RESUMO
Introducción: Estudios recientes encontraron asociación entre blastocistosis y anemia por déficit de hierro. Uno de ellos demostró que en mujeres embarazadas la infección por Blastocystis spp. es un factor de riesgo para padecerla y puede tener consecuencias adversas tanto para la madre, como para el feto que en casos extremos puede conducir a mortalidad maternofetal. Objetivo: Conocer la prevalencia de blastocistosis en mujeres embarazadas y su posible asociación con la anemia ferropénica. Métodos: Se realizó un estudio parasitológico, clínico y epidemiológico, de tipo descriptivo y de corte transversal, al universo de las gestantes atendidas en tres policlínicos del municipio La Lisa, entre julio 2017 y junio 2018. Resultados: De 135 embarazadas, 43 (31,9 por ciento) estaban infectadas por protozoos parásitos. De estos, Blastocystis spp, fue el más prevalente (28,9 por ciento). Del total de gestantes, 41 padecían de anemia. En la mayoría de estas (85,4 por ciento), la anemia clasificaba como ferropénica. La proporción de embarazadas parasitadas por Blastocystis spp. que padecían este tipo de anemia, en relación con las gestantes que no estaban infectadas por ese protozoo y también padecían de ese tipo de anemia fue significativamente mayor (p lt; 0,05). Conclusiones: Blastocistosis es una parasitosis de prevalencia creciente e insuficientemente conocida. Iniciativas para mejorar conocimientos, percepciones y prácticas en relación con su diagnóstico, tratamiento y control son perentorias a nivel popular y académico. Las estrategias de comunicación que se implementen deben informar sobre las posibles consecuencias clínicas de la infección en relación con la mujer embarazada(AU)
Introduction: Recent studies found an association between blastocystosis and iron deficiency anemia. One of them showed that the infection with Blastocystis spp is a risk factor for in pregnant women to suffer. This infection can have adverse consequences for both the mother and the fetus. In extreme cases it can lead to maternal and fetal mortality. Objective: To know the prevalence of blastocystosis in pregnant women and its possible association with iron deficiency anemia. Methods: A parasitological, clinical and epidemiological study, descriptive and cross-sectional was conducted on the universe of pregnant women treated in three clinics in La Lisa municipality from July 2017 to June 2018. Results: We found 43 (31.9 percent) pregnant women infected by parasitic protozoa out of 135 who were studied. Blastocystis spp, was the most prevalent (28.9 percent). 41 pregnant women suffered from anemia. In most of them (85.4 percent), anemia classified as iron deficiency. The proportion of pregnant women parasitized by Blastocystis spp who suffered from this type of anemia was significantly higher (p lt;0.05) in relation to pregnant women who were not infected by that protozoan and also suffered from that type of anemia. Conclusions: Blastocystosis is a parasitosis of increasing prevalence which is insufficiently known. Initiatives to improve knowledge, perceptions and practices are peremptory to their diagnosis, treatment and control at the general and academic levels. The communication strategies that are implemented should inform about possible clinical consequences of this infection in pregnant woman(AU)
Assuntos
Humanos , Feminino , Gravidez , Complicações na Gravidez/parasitologia , /complicações , Infecções por Blastocystis/epidemiologia , Complicações Parasitárias na Gravidez/prevenção & controle , Estudos Epidemiológicos , Mortalidade Fetal/etnologiaRESUMO
Malaria in pregnancy threatens birth outcomes and the health of women and their newborns. This is also the case in low transmission areas, such as Colombia, where Plasmodium vivax is the dominant parasite species. Within the Colombian health system, which underwent major reforms in the 90s, malaria treatment is provided free of charge to patients. However, patients still incur costs, such as transportation and value of time lost due to the disease. We estimated such costs among 40 pregnant women with clinical malaria (30% Plasmodium falciparum, 70% Plasmodium vivax) in the municipality of Tierralta, Northern Colombia. In a cross-sectional study, women were interviewed after an outpatient or inpatient laboratory confirmed malaria episode. Women were asked to report all types of cost incurred before (including prevention), during and immediately after the contact with the health facility. Median total cost was over 16US$ for an outpatient visit, rising to nearly 30US$ if other treatments were sought before reaching the health facility. Median total inpatient cost was 26US$ or 54US$ depending on whether costs incurred prior to admission were excluded or included. For both outpatients and inpatients, direct costs were largely due to transportation and indirect costs constituted the largest share of total costs. Estimated costs are likely to represent only one of the constraints that women face when seeking treatment in an area characterized, at the time of the study, by armed conflict, displacement, and high vulnerability of indigenous women, the group at highest risk of malaria. Importantly, the Colombian peace process, which culminated with the cease-fire in August 2016, may have a positive impact on achieving universal access to healthcare in conflict areas. The current study can inform malaria elimination initiatives in Colombia.