Association between indoor residual spraying and pregnancy outcomes: a quasi-experimental study from Uganda

被引:2
|
作者
Roh, Michelle E. [1 ,2 ]
Mpimbaza, Arthur [3 ]
Oundo, Brenda [4 ]
Irish, Amanda [1 ,2 ]
Murphy, Maxwell [5 ]
Wu, Sean L. [5 ]
White, Justin S. [1 ,6 ]
Shiboski, Stephen [1 ]
Glymour, M. Maria [1 ]
Gosling, Roly [1 ,2 ]
Dorsey, Grant [7 ]
Sturrock, Hugh [1 ,2 ]
机构
[1] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA USA
[2] Univ Calif San Francisco, Inst Global Hlth Sci, Malaria Eliminat Initiat, San Francisco, CA USA
[3] Makerere Univ, Coll Hlth Sci, Child Hlth & Dev Ctr, Kampala, Uganda
[4] Infect Dis Res Collaborat, Kampala, Uganda
[5] Univ Calif Berkeley, Dept Biostat, Berkeley, CA USA
[6] Univ Calif San Francisco, Philip R Lee Inst Hlth Policy Studies, San Francisco, CA USA
[7] Univ Calif San Francisco, Dept Med, Div HIV Infect Dis & Global Med, San Francisco, CA USA
基金
美国国家卫生研究院;
关键词
Malaria in pregnancy; indoor residual spraying; low birthweight; stillbirth; adverse pregnancy outcomes; Plasmodium falciparum; difference-in-differences; matrix completion method; LOW-BIRTH-WEIGHT; MALARIA PREVENTION; PRENATAL EXPOSURE; GESTATIONAL-AGE; HEALTH; MORTALITY; ORGANOPHOSPHATE; INSECTICIDE; PESTICIDES; CHILDREN;
D O I
10.1093/ije/dyac043
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background Malaria is a risk factor for adverse pregnancy outcomes. Indoor residual spraying with insecticide (IRS) reduces malaria infections, yet the effects of IRS on pregnancy outcomes are not well established. We evaluated the impact of a large-scale IRS campaign on pregnancy outcomes in Eastern Uganda. Methods Birth records (n = 59 992) were obtained from routine surveillance data at 25 health facilities from five districts that were part of the IRS campaign and six neighbouring control districts similar to 27 months before and similar to 24 months after the start of the campaign (January 2013-May 2017). Campaign effects on low birthweight (LBW) and stillbirth incidence were estimated using the matrix completion method (MC-NNM), a machine-learning approach to estimating potential outcomes, and compared with the difference-in-differences (DiD) estimator. Subgroup analyses were conducted by HIV and gravidity. Results MC-NNM estimates indicated that the campaign was associated with a 33% reduction in LBW incidence: incidence rate ratio (IRR) = 0.67 [95% confidence interval (CI): 0.49-0.93)]. DiD estimates were similar to MC-NNM [IRR = 0.69 (0.47-1.01)], despite a parallel trends violation during the pre-IRS period. The campaign was not associated with substantial reductions in stillbirth incidence [IRRMC-NNM = 0.94 (0.50-1.77)]. HIV status modified the effects of the IRS campaign on LBW [beta(IRSxHIV) = 0.42 (0.05-0.78)], whereby HIV-negative women appeared to benefit from the campaign [IRR = 0.70 (0.61-0.81)], but not HIV-positive women [IRR = 1.12 (0.59-2.12)]. Conclusions Our results support the effectiveness of the campaign in Eastern Uganda based on its benefit to LBW prevention, though HIV-positive women may require additional interventions. The IRS campaign was not associated with a substantively lower stillbirth incidence, warranting further research.
引用
收藏
页码:1489 / 1501
页数:13
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