Malaria associated symptoms in pregnant women followed-up in Benin

Malaria Journal

Research

Achille Massougbodji¹  Blaise Guézo Mévo²  Gildas Gbaguidi³  Sophie Borgella³  Bich-Tram Huynh⁴  Nadine Fievet⁴  Michel Cot⁴  Philippe Deloron⁴ 

[1] Faculté des Sciences de la Santé (FSS), UER de Parasitologie, Université de Cotonou, 01BP188, Cotonou, Bénin;Hôpital de Comé, BP 294, Comé, Bénin;IRD/UMR 216 - Mère et enfant face aux infections tropicales, Faculté des sciences pharmaceutiques, 4 avenue de l'Observatoire, 75270, Paris cedex 06, France;IRD/UMR 216 - Mère et enfant face aux infections tropicales, Faculté des sciences pharmaceutiques, 4 avenue de l'Observatoire, 75270, Paris cedex 06, France;Université Paris Descartes, Faculté des sciences pharmaceutiques, 4 avenue de l'Observatoire, 75270, Paris cedex 06, France;

关键词: Pregnant Woman;    Malaria;    Malaria Infection;    Rapid Diagnostic Test;    Antenatal Visit;   

DOI  :  10.1186/1475-2875-10-72

 received in 2010-11-02, accepted in 2011-03-31,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundIt is generally agreed that in high transmission areas, pregnant women have acquired a partial immunity to malaria and when infected they present few or no symptoms. However, longitudinal cohort studies investigating the clinical presentation of malaria infection in pregnant women in stable endemic areas are lacking, and the few studies exploring this issue are unconclusive.MethodsA prospective cohort of women followed monthly during pregnancy was conducted in three rural dispensaries in Benin from August 2008 to September 2010. The presence of symptoms suggestive of malaria infection in 982 women during antenatal visits (ANV), unscheduled visits and delivery were analysed. A multivariate logistic regression was used to determine the association between symptoms and a positive thick blood smear (TBS).ResultsDuring routine ANVs, headache was the only symptom associated with a higher risk of positive TBS (aOR = 1.9; p < 0.001). On the occasion of unscheduled visits, fever (aOR = 5.2; p < 0.001), headache (aOR = 2.1; p = 0.004) and shivering (aOR = 3.1; p < 0.001) were significantly associated with a malaria infection and almost 90% of infected women presented at least one of these symptoms. Two thirds of symptomatic malaria infections during unscheduled visits occurred in late pregnancy and long after the last intermittent preventive treatment dose (IPTp).ConclusionThe majority of pregnant women were symptomless during routine visits when infected with malaria in an endemic stable area. The only suggestive sign of malaria (fever) was associated with malaria only on the occasion of unscheduled visits. The prevention of malaria in pregnancy could be improved by reassessing the design of IPTp, i.e. by determining an optimal number of doses and time of administration of anti-malarial drugs.

【 授权许可】

CC BY   
© Huynh et al; licensee BioMed Central Ltd. 2011