疟疾
间日疟原虫
入射(几何)
人口
流行病学
人口学
流产
怀孕
医学
公共卫生
地理
环境卫生
恶性疟原虫
生物
免疫学
内科学
遗传学
护理部
社会学
物理
光学
作者
Jamille Gregório Dombrowski,Laura Cordeiro Gomes,Camila Lorenz,Raquel Gardini Sanches Palasio,Paola Marchesini,Sabrina Epiphanio,Claudio Romero Farias Marinho
标识
DOI:10.1016/j.lana.2022.100285
摘要
Malaria in pregnancy (MiP) is a public health problem in the Brazilian Amazon region that requires special attention due to associated serious adverse consequences, such as low birth weight, increased prematurity and spontaneous abortion rates. In Brazil, there have been no comprehensive epidemiological studies of MiP. In this study, we aimed to explore the spatial and spatiotemporal patterns of MiP in Brazil and epidemiologically characterize this population of pregnant women over a period of 15 years. We performed a national-scale ecological analysis using a Bayesian space-time hierarchical model to estimate the incidence rates of MiP between 1 January 2004 and 31 December 2018. We mapped the high-incidence clusters among pregnant women aged 10-49 years old using a Poisson model, and we characterized the population based on data from the Epidemiological Surveillance Information System for Malaria (SIVEP-Malaria). We consolidated the data of 61,833 women with MiP in Brazil. Our results showed a reduction of 50·1% (95% CI: 47·3 to 52·9) in the number of malaria cases over the period analysed, with Plasmodium vivax malaria having the highest incidence. MiP was widely distributed throughout the Amazon region, and spatial and spatiotemporal analyses revealed statistically significant clusters in some municipalities of Amazonas, Acre, Rondônia and Pará. In addition, we observed that younger pregnant women had a higher risk of infection, and the administration of appropriate treatment requires more attention. This nationwide study provides robust evidence that, despite the reduction in the number of MiP cases in the country, it remains a serious public health problem, especially for young pregnant women. Our analyses highlight focus areas for strengthening interventions to control and eliminate MiP. FAPESP and CNPq - Brazil.
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