Maternal Anemia in Pregnancy: Assessing the Effect of Routine Preventive Measures in a Malaria-Endemic Area.
We investigated the effectiveness of routine preventive measures for anemia in Beninese pregnant women during pregnancy. Anemia (hemoglobin < 110 g/L) was common: 68.3% at first antenatal visit (ANV1), 64.7% at second antenatal visit (ANV2), and 40.6% at delivery. Parasitic infections and nutritional deficiencies were the most preventable causes. After intermittent preventive treatment (IPTp) and antihelminthic treatments, malaria prevalence decreased from 15.1% (ANV1) to 4.0% (ANV2) and increased again to 9.6% at delivery. Helminth infections dropped from 11.1% (ANV1) to 7.2% (ANV2) and 2.4% at delivery. Malaria was associated with lower mean hemoglobin on ANV1 and delivery, and iron deficiency was associated with lower mean hemoglobin on ANV1 and ANV2. IPTp and antihelminthic treatments were efficacious to clear parasitic infections and improve hematologic status, whereas the effectiveness of daily iron and folic acid supplements to correct iron and folate deficiencies and decrease anemia was less marked, possibly because of lack of compliance.
Available from: Valérie Briand
- "Primigravidae had a lower mean Hb and an increased risk for anaemia in early pregnancy compared to multigravidae, prior to the administration of IPTp. Furthermore, an overall decrease in the proportion of malaria infections after women were given IPTp has been shown [1,15-17]. In the study, more than 20% of primigravidae were infected by malarial parasites at inclusion, whereas only less than 10% of them were malaria positive at delivery. "
[Show abstract] [Hide abstract]
Primigravidity is one of the main risk factors for both malaria and anaemia. Since the implementation of intermittent preventive treatment (IPTp) in sub-Saharan Africa, the relationship between anaemia and gravidity and its evolution during pregnancy has been little explored. This study aimed to evaluate the impact of gravidity on the variation of haemoglobin during pregnancy according to the timing of gestation.
Data from three studies carried out in nearby areas in south Benin (Ouidah, Comé, Allada) between 2005 and 2012 were analysed. At inclusion (first antenatal visit, ANV1) women’s age, area of residence, schooling, gravidity, gestational age, weight and height were recorded. Thick blood smears were performed on ANV1, second visit (ANV2) and at delivery. In Allada, women’s serum ferritin and CRP concentrations were also assessed. The impact of gravidity on maternal haemoglobin (Hb) was analysed using a logistic or linear regression depending on the outcome. The statistical significance was set to P < 0.05.
In total, data from 3,591 pregnant women were analysed. Both univariate and multivariate analyses showed a constant association between Hb concentrations and gravidity in the three periods of Hb assessment (ANV1, ANV2 and delivery). Mean Hb concentration was significantly lower in primigravidae than in multigravidae at ANV1 (mean difference = -2.4 g/L, CI 95%: [-3.4, -1.4], P < 0.001). Afterwards, there was a significant increase in primigravidae only, with a tendency to reversal between primigravidae and multigravidae, which was confirmed at delivery (mean difference = 2.8 g/L, CI 95%: [1.3, 4.2], P < 0.001). The prevalence of malaria infection was halved between ANV1 and delivery in primigravidae while it decreased by only 38% among multigravidae, who were less prone to malaria infection (prevalence at ANV1, 20% and 10% respectively). Iron deficiency was more common in multigravidae, and it decreased slightly in this group between ANV1 and delivery.
In a context of IPTp, Hb levels improved progressively throughout pregnancy in primigravidae, likely as a result of reduction in malaria infection. In multigravidae, the improvement was less perceptible and anaemia was mainly due to iron deficiency.
Malaria Journal 10/2012; 11(1):348. DOI:10.1186/1475-2875-11-348 · 3.11 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: A boron-doped glassy carbon was fabricated by chemical vapor deposition from a gaseous CH4/BCl3 mixture. It was characterized by X-ray diffraction, Raman spectroscopy, scanning, and transmission electron microscopy. Results show that the deposited carbon is characteristic of a glass-like carbon but with boron carbide nanocrystals around 20 nm in diameter uniformly distributed in its matrix. In contrast to the conventional non-graphitizable glassy carbon, the product behaved similarly to a graphitizable carbon on high-temperature treatment because of the strong catalytic graphitization effect of the boron. The glass carbon was transformed into lamellar carbon structures, probably by a dissolution-precipitation mechanism.
New Carbon Materials 06/2012; 27(3):226–232. DOI:10.1016/S1872-5805(12)60014-6
[Show abstract] [Hide abstract]
ABSTRACT: When it comes to abdominal delivery, there is opinion and there is fact. This particular effort is made to eliminate the former, and to extend the latter. A 200-page textbook, it contains 56 illustrations of surgical scenes, nuances and principles, and based on 306 references it presents the up-to-date knowledge about the art and optimization of cesarean section, covering topics like indications, contraindications, surgical alternatives, global expenditures on elective cesarean sections, complications, rare cases (management of the abdominal pregnancy), anethesiological preferences and complications, the trial of labor (TOL), tips for presurgical orders and assistantship, postsurgical maternal neural circuits and depression, neonatal adaptation, perimortem c-section, cesarean myomectomy and total hysterectomy, legal issues and litigations, as well as review questions and scenarios.
This book is available at: https://www.createspace.com/4112955
or at www.amazon.com (co.uk)
01/2013; CreateSpace., ISBN: 978-1481858984
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.