Factors influencing dropout rate of intermittent preventive treatment of malaria during pregnancy

ABSTRACT The combination of sulfadoxine-pyrimethamine is recommended for use as intermittent preventive treatment of malaria during pregnancy and is deployed in Africa. The emergence and the spread of resistant parasites are major threats to such an intervention. We have characterized the Plasmodium falciparum dhfr (pfdhfr) haplotypes and flanking microsatellites in 322 P. falciparum isolates collected from the Comoros Islands and Madagascar. One hundred fifty-six (48.4%) carried the wild-type pfdhfr allele, 19 (5.9%) carried the S108N single-mutation allele, 30 (9.3%) carried the I164L single-mutation allele, 114 (35.4%) carried the N51I/C59R/S108N triple-mutation allele, and 3 (1.0%) carried the N51I/C59R/S108N/I164L quadruple-mutation allele. Microsatellite analysis showed the introduction from the Comoros Islands of the ancestral pfdhfr triple mutant allele of Asian origin and its spread in Madagascar. Evidence for the emergence on multiple occasions of the I164L single-mutation pfdhfr allele in Madagascar was also obtained. Thus, the conditions required to generate mutants with quadruple mutations are met in Madagascar, representing a serious threat to current drug policy.

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The combined effect of determinants on coverage of intermittent preventive treatment of malaria during pregnancy in the Kilombero Valley, Tanzania

Malaria Journal ◽

10.1186/1475-2875-10-140 ◽

2011 ◽

Vol 10 (1) ◽

Cited By ~ 31

Author(s):

Karin Gross ◽

Sandra Alba ◽

Joanna Schellenberg ◽

Flora Kessy ◽

Iddy Mayumana ◽

...

Keyword(s):

Intermittent Preventive Treatment ◽

Preventive Treatment ◽

Combined Effect ◽

Kilombero Valley ◽

Malaria During Pregnancy

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Field evaluation of the intermittent preventive treatment of malaria during pregnancy (IPTp) in Benin: evolution of the coverage rate since its implementation

Parasites & Vectors ◽

10.1186/1756-3305-4-108 ◽

2011 ◽

Vol 4 (1) ◽

pp. 108 ◽

Cited By ~ 10

Author(s):

Tania CDA d'Almeida ◽

Marie-Agnès Agboton-Zoumenou ◽

André Garcia ◽

Achille Massougbodji ◽

Valérie Briand ◽

...

Keyword(s):

Intermittent Preventive Treatment ◽

Preventive Treatment ◽

Field Evaluation ◽

Coverage Rate ◽

Malaria During Pregnancy

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Quality of Sulfadoxine-Pyrimethamine Given as Antimalarial Prophylaxis in Pregnant Women in Selected Health Facilities in Central Region of Ghana

Journal of Parasitology Research ◽

10.1155/2016/9231946 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Danny F. Yeboah ◽

Richmond Afoakwah ◽

Ekene K. Nwaefuna ◽

Orish Verner ◽

Johnson N. Boampong

Keyword(s):

Pregnant Women ◽

Central Region ◽

Malaria Infection ◽

High Performance ◽

Intermittent Preventive Treatment ◽

Preventive Treatment ◽

Health Facilities ◽

African Countries ◽

Malaria During Pregnancy

The use of sulfadoxine-pyrimethamine (SP) as an intermittent preventive treatment (IPT) against malaria during pregnancy has become a policy in most sub-Sahara African countries and crucially depends on the efficacy of SP. This study sets out to evaluate the effectiveness of the SP given to the pregnant women in some selected health facilities in the Central Region of Ghana to prevent maternal malaria in pregnant women. A total of 543 pregnant women recruited from 7 selected health centres in Central Region of Ghana participated in the study. Parasite density ofPlasmodium falciparumwas determined from peripheral blood of the pregnant women using microscopy. High performance liquid chromatography (HPLC) and dissolution tester were used to determine the quality of the SP. Malaria infection was recorded in 11.2% of pregnant women who had a history of SP consumption. SP failed the dissolution test. Pregnant women who did not receive IPT-SP were 44%. Low haemoglobin level was recorded in 73.5% of the pregnant women. The results indicated that SP was substandard. IPT-SP is ineffective in preventing malaria infection.

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Monitoring Compliance and Acceptability of Intermittent Preventive Treatment of Malaria Using Sulfadoxine Pyrimethamine after Ten Years of Implementation in Tanzania

Malaria Research and Treatment ◽

10.1155/2017/9761289 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Mdetele B. Ayubu ◽

Winifrida B. Kidima

Keyword(s):

Pregnant Women ◽

Placental Malaria ◽

Intermittent Preventive Treatment ◽

Preventive Treatment ◽

Antenatal Clinic ◽

Drug Uptake ◽

Cross Sectional ◽

Start Date ◽

Malaria During Pregnancy ◽

Endemic Areas

Intermittent preventive treatment using SP (IPTp-SP) is still a superior interventional approach to control malaria during pregnancy. However its rate of use has gone down tremendously in malaria endemic areas. This study forms part of a larger study aimed at monitoring the compliance of IPTp-SP policy in malaria endemic areas of Tanzania. Two cross-sectional studies were conducted in Dar es Salaam and Njombe Regions of Tanzania. Overall, 540 pregnant women and 21 healthcare workers were interviewed using structured questionnaires. This study revealed that 63% of women were not willing to take SP during pregnancy while 91% would only take it if they tested positive for malaria during antennal visits. 63% of the interviewed women did not know the recommended dose of SP required during pregnancy, despite the fact that 82% of the women were aware of the adverse effect of malaria during pregnancy. It was found out that 54% of pregnant women (30–40 weeks) took single dose, 34% took two doses, and 16% did not take SP at the time of interview. It was also found that SP was not administered under direct observed therapy in 86% of women. There was no significant relationship between number of doses received by pregnant women and antenatal clinic (ANC) start date (r2 = 0.0033, 95% CI (−0.016 to 0.034)). However positive correlation between drug uptake and drug availability was revealed (p=0.0001). Knowledge on adverse effects of placental malaria among pregnant women was significantly associated with drug uptake (OR 11.81, 95% CI (5.755–24.23), p=0.0001). We conclude that unavailability of drugs in ANC is the major reason hindering the implementation of IPTp-SP.

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