一个多元件干预措施,以改善孕产妇感染的结果
David Lissauer1,2, Luis Gadama3, Catriona Waitt1,4
1Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool Women's Hospital, Liverpool, United Kingdom.
积极预防和治疗孕产妇败血症 (APT-败血症) 计划显著减少了孕产妇死亡率和严重疾病. 这种多组件干预措施改善了低资源环境中的败血症预防和管理.
科学领域:
- 全球健康 全球健康
- 产科和妇科 产科和妇科
- 传染性疾病 传染性疾病
背景情况:
- 孕产妇感染和败血症是全球孕产妇死亡的主要原因,特别是在低收入和中等收入国家.
- 延迟检测和不一致的基于证据的实践实施有助于预防的孕产妇死亡.
研究的目的:
- 评估主动预防和治疗孕产妇败血症 (APT-败血症) 计划的有效性.
- 减少与感染相关的孕产妇死亡,近乎失踪事件和严重疾病.
主要方法:
- 一个集群随机试验,涉及马拉维和乌干达的59个卫生机构.
- 干预包括遵守手部卫生,基于证据的感染管理和使用FAST-M捆绑的早期败血症检测.
- 对照组接受了通常的护理和指南传播.
主要成果:
- 该APT-败血症计划导致复合结果减少了32% (风险比,0.68;P<0.001).
- 主要结局事件发生在1.4%的干预组中,而在通常护理组中为1.9%.
- 干预的好处在不同国家和设施类型中是一致的,并且随着时间的推移而持续.
结论:
- 与通常护理相比,APT-Sepsis计划显著降低了与感染相关的孕产妇发病率和死亡率的风险.
- 这种多组件干预措施有效地改善了在资源有限的环境中改善母亲的结果.
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