scholarly journals Missed opportunities to deliver intermittent preventive treatment for malaria to pregnant women 2003–2013: a systematic analysis of 58 household surveys in sub-Saharan Africa

2015 ◽  
Vol 14 (1) ◽  
Author(s):  
Kathryn G. Andrews ◽  
Michael Lynch ◽  
Erin Eckert ◽  
Julie Gutman
Keyword(s):  
Pregnant Women ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Sub Saharan Africa ◽  
Household Surveys ◽  
Systematic Analysis ◽  
Missed Opportunities ◽  
Sub Saharan

scholarly journals Asymptomatic Malaria Correlates with Anaemia in Pregnant Women at Ouagadougou, Burkina Faso

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Zoenabo Douamba ◽  
Cyrille Bisseye ◽  
Florencia W. Djigma ◽  
Tegwinde R. Compaoré ◽  
Valérie Jean Telesphore Bazie ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Pregnant Women ◽  
Rapid Detection ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Asymptomatic Infection ◽  
Sub Saharan Africa ◽  
Asymptomatic Malaria ◽  
Low Levels ◽  
Sub Saharan

Sub-Saharan Africa records each year about thirty-two million pregnant women living in areas of high transmission ofPlasmodium falciparumcausing malaria. The aim of this study was to carve out the prevalence of asymptomatic malaria among pregnant women and to emphasize its influence on haematological markers. The prevalence ofPlasmodium falciparumasymptomatic infection among pregnant women was 30% and 24% with rapid detection test (RDT) and microscopy, respectively. The prevalence ofP. falciparumasymptomatic malaria was reduced among pregnant women using sulfadoxine-pyrimethamine's intermittent preventive treatment and 61% of them were anaemic. Anaemia was significantly more common in women infected withP. falciparumcompared with the uninfected pregnant women. Most of the women had normal levels of homocysteine and low levels of folate, respectively. Therefore, the systematic diagnosis of malaria should be introduced to pregnant women as a part of the antenatal care.

scholarly journals Coverage of intermittent preventive treatment of malaria in pregnancy in four sub-Saharan countries: findings from household surveys

2020 ◽  
Author(s):  
Clara Pons-Duran ◽  
Mireia Llach ◽  
Charfudin Sacoor ◽  
Sergi Sanz ◽  
Eusebio Macete ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Malaria Prevention ◽  
Reproductive Age ◽  
Cluster Sampling ◽  
Household Surveys ◽  
Cross Sectional ◽  
Sub Saharan ◽  
In Pregnancy

Abstract Background Intermittent preventive treatment in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) is a key malaria prevention strategy in areas with moderate to high transmission. As part of the TIPTOP (Transforming IPT for Optimal Pregnancy) project, baseline information about IPTp coverage was collected in eight districts from four sub-Saharan countries: Democratic Republic of Congo (DRC), Madagascar, Mozambique and Nigeria. Methods Cross-sectional household surveys were conducted using a multistage cluster sampling design to estimate the coverage of IPTp and antenatal care attendance. Eligible participants were women of reproductive age who had ended a pregnancy in the 12 months preceding the interview and who had resided in the selected household during at least the past 4 months of pregnancy. Coverage was calculated using percentages and 95% confidence intervals. Results A total of 3911 women were interviewed from March to October 2018. Coverage of at least three doses of IPTp (IPTp3+) was 22% and 24% in DRC project districts; 23% and 12% in Madagascar districts; 11% and 16% in Nigeria local government areas; and 63% and 34% in Mozambique districts. In DRC, Madagascar and Nigeria, more than two-thirds of women attending at least four antenatal care visits during pregnancy received less than three doses of IPTp. Conclusions The IPTp3+ uptake in the survey districts was far from the universal coverage. However, one of the study districts in Mozambique showed a much higher coverage of IPTp3+ than the other areas, which was also higher than the 2018 average national coverage of 41%. The reasons for the high IPTp3+ coverage in this Mozambican district are unclear and require further study.

scholarly journals Intermittent screening and treatment with dihydroartemisinin-piperaquine for the prevention of malaria in pregnancy: implementation feasibility in a routine healthcare system setting in western Kenya

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Jenny Hill ◽  
Peter Ouma ◽  
Seth Oluoch ◽  
Jane Bruce ◽  
Simon Kariuki ◽  
...  
Keyword(s):  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Standard Of Care ◽  
Health Facilities ◽  
Malaria In Pregnancy ◽  
Sub Saharan Africa ◽  
Directly Observed Therapy ◽  
Western Kenya ◽  
Sub Saharan ◽  
In Pregnancy

Abstract Background Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is recommended for preventing malaria in pregnancy in areas of moderate-to-high transmission in sub-Saharan Africa. However, due to increasing parasite resistance to SP, research on alternative strategies is a priority. The study assessed the implementation feasibility of intermittent screening and treatment (ISTp) in the second and third trimester at antenatal care (ANC) with malaria rapid diagnostic tests (RDTs) and treatment of positive cases with dihydroartemisinin-piperaquine (DP) compared to IPTp-SP in western Kenya. Methods A 10-month implementation study was conducted in 12 government health facilities in four sub-counties. Six health facilities were assigned to either ISTp-DP or IPTp-SP. Evaluation comprised of facility audits, ANC observations, and exit interviews. Intermediate and cumulative effectiveness analyses were performed on all processes involved in delivery of ISTp-DP including RDT proficiency and IPTp-SP ± directly observed therapy (DOT, standard of care). Logistic regression was used to identify predictors of receiving each intervention. Results A total of 388 and 389 women were recruited in the ISTp-DP and IPTp-SP arms, respectively. For ISTp-DP, 90% (289/320) of eligible women received an RDT. Of 11% (32/289) who tested positive, 71% received the correct dose of DP and 31% the first dose by DOT, and only 6% were counselled on subsequent doses. Women making a sick visit and being tested in a facility with a resident microscopist were more likely to receive ISTp-DP (AOR 1.78, 95% CI 1.31, 2.41; and AOR 3.75, 95% CI 1.31, 2.40, respectively). For IPTp-SP, only 57% received a dose of SP by DOT. Payment for a laboratory test was independently associated with receipt of SP by DOT (AOR 6.43, 95% CI 2.07, 19.98). Conclusions The findings indicate that the systems effectiveness of ANC clinics to deliver ISTp-DP under routine conditions was poor in comparison to IPTp-SP. Several challenges to integration of ISTp with ANC were identified that may need to be considered by countries that have introduced screening at first ANC visit and, potentially, for future adoption of ISTp with more sensitive RDTs. Understanding the effectiveness of ISTp-DP will require additional research on pregnant women’s adherence to ACT.

scholarly journals Gestational malaria in Kisangani : Efficacy of Mefloquine vs Sulfadoxine-Pyrimethamine in Intermittent Preventive Treatment : A Study Protocol for a randomized controlled clinical trial

2019 ◽  
Author(s):  
Labama Otuli Noël ◽  
Bosenge Nguma ◽  
Maindo Alongo Mike-Antoine ◽  
Katenga Bosunga Gédéon ◽  
Losimba Likwela Joris ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Pregnant Women ◽  
Randomized Clinical Trials ◽  
Democratic Republic ◽  
Placental Malaria ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Sub Saharan Africa ◽  
Controlled Clinical Trial

Abstract Background : In order to reduce malaria-related morbidity and mortality during pregnancy, WHO recommends : Insecticide-treated mosquito nets, Intermittent Preventive Treatment of malaria in pregnancy, Prompt and effective case management. Nevertheless, several cases of resistance to Sulfadoxine-Pyrimethamine, used in intermittent preventive treatment, and to Chloroquine are reported in sub-Saharan Africa and in the Democratic Republic of the Congo. The prevalence of malaria among pregnant women remains high in Africa in general, and in the Democratic Republic of Congo in particular. This issue leads us to conduct this study, which aims at proposing an alternative to SP for preventing malaria in pregnant women. Materials and methods : From June 1 to October 31, 2019, we enrolled pregnant women from five health facilities in Kisangani for randomized, single-blind controlled clinical trials to compare the efficacy of two intermittent preventive treatment regimens in Kisangani pregnant women, selected before 18 th weeks of amenorrhea. The first regimen consists of 4 doses of Sulfadoxine-Pyrimethamine starting at the selection time and spaced at least 4 weeks during pregnancy. Each dose is made of 3 tablets of 525 mg Sulfadoxine-Pyrimethamine. The second regimen consists of 2 doses of Mefloquine during pregnancy. The first dose is taken at the selection time and the second dose between the 28 th and 32 nd weeks of amenorrhea. Each dose is made of 3 tablets of 250 mg Mefloquine. The efficacy criteria for these two regimens are placental malaria parasitemia, low birth weight of newborn and maternal anemia at delivery. The safety criterion was the occurrence of major side effects. Discussion : There are not enough randomized clinical trials assessing the efficacy of Mefloquine for the intermittent preventive treatment of malaria in African pregnant women, hence the recommendation for clinical trials. The present study is the only one that conducts such assessment in a hyper-endemic area with resistance to Sulfadoxine-Pyrimethamine and Chloroquine. The findings are therefore intended to promote the use of Mefloquine as the best alternative to Sulfadoxine-Pyrimethamine in the intermittent preventive treatment of malaria. Clinical trial registration : PACTR201905899965726. Key words : Intermittent preventive treatment, efficacy, safety, Mefloquine, Sulfadoxine-Pyrimethamine, Kisangani.

scholarly journals Epidemiology of Malaria in Pregnancy and Associated Risk Factors in Nigeria: a Review

2021 ◽  
pp. 59-72
Author(s):  
Chibuzo Christian Uba ◽  
Moses Nkechukwu Ikegbunam ◽  
Emmanuel Chigozie Udegbunam ◽  
Chioma Abana ◽  
Stephen Nnaemeka Ezekwueche ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Preventive Treatment ◽  
Malaria In Pregnancy ◽  
Sub Saharan Africa ◽  
Drug Misuse ◽  
Care Services ◽  
Sub Saharan ◽  
Associated Risk Factors ◽  
In Pregnancy

Each year, an estimated number of 300–500 million people are infected with malaria parasite, with an undesirable effect of over one million deaths. Pregnant women as well as young children, non-immune travellers visiting malaria-endemic zones are at the highest risk of suffering or experiencing life - threatening malaria infection. Maternal immunity, parasite density, parity, inadequate antenatal care services, drug misuse and abuse as well intermitted preventive treatment drug failure cum resistance are the most associated risk factors of malaria in pregnancy obtainable in endemic regions of sub-Saharan Africa. Identification and understanding of these factors will play a major role in reducing the burden as well as eliminating malaria disease among pregnant women living in endemic regions.

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