municipalities of the departments of Córdoba and Antioquia. The frequency of infection was determined with 95% confidence intervals. Comparisons were made with the Chi-square test, Student t-test, prevalence ratios, and control for confounding variables by log-binomial regression.
RESULTS: The frequency of MiP was 22.3% (4.6% using TBS), PM 24.8% (1.4% using TBS), and CM 11.8% (0% using TBS). Using TBS predominated P. vivax. Using qPCR the proportions of P. vivax and P. falciparum were similar for MiP and PM, but P. falciparum predominated in CM. The frequency was higher in nulliparous, and women with previous malaria. The main clinical effects of PAM were anaemia, low birth weight, and abnormal APGAR score.
CONCLUSIONS: The magnitude of infections was not detected with TBS because most cases were submicroscopic (TBS-negative, qPCR-positive). This confirmed the importance of improving the molecular detection of cases. PAM continue being underestimated in the country due to that in Colombia the control programme is based on TBS, despite its outcomes on maternal, and congenital health.
METHODS: Prospective study of 431 pregnant women, their placenta, and newborns registered in the data bank of the research Group \"Salud y Comunidad César Uribe Piedrahíta\" which collected information between 2014 and 2020 in endemic municipalities of the departments of Córdoba and Antioquia. The frequency of infection was determined with 95% confidence intervals. Comparisons were made with the Chi-square test, Student t-test, prevalence ratios, and control for confounding variables by log-binomial regression.
RESULTS: The frequency of MiP was 22.3% (4.6% using TBS), PM 24.8% (1.4% using TBS), and CM 11.8% (0% using TBS). Using TBS predominated P. vivax. Using qPCR the proportions of P. vivax and P. falciparum were similar for MiP and PM, but P. falciparum predominated in CM. The frequency was higher in nulliparous, and women with previous malaria. The main clinical effects of PAM were anaemia, low birth weight, and abnormal APGAR score.
CONCLUSIONS: The magnitude of infections was not detected with TBS because most cases were submicroscopic (TBS-negative, qPCR-positive). This confirmed the importance of improving the molecular detection of cases. PAM continue being underestimated in the country due to that in Colombia the control programme is based on TBS, despite its outcomes on maternal, and congenital health.
摘要：
背景：妊娠相关疟疾（PAM）包括妊娠期疟疾（MiP），胎盘疟疾（PM），和先天性疟疾（CM）。哥伦比亚关于PAM的现有证据集中在其中一个演示文稿上(MiP，PM或CM)，没有研究纵向分析孕妇的感染，穿过胎盘，直到新生儿的高潮。这项研究确定了MiP的频率，PM,由间日疟原虫引起的CM，恶性疟原虫,或者混合感染，根据厚血涂片(TBS)和定量聚合酶链反应(qPCR)。哥伦比亚西北部PAM的相关因素和临床流行病学结果。
方法：对431名孕妇进行前瞻性研究，他们的胎盘,以及在“SaludyComunidadCésarUribePiedrahíta”研究小组的数据库中注册的新生儿，该小组在2014年至2020年之间在科尔多瓦和安蒂奥基亚省的地方城市收集了信息。以95%置信区间确定感染频率。用卡方检验进行了比较，学生t检验，患病率比率，并通过对数二项回归控制混杂变量。
结果：MiP的频率为22.3％（使用TBS为4.6％），PM24.8%（使用TBS为1.4%），和厘米11.8%（0%使用TBS）。使用TBS占优势的间日疟原虫。使用qPCR，MIP和PM的间日疟原虫和恶性疟原虫的比例相似，但恶性疟原虫在CM中占主导地位。未产的频率更高，和以前患有疟疾的妇女。PAM的主要临床疗效是贫血，低出生体重,APGAR评分异常。
结论：TBS未检测到感染程度，因为大多数病例是亚显微镜下（TBS阴性，qPCR阳性）。这证实了改进病例分子检测的重要性。由于哥伦比亚的控制计划是基于TBS的，因此该国的PAM继续被低估，尽管它对产妇有影响，和先天健康。
方法：对431名孕妇进行前瞻性研究，他们的胎盘,以及在“SaludyComunidadCésarUribePiedrahíta”研究小组的数据库中注册的新生儿，该小组在2014年至2020年之间在科尔多瓦和安蒂奥基亚省的地方城市收集了信息。以95%置信区间确定感染频率。用卡方检验进行了比较，学生t检验，患病率比率，并通过对数二项回归控制混杂变量。
结果：MiP的频率为22.3％（使用TBS为4.6％），PM24.8%（使用TBS为1.4%），和厘米11.8%（0%使用TBS）。使用TBS占优势的间日疟原虫。使用qPCR，MIP和PM的间日疟原虫和恶性疟原虫的比例相似，但恶性疟原虫在CM中占主导地位。未产的频率更高，和以前患有疟疾的妇女。PAM的主要临床疗效是贫血，低出生体重,APGAR评分异常。
结论：TBS未检测到感染程度，因为大多数病例是亚显微镜下（TBS阴性，qPCR阳性）。这证实了改进病例分子检测的重要性。由于哥伦比亚的控制计划是基于TBS的，因此该国的PAM继续被低估，尽管它对产妇有影响，和先天健康。
