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1.
Rev Soc Bras Med Trop ; 52: e20190250, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31800920

RESUMO

INTRODUCTION: Toxoplasmosis is an asymptomatic disease that can lead to systemic disease in the fetus of pregnant women with primary infection. This study aimed to determine the prevalence of toxoplasmosis, associated factors, and correlation between the serology of pregnant women and their pets, in the municipality of Ilhéus, Bahia, Brazil. METHODS: This cross-sectional study was conducted in 196 pregnant women and their cats or dogs (n=89). Semi-structured interviews were conducted and serum samples from the pregnant women were tested to detect IgM and IgG antibodies against Toxoplasma gondii, and avidity tests were performed for IgM-positive samples. The serum collected from pets were tested for IgG antibodies, and IgM antibodies in cats. A non-conditional logistic regression analysis was performed to identify infection-associated factors. RESULTS: IgG and IgM antibodies were detected in 67.9% (133/196) and 1.5% (3/196) samples, respectively, for women with an avidity of over 60%. Age ≥ 25 and the presence of cats in the vicinity were found to be associated with infection, while the level of education and previous orientation toward prevention of toxoplasmosis were protective factors in pregnant women. IgG antibodies were detected in 46.1% (41/89) of the animals, and cats were found to be negative for IgM. For the animals, age ≥ 1 year was a factor associated with infection. There was no correlation between serology of the pregnant women and the animals (p=0.15). CONCLUSIONS: An elevated prevalence of toxoplasmosis was detected in the region. Therefore, the adoption of preventive measures by public healthcare bodies is recommended.


Assuntos
Anticorpos Antiprotozoários/sangue , Complicações Parasitárias na Gravidez/epidemiologia , Toxoplasma/imunologia , Toxoplasmose/epidemiologia , Adulto , Animais , Brasil/epidemiologia , Gatos , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Gravidez , Complicações Parasitárias na Gravidez/diagnóstico , Complicações Parasitárias na Gravidez/etiologia , Prevalência , Fatores de Risco , Toxoplasmose/diagnóstico , Toxoplasmose/etiologia
2.
BMC Infect Dis ; 19(1): 1056, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31842783

RESUMO

BACKGROUND: Toxoplasmosis is caused by infection with the protozoan parasite Toxoplasma gondii. It is acquired by consumption of raw or undercooked meat containing tissue cyst, food or water contaminated with oocyst and congenital infection through the placenta leading to serious congenital abnormalities in the fetus like miscarriage, stillbirth, intrauterine death and neurologic defects. Therefore; this study was aimed to determine the prevalence of toxoplasmosis infection and its possible risk factors associated with pregnant women attending antenatal clinics in Hawassa and Yiregalem Hospitals, Southern Ethiopia. METHODS: A hospital-based cross-sectional study was conducted from December 2016 to May 2017. The study was done in antenatal care clinics of Hawassa and Yiregalem Hospitals in Southern, Ethiopia. Five hundred pregnant women were interviewed with a pretested structured questionnaire to collect risk factors and socio-demographic data. Blood samples were collected and serum was separated and tested for anti- Toxoplasma gondii antibodies using ELISA (Enzyme-linked Immunosorbent Assay). Data were analyzed using SPSS version 20 statistical software. The risk factors were tested for significance using Bivariate and multivariate analysis. P-value < 0.05 was considered statistically significant. RESULTS: The weighted prevalence of this study was 81.8% for the anti- Toxoplasma gondii antibody. Almost all participants (99.6%) had no information about the disease. A significant association was observed between seroprevalence and contact with domestic cats (OR = 1.206, 95% CI (1.627-2.206, P = 0.043), consumption of raw meat (OR = 0.848, 95% CI: 1.517-2.941, P = 0.019) and unpasteurized milk (OR = 0.871, 95% CI 1.531-2.221, P = 0.032). A significant association was not observed between seroprevalence and age, history of abortion, and blood transfusion. CONCLUSIONS: The findings of this study demonstrated a relatively higher prevalence of seropositivity than studies reported from other countries. Existence of domestic cats at home, consumption of undercooked meat and unpasteurized milk were identified as risk factors for T. gondii infection. Therefore, a health education program to increase the mother's knowledge about toxoplasmosis towards avoiding eating undercooked meat, contact with cats and consumption of unpasteurized milk during pregnancy is recommended. Furthermore, our results suggested that the implementation of newborn screening and follow-up testing can lead to reducing of toxoplasmosis associated complications.


Assuntos
Hospitais Gerais , Complicações Parasitárias na Gravidez/epidemiologia , Cuidado Pré-Natal , Toxoplasma/imunologia , Toxoplasmose/epidemiologia , Universidades , Adolescente , Adulto , Animais , Anticorpos Antiprotozoários/sangue , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Etiópia/epidemiologia , Feminino , Humanos , Carne/parasitologia , Leite/parasitologia , Mães/psicologia , Animais de Estimação/parasitologia , Gravidez , Prevalência , Alimentos Crus/parasitologia , Fatores de Risco , Estudos Soroepidemiológicos , Inquéritos e Questionários , Toxoplasmose/parasitologia , Adulto Jovem
3.
Turkiye Parazitol Derg ; 43(3): 106-110, 2019 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-31502771

RESUMO

Objective: The aim of this study was to determine the frequency of toxoplasmosis in pregnant women who were admitted to our hospital in their first trimester and to contribute to screening and management strategies by evaluating clinical outcomes. Methods: In this retrospective study, women in their first trimester of pregnancy who were aged between 15-49 years, admitted to the Mersin University Medical Faculty Gynecology and Obstetrics outpatient clinic between 2012-2017, and screened for Toxoplasma gondii immunoglobulin M (IgM) antibodies were included. The data was obtained from the hospital's digital records. First, the high-risk patients were identified who had anti-T. gondii IgM seropositivity and subsequently underwent anti-T. gondii immunoglobulin G (IgG) and anti-T. gondii IgG avidity tests. Next, the invasive procedures and medical treatments performed for diagnosis and treatment, as well as the clinical course and results for each patient were evaluated. Cases were then analyzed according to the admittance year and patient's age. Results: Anti-T. gondii IgM positivity was found in 266 (7.66%) of 3474 pregnant women meeting the study's criteria. The frequency of the Toxoplasma IgM seropositivity was the highest in the 15-25 age group and this frequency decreased gradually as the age of the patients increased. Congenital toxoplasmosis was detected in 1 of 61 patients who had a positive polymerase chain reaction for T. gondii performed in the amniotic fluid. Conclusion: In our province, the prevalence of anti-T. gondii IgM was found to be 7.66% in pregnant women who were admitted to a tertiary health institution in their first trimester of pregnancy. This rate is much higher than the average in Turkey; therefore, we suggest that routine screening of pregnant women for T. gondii may be recommended in this region.


Assuntos
Anticorpos Antiprotozoários/sangue , Complicações Parasitárias na Gravidez/epidemiologia , Toxoplasma/imunologia , Toxoplasmose/epidemiologia , Adolescente , Adulto , Afinidade de Anticorpos , Feminino , Hospitalização , Humanos , Técnicas Imunoenzimáticas , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Pessoa de Meia-Idade , Gravidez , Primeiro Trimestre da Gravidez , Prevalência , Estudos Retrospectivos , Estudos Soroepidemiológicos , Centros de Atenção Terciária , Toxoplasmose Congênita/epidemiologia , Turquia/epidemiologia , Adulto Jovem
4.
Pan Afr Med J ; 33: 127, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31558926

RESUMO

Introduction: Low birth weight (LBW) is an important predictor of newborn survival and development. Given its pathophysiology, malaria is presumed to be one of the risk factors for low birth weight. This study aims to determine the association between malaria in pregnant women (PW) and LBW (weight < 2500 g). Methods: We conducted a case-control analytical study based on the administration of a questionnaire and an observation chart. We calculated the crude odds ratio (OR) and the adjusted odds ratio to determine this association. Logistic regression was applied to recognize the variables which act as determinants of the issue under discussion. Results: This study involved 156 women (78 cases and 78 controls). The prevalence of LBW was 12.32% (105/852); 41.02% (64/156) of women had had malaria during pregnancy and 42.14% of parturients had received three doses of IPT (intermittent preventive treatment). A significant association between malaria and LBW emerged. Crude odds ratio= 3.75 [P = 0.0001 (p < 0.05)] and adjusted OR = 2.82 [P = 0.01 (p < 0.05)] were calculated taking into account the various confusion factors. Conclusion: Malaria during pregnancy is a factor increasing the risk of LBW. Efforts should be made to improve IPT coverage and the use of long lasting impregnated mosquito nets in order to prevent malaria during pregnancy.


Assuntos
Antimaláricos/administração & dosagem , Peso ao Nascer , Malária/complicações , Complicações Parasitárias na Gravidez/epidemiologia , Adolescente , Camarões , Estudos de Casos e Controles , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Modelos Logísticos , Malária/epidemiologia , Malária/prevenção & controle , Gravidez , Complicações Parasitárias na Gravidez/prevenção & controle , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
5.
Pan Afr Med J ; 33: 137, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31558935

RESUMO

Introduction: Malaria is a life threatening disease caused by the Plasmodium parasite, transmitted through the bites of infected female anopheles' mosquitoes. According to the latest WHO data published in 2017, malaria deaths in Cameroon reached 9.161 deaths accounting for 4.14% of total deaths. The age adjusted death rate is 29.11 per 100,000 and Cameroon is ranked the 30th in the world with a high prevalence of malaria. The aim of this study was therefore, to access the knowledge of the modes of transmission and prevention of malaria among pregnant women attending Antenatal Clinic (ANC) at the Nkwen Health Center, Bamenda. Methods: This was a cross-sectional hospital based survey study. The researchers recruited 51 eligible women in the Nkwen Health Centre and used a validated and pre-tested questionnaires to collect data. Collected data were entered into Excel and analysed using descriptive statistics and the results presented in tables and figures. Results: Sixty four percent of the women have basic knowledge about the mode of malaria transmission. Thirty six percent of the women had little knowledge about malaria transmission modes and the possible dangers of the disease. Conclusion: Slightly above 50% of pregnant women have basic knowledge on the modes of malaria transmission. Lack of knowledge regarding the modes of malaria transmission can be one of the reasons why there is still quite a high level of malaria prevalence among pregnant women attending ANC at the Nkwen Health Center, Bamenda. There is therefore, a need to educate women on malaria transmission modes.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Malária/prevenção & controle , Complicações Parasitárias na Gravidez/prevenção & controle , Cuidado Pré-Natal/métodos , Adolescente , Adulto , Camarões , Estudos Transversais , Feminino , Humanos , Malária/epidemiologia , Malária/transmissão , Gravidez , Complicações Parasitárias na Gravidez/epidemiologia , Prevalência , Inquéritos e Questionários , Adulto Jovem
6.
Bull Soc Pathol Exot ; 112(2): 79-89, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31478622

RESUMO

To assess the seroprevalence of toxoplasmosis among pregnant women in Benin, we conducted a meta-analysis using the PRISMA criteria. Al research published between 1990 and 2018 on toxoplasmosis among pregnant women Benin were eligible. A total of five databases were investigated, and the extracted data were subjected to a meta-analysis under R 3.1 using both random effect model and fixed effect model. The overall prevalence of toxoplasma-specific IgG among pregnant women was 47% (CI 95%: 40-53) and that of specific IgM was 2% (CI 95%: 1-3). The infection rate in urban areas (52%) was significantly higher than in rural areas (33%). The two main risk factors identified by the various eligible studies were the age of the pregnant women and the consumption of raw vegetables. We show that toxoplasmosis is endemic in pregnant women in Benin, implying that primary prevention measures must be put in place by the competent authorities to control this infection.


Assuntos
Complicações Parasitárias na Gravidez/epidemiologia , Toxoplasmose/epidemiologia , Adulto , Benin/epidemiologia , Estudos Transversais , Feminino , Humanos , Gravidez , Prevalência , Análise de Regressão , Estudos Soroepidemiológicos , Adulto Jovem
7.
Malar J ; 18(1): 304, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31481075

RESUMO

BACKGROUND: Studies of the association between malaria in pregnancy (MiP) and malaria during infancy have provided mixed results. A systematic review was conducted to evaluate available evidence on the impact of Plasmodium falciparum malaria infection during pregnancy, and intermittent preventive treatment of malaria during pregnancy (IPTp), on the risk of clinical malaria or parasitaemia during infancy. METHODS: MEDLINE, EMBASE, Global Health, and Malaria in Pregnancy Library databases were searched from inception to 22 May 2018 for articles published in English that reported on associations between MiP and malaria risk in infancy. Search terms included malaria, Plasmodium falciparum, pregnancy, placenta, maternal, prenatal, foetal, newborn, infant, child or offspring or preschool. Randomized controlled trials and prospective cohort studies, which followed infants for at least 6 months, were included if any of the following outcomes were reported: incidence of clinical malaria, prevalence of parasitaemia, and time to first episode of parasitaemia or clinical malaria. Substantial heterogeneity between studies precluded meta-analysis. Thus, a narrative synthesis of included studies was conducted. RESULTS: The search yielded 14 published studies, 10 prospective cohort studies and four randomized trials; all were conducted in sub-Saharan Africa. Infants born to mothers with parasitaemia during pregnancy were at higher risk of malaria in three of four studies that assessed this association. Placental malaria detected by microscopy or histology was associated with a higher risk of malaria during infancy in nine of 12 studies, but only one study adjusted for malaria transmission intensity. No statistically significant associations between the use of IPTp or different IPTp regimens and the risk of malaria during infancy were identified. CONCLUSION: Evidence of an association between MiP and IPTp and risk of malaria in infancy is limited and of variable quality. Most studies did not adequately adjust for malaria transmission intensity shared by mothers and their infants. Further research is needed to confirm or exclude an association between MiP and malaria in infancy. Randomized trials evaluating highly effective interventions aimed at preventing MiP, such as IPTp with dihydroartemisinin-piperaquine, may help to establish a causal association between MiP and malaria in infancy.


Assuntos
Malária Falciparum/epidemiologia , Parasitemia/epidemiologia , Plasmodium falciparum/fisiologia , Complicações Parasitárias na Gravidez/epidemiologia , Antimaláricos/uso terapêutico , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Malária Falciparum/parasitologia , Masculino , Parasitemia/parasitologia , Gravidez , Complicações Parasitárias na Gravidez/parasitologia , Risco
8.
PLoS One ; 14(7): e0218491, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31291269

RESUMO

BACKGROUND: Chagas disease (CD) is an emergent disease in Europe, due to immigration. The aims of this study are to describe the epidemiological characteristics of a cohort of Chagas infected pregnant women in Spain, to assess the vertical transmission (VT) rate and evaluate the usefulness of the PCR in the diagnosis of congenital infection in the first months of life. METHODS: A descriptive, retrospective study including Chagas seropositive pregnant women who were attended at three tertiary hospitals in Madrid, from January 2012 to September 2016. Infants were examined by PCR at birth and 1 month later and serologically studied at 9 months or later. Children were considered infected when the parasite was detected by PCR at any age or when serology remained positive without decline over the age of 9 months. RESULTS: We included 122 seropositive-infected pregnant women, 81% were from Bolivia and only 8.2% had been treated before. 125 newborns were studied and finally 109 were included (12.8% lost the follow-up before performing the last serology). The VT rate was 2.75% (95% CI: 0,57-8,8%). Infected infants had positive PCR at birth and 1 month later. All of them were treated successfully with benznidazole (PCR and serology became negative later on). All non-infected children presented negative PCR. The mean age at which uninfected patients had negative serology was 10.5 months. CONCLUSIONS: The VT rate is in keeping with literature and confirms the need to carry out a screening in pregnant women coming from endemic areas. PCR seems to be a useful tool to provide early diagnosis of congenital CD.


Assuntos
Doença de Chagas/diagnóstico , Doença de Chagas/transmissão , Adulto , Bolívia/epidemiologia , Doença de Chagas/epidemiologia , Diagnóstico Precoce , Emigração e Imigração , Feminino , Humanos , Recém-Nascido , Transmissão Vertical de Doença Infecciosa , Gravidez , Complicações Parasitárias na Gravidez/diagnóstico , Complicações Parasitárias na Gravidez/epidemiologia , Estudos Retrospectivos , Espanha/epidemiologia , Trypanosoma cruzi/isolamento & purificação , Adulto Jovem
9.
BMC Pregnancy Childbirth ; 19(1): 236, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286878

RESUMO

BACKGROUND: Malaria in pregnancy increases the risk of adverse birth outcomes such as low birth weight (LBW), maternal and foetal anemia. In Tanzania, some areas have attained low malaria transmission. However, data on the burden of preterm delivery, LBW, maternal and foetal anemia following substantial reduction of malaria transmission in recent years is still scarce in these settings. METHODS: A study involving 631 pregnant women was conducted at Mwananyamala referral hospital in Dar es Salaam from April to August, 2018. Study enrollment was done prior to delivery. Structured interview and antenatal clinic cards were used to obtain data including the use of intermittent preventive therapy in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP). Infants birth weights were recorded, maternal venous and cord blood were taken for testing of malaria and determination of haemoglobin (Hb) levels. Chi-square test and regression analysis were done to identify risk factors for preterm delivery, LBW, maternal and foetal anemia. RESULTS: The prevalence of malaria among mothers who used at least one dose of IPTp-SP was 0.6% (4/631). Fourteen mothers (2.2%) did not use IPTp-SP and had no malaria infection. The prevalence of maternal anemia, LBW, foetal anemia and preterm delivery was 40.6, 6.5, 5.9 and 9.2% respectively. Participants who were malaria positive had 11 times more risk of LBW compared to those who were negative (AOR, 11; 95%, CI 1.07-132.2; p = 0.04). The risk of delivering babies with LBW was 1.12 times high among mothers who were ≤ 36 weeks of gestation (AOR, 1.12; 95% CI, 0.06-0.25; p = < 0.001). The use of ≥3 doses of IPTp-SP was associated with 83% decrease in risk of LBW compared to those who did not use any dose of IPTp-SP (AOR, 0.17; 95% CI, 0.03-0.88; p = 0.05). Severe anaemia at delivery was associated with seven times increased risk of preterm delivery compared to non-anemic participants (AOR, 6.5; 95% CI, 1.49-28.16; p = 0.013). CONCLUSION: Despite the reduced malaria transmission and use of IPTp-SP, prevalence of preterm delivery, maternal anemia, LBW and foetal anemia is still high in Tanzania. The recommended ≥3 doses of IPTp-SP should continue be provided even in areas with substantial reduction of malaria.


Assuntos
Antimaláricos/uso terapêutico , Malária/prevenção & controle , Complicações Parasitárias na Gravidez/prevenção & controle , Pirimetamina/uso terapêutico , Sulfadoxina/uso terapêutico , Adolescente , Adulto , Anemia/epidemiologia , Anemia/parasitologia , Anemia/prevenção & controle , Estudos Transversais , Combinação de Medicamentos , Feminino , Humanos , Recém-Nascido de Baixo Peso , Malária/epidemiologia , Pessoa de Meia-Idade , Gravidez , Complicações Hematológicas na Gravidez/epidemiologia , Complicações Hematológicas na Gravidez/parasitologia , Complicações Hematológicas na Gravidez/prevenção & controle , Complicações Parasitárias na Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/parasitologia , Nascimento Prematuro/prevenção & controle , Prevalência , Fatores de Risco , Tanzânia , Adulto Jovem
10.
BMC Infect Dis ; 19(1): 483, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31146689

RESUMO

BACKGROUND: Previous studies reported contradicting findings about the association between intestinal parasitosis and maternal anemia. In this study we aimed to determine the prevalence of intestinal parasitic infection and its association with anemia among pregnant women in Wondo Genet district, Southern Ethiopia. METHODS: This facility-based cross-sectional study was conducted in June and July 2018. Pregnant women (n = 352) were randomly drawn from five health centers using antenatal care follow-up lists. Trained data collectors administered the questionnaire. Capillary blood was collected and analyzed for hemoglobin using the HemoCue method. Stool sample was collected following standard procedure and analyzed for the presence and types of intestinal parasites using direct microscopy with Formalin-ether concentration technique. Association between intestinal parasitosis and anemia was measured using multivariable binary logistic regression analysis. The outputs are presented using adjusted odds ratio (AOR) with 95% confidence intervals (CI). RESULTS: The overall prevalence of intestinal parasitic infection was 38.7% (95% CI: 33.6-43.8%). One-tenth (9.7%) of the pregnant women were infected with polyparasites. Ascaris lumbricoides was the predominant infection encountered in 24.9% of the women. The other infections identified were: hookworms (11.2%), Giardia lamblia (5.4%), Entamoeba histolytica (3.4%), Trichuris trichiura (2.9%) and Schistosoma mansoni (2.3%). The mean (± standard deviation) hemoglobin concentration was 12.3 (±1.9) g/dl and 31.5% (95% CI: 26.6-36.4%) women were anemic (hemoglobin < 11 g/dl). The prevalence of anemia among women infected with intestinal parasite (55.6%) was substantially higher than the prevalence in their counterparts (16.4%) (p <  0.001). In a multivariable model adjusted for multiple potential confounders including socio-economic status indicators, the odds of anemia were six times increased (AOR = 6.14, 95% CI: 2.04-18.45) among those affected by at least one intestinal parasite. CONCLUSION: Strengthening the existing water, sanitation and hygiene programs and routine deworming of pregnant mothers may help to reduce the burden of both intestinal parasitic infection and anemia in pregnant women.


Assuntos
Anemia/epidemiologia , Enteropatias Parasitárias/epidemiologia , Complicações Hematológicas na Gravidez/epidemiologia , Complicações Parasitárias na Gravidez/epidemiologia , Adolescente , Adulto , Anemia/complicações , Anemia/parasitologia , Animais , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Higiene , Enteropatias Parasitárias/complicações , Masculino , Gravidez , Complicações Hematológicas na Gravidez/parasitologia , Prevalência , Saneamento , Classe Social , Adulto Jovem
11.
PLoS Negl Trop Dis ; 13(5): e0007406, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31083673

RESUMO

BACKGROUND: The World Health Organization has recently reemphasized the importance of providing preventive chemotherapy to women of reproductive age in countries endemic for soil-transmitted helminthiasis as they are at heightened risk of associated morbidity. The Demographic and Health Surveys (DHS) Program is responsible for collecting and disseminating accurate, nationally representative data on health and population in developing countries. Our study aims to estimate the number of pregnant women at risk of soil-transmitted helminthiasis that self-reported deworming by antenatal services in endemic countries that conducted Demographic and Health Surveys. METHODOLOGY/PRINCIPAL FINDINGS: The number of pregnant women living in endemic countries was extrapolated from the United Nations World Population Prospects 2015. National deworming coverage among pregnant women were extracted from Demographic and Health Surveys and applied to total numbers of pregnant women in the country. Sub-national DHS with data on self-reported deworming were available from 49 of the 102 endemic countries. In some regions more than 73% of STH endemic countries had a DHS. The DHS report an average deworming coverage of 23% (CI 19-28), ranging from 2% (CI 1-3) to 35% (CI 29-40) in the different regions, meaning more than 16 million pregnant women were dewormed in countries surveyed by DHS. The deworming rates amongst the 43 million pregnant women in STH endemic countries not surveyed by DHS remains unknown. CONCLUSIONS/SIGNIFICANCE: These estimates will serve to establish baseline numbers of deworming coverage among pregnant women, monitor progress, and urge endemic countries to continue working toward reducing the burden of soil-transmitted helminthiasis. The DHS program should be extended to STH-endemic countries currently not covering the topic of deworming during pregnancy.


Assuntos
Anti-Helmínticos/uso terapêutico , Helmintíase/tratamento farmacológico , Helmintos/isolamento & purificação , Complicações Parasitárias na Gravidez/tratamento farmacológico , Solo/parasitologia , Adulto , África/epidemiologia , Animais , Ásia/epidemiologia , Doenças Endêmicas/prevenção & controle , Feminino , Helmintíase/epidemiologia , Helmintos/classificação , Helmintos/genética , Humanos , Gravidez , Complicações Parasitárias na Gravidez/epidemiologia , Autorrelato , América do Sul/epidemiologia , Organização Mundial da Saúde , Adulto Jovem
12.
Acta Trop ; 196: 52-59, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31078470

RESUMO

INTRODUCTION: HLA-G plays a key role on immune tolerance. Pathogens can induce soluble HLA-G (sHLA-G) production to down-regulate the host immune response, creating a tolerogenic environment favorable for their dissemination. To our knowledge, no study has yet been conducted to assess the relationship between sHLA-G and geohelminth infections. METHODS: The study was conducted in Allada, Southeastern Benin, from 2011-2014. The study population encompassed 400 pregnant women, included before the end of the 28th week of gestation and followed-up until delivery. At two antenatal care visits and at delivery, stool and blood samples were collected. Helminths were diagnosed by means of the Kato-Katz concentration technique. We used quantile regression to analyze the association between helminth infections and sHLA-G levels during pregnancy. RESULTS: sHLA-G levels gradually increased during pregnancy and reached maximal levels at delivery. Prevalence of helminth infections was low, with a majority of hookworm infections. We found significantly more hookworm-infected women above the 80th quantile (Q80) of the distribution of the mean sHLA-G level (p < 0.03, multivariate quantile regression). Considering only women above the Q80 percentile, the mean sHLA-G level was significantly higher in hookworm-infected compared to uninfected women (p = 0.04). CONCLUSION: High levels of sHLA-G were associated with hookworm infection in pregnant women. This result is consistent with the potential involvement of sHLA-G in immune tolerance induced by helminths during pregnancy.


Assuntos
Antígenos HLA-G/metabolismo , Infecções por Uncinaria/metabolismo , Complicações Parasitárias na Gravidez/metabolismo , Adulto , Benin/epidemiologia , Feminino , Antígenos HLA-G/genética , Infecções por Uncinaria/epidemiologia , Infecções por Uncinaria/imunologia , Humanos , Gravidez , Complicações Parasitárias na Gravidez/epidemiologia , Prevalência , Adulto Jovem
13.
PLoS One ; 14(5): e0216536, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31063503

RESUMO

AIM: Intermittent preventive treatment in pregnancy (IPTp) with azithromycin and monthly sulfadoxine-pyrimethamine increased the mean child weight, mid-upper arm and head circumference at four weeks of age in a rural low-income setting. Now we assess for how long these gains were sustained during 0-5 years of age. METHODS: We enrolled 1320 pregnant Malawian women in a randomized trial and treated them with two doses of sulfadoxine-pyrimethamine (control) or monthly sulfadoxine-pyrimethamine as IPTp against malaria, or monthly sulfadoxine-pyrimethamine and two doses of azithromycin (AZI-SP) as IPTp against malaria and reproductive tract infections. Child weight, mid-upper arm circumference, head circumference and weight-for-height Z-score were recorded at one, six, 12, 24, 36, 48, and 60 months. RESULTS: Throughout follow-up, the mean child weight was approximately 100 g higher (difference in means 0.12 kg, 95% CI 0.04-0.20, P = 0.003 at one month; 0.19 kg, 95% CI 0.05-0.33, P = 0.007, at six months), mean head circumference 2 mm larger (0.3 cm, 95% CI 0.1 to 0.5, P = 0.004 at one month) and the cumulative incidence of underweight by five years of age was lower (hazard ratio 0.74, 95% CI 0.60 to 0.90, P = 0.002) in the AZI-SP group than in the control group. The 2 mm difference in the mean mid-upper arm circumference at one month (0.2 cm, 95% CI 0.0 to 0.3, P = 0.007) disappeared after three years of age. There was no difference in mean weight-for-height Z-score at any time point. CONCLUSION: In Malawi, IPTp with azithromycin and monthly sulfadoxine-pyrimethamine has a modest, 3-5-year positive impact on child weight, mid-upper arm circumference and head circumference, but not on weight-for-height Z-score.


Assuntos
Braço/anatomia & histologia , Azitromicina/administração & dosagem , Peso ao Nascer/efeitos dos fármacos , Cabeça/anatomia & histologia , Malária/prevenção & controle , Pirimetamina/administração & dosagem , Infecções Respiratórias/prevenção & controle , Sulfadoxina/administração & dosagem , Adulto , Antibacterianos/administração & dosagem , Antimaláricos/administração & dosagem , Criança , Pré-Escolar , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Incidência , Lactente , Recém-Nascido , Malária/epidemiologia , Malaui , Masculino , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Complicações Parasitárias na Gravidez/epidemiologia , Complicações Parasitárias na Gravidez/prevenção & controle , Infecções Respiratórias/epidemiologia
14.
Medicina (B Aires) ; 79(2): 81-89, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31048272

RESUMO

In Argentina, around 1500 children are born each year with Trypanosoma cruzi infection. Mother-to-child transmission is the main source of new cases of Chagas disease and of its occurrence in non-endemic areas. Our objective was to survey the information available on congenital T. cruzi infection, to analyze its evolution and its relation with the index of maternal infection and the risk for vector-borne infection by province of Argentina. Data concerning the public health sector for the period 1997-2014 were retrieved from national and local records. An increase in the number and proportion of pregnant women examined for Chagas was observed, reaching 60.3% coverage in 2014. The prevalence of maternal infection dropped from 9.0% to 2.6%. The control of newborns from infected women was highly variable (23.3%-93.6%), and data quality was deficient, varying amply by province and year. The rate of congenital infection had an irregular evolution and its national average fluctuated between 1.9 and 8.2%. An association was observed between the risk for vector-borne infection and the prevalence of maternal infection by province (Wilcoxon test p = 0.017). The rate of congenital transmission by province was neither associated with the rate of maternal infection (linear regression p = 0.686) nor with the risk for vectorial infection (Kruskal-Wallis test p = 0.3154). The available data show insufficient control of children born from infected mothers, as well as deficient recording of these procedures. Both aspects must be improved to achieve better epidemiological information and to enable timely access of infected children to treatment.


Assuntos
Doença de Chagas/epidemiologia , Doença de Chagas/transmissão , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Complicações Parasitárias na Gravidez/epidemiologia , Argentina/epidemiologia , Doença de Chagas/congênito , Feminino , Humanos , Lactente , Recém-Nascido , Modelos Lineares , Masculino , Gravidez , Prevalência , Medição de Risco , Fatores de Risco , Estatísticas não Paramétricas , Fatores de Tempo
15.
Int J Infect Dis ; 84: 54-65, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31028878

RESUMO

A novel conceptual framework to describe the relationship between placental malaria and adverse infant neurodevelopmental outcomes is proposed. This conceptual framework includes three distinct stages: (1) maternal and environmental risk factors for the development of placental malaria; (2) placental pathology and inflammation associated with placental malaria infection; and (3) postnatal impacts of placental malaria. The direct, indirect, and bidirectional effects of these risk factors on infant neurodevelopment across the three stages were critically examined. These factors ultimately culminate in an infant phenotype that not only leads to adverse birth outcomes, but also to increased risks of neurological, cognitive, and behavioural deficits that may impact the quality of life in this high-risk population. Multiple risk factors were identified in this conceptual framework; nonetheless, based on current evidence, a key knowledge gap is the uncertainty regarding which are the most important and how exactly they interact.


Assuntos
Malária/complicações , Transtornos do Neurodesenvolvimento/etiologia , Doenças Placentárias/parasitologia , Complicações Parasitárias na Gravidez , Adulto , Feminino , Humanos , Lactente , Recém-Nascido , Inflamação/complicações , Placenta/parasitologia , Placenta/patologia , Doenças Placentárias/patologia , Gravidez , Complicações Parasitárias na Gravidez/epidemiologia , Qualidade de Vida , Fatores de Risco
16.
BMC Public Health ; 19(1): 392, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30971223

RESUMO

BACKGROUND: In 2014, a study in Munyenge revealed a high prevalence of urogenital schistosomiasis (UGS) among pregnant women. This study investigated he prevalence and risk factors of UGS in pregnancy following scale-up of piped water sources from 2014 to 2017. Secondly, we compared stream usage, stream contact behaviour, infection rate and intensity with the findings of 2014. METHODS: Consenting pregnant women reporting for antenatal care (ANC) in the different health facilities were enrolled consecutively between November 2016 and January 2018. Information on age, gravidity status, residence, marital status, educational level, occupation, household water source, frequency of contact with water and stream activities were obtained using a semi-structured questionnaire. Urine samples were examined for the presence of microhaematuria and S. haematobium ova using test strip and filtration/microscopy methods respectively. Data were analysed using univariate and multivariate regression analyses and relative risk reductions calculated. RESULTS: Of the 368 women enrolled, 22.3% (82) were diagnosed with UGS. Marital status (single) (aOR = 2.24, 95% CI: 1.04-4.79), primary - level of education (aOR = 2.0; 95% CI: 1.04-3.85) and domestic activity and bathing in the stream (aOR = 3.3; 95% CI: 1.83-6.01) increased risk of S. haematobium infection. Meanwhile, fewer visits (< 3 visits/week) to stream (aOR = 0.35, 95% CI = 0.17-0.74) reduced exposure to infection. Piped water usage was associated with reduced stream usage and eliminated the risk of infection among women who used safe water only. Compared with the findings of 2014, stream usage (RRR = 23 95% CI: 19-28), frequency (≥ 3 visits) (RRR = 69 95% CI: 59-77) and intensity of contact with water (RRR = 37 95% CI = 22-49) has reduced. Similarly, we observed a decrease in infection rate (RRR = 52, 95% CI = 40-62) and prevalence of heavy egg intensity (RRR = 71, 95% CI = 53-81). CONCLUSION: Following increased piped water sources in Munyenge, S. haematobium infection has declined due to reduced stream contact. This has important implication in the control of UGS in pregnancy.


Assuntos
Complicações Parasitárias na Gravidez/epidemiologia , Schistosoma haematobium , Esquistossomose Urinária/epidemiologia , Abastecimento de Água/métodos , Água/parasitologia , Adolescente , Adulto , Animais , Camarões/epidemiologia , Estudos Transversais , Feminino , Filtração , Hematúria/epidemiologia , Hematúria/parasitologia , Humanos , Microscopia , Gravidez , Complicações Parasitárias na Gravidez/etiologia , Complicações Parasitárias na Gravidez/parasitologia , Cuidado Pré-Natal , Prevalência , Fatores de Risco , Rios/parasitologia , Esquistossomose Urinária/etiologia , Esquistossomose Urinária/parasitologia , Inquéritos e Questionários , Adulto Jovem
17.
Malar J ; 18(1): 144, 2019 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-31014336

RESUMO

BACKGROUND: Malaria in pregnancy is a major public health challenge, but its risk factors remain poorly understood in some settings. This study assessed the association between household and maternal characteristics and malaria among pregnant women in a high transmission area of Uganda. METHODS: A nested prospective study was conducted between 6th September 2016 and 5th December 2017 in Busia district. 782 HIV uninfected women were enrolled in the parent study with convenience sampling. Socioeconomic and house construction data were collected via a household survey after enrolment. Homes were classified as modern (plaster or cement walls, metal or wooden roof and closed eaves) or traditional (all other homes). Maternal and household risk factors were evaluated for three outcomes: (1) malaria parasitaemia at enrolment, measured by thick blood smear and qPCR, (2) malaria parasitaemia during pregnancy following initiation of IPTp, measured by thick blood smear and qPCR and (3) placental malaria measured by histopathology. RESULTS: A total of 753 of 782 women were included in the analysis. Most women had no or primary education (75%) and lived in traditional houses (77%). At enrolment, microscopic or sub-microscopic parasitaemia was associated with house type (traditional versus modern: adjusted risk ratio (aRR) 1.29, 95% confidence intervals 1.15-1.45, p < 0.001), level of education (primary or no education versus O-level or beyond: aRR 1.13, 95% confidence interval 1.02-1.24, p = 0.02), and gravidity (primigravida versus multigravida: aRR 1.10, 95% confidence interval 1.02-1.18, p = 0.009). After initiation of IPTp, microscopic or sub-microscopic parasitaemia was associated with wealth index (poorest versus least poor: aRR 1.24, 95% CI 1.10-1.39, p < 0.001), house type (aRR 1.14, 95% CI 1.01-1.28, p = 0.03), education level (aRR 1.19, 95% CI 1.06-1.34, p = 0.002) and gravidity (aRR 1.32, 95% CI 1.20-1.45, p < 0.001). Placental malaria was associated with gravidity (aRR 2.87, 95% CI 2.39-3.45, p < 0.001), but not with household characteristics. CONCLUSIONS: In an area of high malaria transmission, primigravid women and those belonging to the poorest households, living in traditional homes and with the least education had the greatest risk of malaria during pregnancy.


Assuntos
Características da Família , Malária/epidemiologia , Complicações Parasitárias na Gravidez/epidemiologia , Adolescente , Adulto , Antimaláricos/uso terapêutico , Escolaridade , Doenças Endêmicas , Feminino , Humanos , Malária/tratamento farmacológico , Mães , Razão de Chances , Gravidez , Estudos Prospectivos , Fatores de Risco , Fatores Socioeconômicos , Uganda/epidemiologia , Adulto Jovem
18.
BMC Infect Dis ; 19(1): 327, 2019 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-30991956

RESUMO

BACKGROUND: Toxoplasma gondii infection is a great health concern to pregnant women and the developing fetus. The aim of this study was to determine the seroprevalence of T. gondii and its associated factors in Adwa district. METHODS: A facility based cross-sectional study was conducted from January to June 2018 in Adwa district. Structured, a pre-tested questionnaire was used to collect the demographic and risk factor related data. Serum sample, collected from each of the study subjects was tested for IgG and IgM anti T.godii specific antibodies using Enzyme-Linked Immunosorbent Assay. A bivariable and multivariable logistic regression model was applied to show association between the dependent and independent variables considering P < 0.05 and the 95% confidence interval. RESULT: Out of the 360, 128 (35.6%) pregnant women were found to be positive for antibodies specific to T. gondii. Furthermore, 117 (32.5%) women were positive only for IgG, and 11 (3.1%) were positive both for IgM and IgG antibodies. Age, educational level, habit of hand washing after contact with garden soil or domestic animals, presence of domestic cat, history of contact with domestic dog and consumption of raw vegetables were significantly associated with T. gondii. CONCLUSION: The seroprevalence of T. gondii among pregnant women in the study area is low compared to the other regions of Ethiopia, and within the range of the seroprevalences in the central and East Africa region. However, efforts should be done to create awareness on the potential risk factors of the parasite in the community.


Assuntos
Complicações Parasitárias na Gravidez/epidemiologia , Toxoplasmose/epidemiologia , Adolescente , Adulto , Animais , Animais Domésticos , Anticorpos Antiprotozoários/sangue , Gatos , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Etiópia/epidemiologia , Feminino , Jardinagem , Desinfecção das Mãos , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Modelos Logísticos , Gravidez , Fatores de Risco , Estudos Soroepidemiológicos , Toxoplasmose Congênita/epidemiologia
19.
BMC Infect Dis ; 19(1): 329, 2019 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-30999869

RESUMO

BACKGROUND: In Vietnam, few studies have determined the epidemiological status of toxoplasmosis in pregnant women and no routine prenatal screening is in place. This study was conducted to evaluate the seroprevalence of this zoonotic parasitic infection in pregnant women in Northern Vietnam and to assess the association with awareness, risk factors and congenital toxoplasmosis. METHODS: Approximately 800 pregnant women were included in the study from two hospitals, one in Hanoi and one in Thai Binh province, which is known to have a dense cat population. Serological immunoglobulin G (IgG) and immunoglobulin M (IgM) detection was performed to estimate the seroprevalence of toxoplasmosis and sero-incidence of maternal and congenital toxoplasmosis. In addition, a survey was conducted about awareness, clinical history, presentation of signs and symptoms relating to toxoplasmosis and to detect biologically plausible and socio-demographic risk factors associated with toxoplasmosis. Associations with seroprevalence were assessed using univariable and multivariable analysis. RESULTS: The mean IgG seroprevalence after the full diagnostic process was 4.5% (95% confidence interval(CI): 2.7-7.0) and 5.8% (95% CI: 3.7-8.6) in Hanoi and Thai Binh hospital, respectively, and included one seroconversion diagnosed in Thai Binh hospital. Only 2.0% of the pregnant women in Hanoi hospital and 3.3% in Thai Binh hospital had heard about toxoplasmosis before this study. CONCLUSION: Since the percentage of seronegative, and thus susceptible, pregnant women was high and the awareness was low, we suggest to distribute information about toxoplasmosis and its prevention among women of child bearing age. Furthermore, future studies are recommended to investigate why such a low seroprevalence was seen in pregnant women in Northern Vietnam compared to other countries in South East Asia and globally.


Assuntos
Complicações Parasitárias na Gravidez/epidemiologia , Toxoplasmose/epidemiologia , Adulto , Animais , Gatos , Feminino , Hospitais/estatística & dados numéricos , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Densidade Demográfica , Gravidez , Fatores de Risco , Estudos Soroepidemiológicos , Toxoplasmose Congênita/epidemiologia , Vietnã/epidemiologia , Zoonoses/epidemiologia
20.
Parasite ; 26: 13, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30838974

RESUMO

We assessed clinical and serologic findings in 25 infants with congenital toxoplasmosis born to mothers treated during pregnancy in the United States. Results indicate a lower prevalence of eye findings and hydrocephalus in the group of infants born to treated mothers (62.5% and 38.5%, respectively) compared to results on the same pathologies reported in our previous cohort of infants born to untreated mothers (92.2% and 67.7%, respectively). The sensitivity of the IgM ISAGA and IgA ELISA in the present study were lower (44% and 60%, respectively) compared to sensitivity of these methods in our previously studied group of infants born to untreated mothers (86.6% and 76.5%, respectively). These findings provide further evidence that anti-parasitic treatment if administered during pregnancy can contribute to better clinical outcomes, even in countries where systematic screening and treatment have not been routinely implemented.


Assuntos
Anticorpos Antiprotozoários/sangue , Complicações Parasitárias na Gravidez/tratamento farmacológico , Toxoplasmose Congênita/sangue , Toxoplasmose Congênita/epidemiologia , Técnicas de Laboratório Clínico , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Hidrocefalia/epidemiologia , Hidrocefalia/etiologia , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Lactente , Recém-Nascido , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Masculino , Mães , Gravidez , Complicações Parasitárias na Gravidez/epidemiologia , Estudos Retrospectivos , Sensibilidade e Especificidade , Testes Sorológicos , Toxoplasmose Congênita/tratamento farmacológico , Estados Unidos/epidemiologia
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