Glucose-6-Phosphate Dehydrogenase Deficiency and Haemoglobin Drop after Sulphadoxine-Pyrimethamine Use for Intermittent Preventive Treatment of Malaria during Pregnancy in Ghana – A Cohort Study

Abstract Background: Malawi adopted the 2012 updated Word Health Organization (WHO) Intermittent preventive treatment of malaria during pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) policy in 2013. This study aimed to estimate the proportion of and identify factors associated with the uptake of at least three doses of IPTp with SP among pregnant women in Malawi after the adoption and operationalisation of updated WHO IPTp-SP policy. Methods: The 2015-16 Malawi Demographic and Health Survey dataset was analysed. Of 1,219 women aged 15-49 years who had live births and the children were born after the date of July 2015, 1,069 women were included in the analysis. Bivariate and multiple logistic regression were used in data analysis. The statistical analysis took into account a complex survey sample design. Results: Of the 1,069 women, 447 (42%, 95% CI: 38.1-45.6) received three (optimal) or more doses of IPTp-SP. Less than half (47%) managed to attend at least four antenatal care (ANC) clinics. Only 52% received optimal SP doses among those who made at least four ANC visits. Only the number of ANC visits was associated with the optimal uptake of SP. Women who attended ANC three times only and those who visited ANC once or twice only were less likely to receive at least three doses of SP than those who managed to attend ANC at least four times during pregnancy (AOR=0.71, 95% CI 0.49-1.02) and (AOR=0.12, 95% CI 0.06-0.21) respectively. Conclusions: To achieve effective malaria prevention in pregnancy, IPTP-SP is used alongside other interventions. However, there is low uptake of optimal SP doses in Malawi, and this seems to be associated with the number of ANC visits. Moreover, there is limited effectiveness of an increased number of ANC visits on the uptake of optimal SP doses. Further research should be done to explore health systems factors affecting uptake of optimal IPTp with SP doses during pregnancy.

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1345Uptake of Intermittent Preventive Treatment for malaria during pregnancy with Sulphadoxine-Pyrimethamine in Malawi

International Journal of Epidemiology ◽

10.1093/ije/dyab168.047 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Steven Azizi

Keyword(s):

Intermittent Preventive Treatment ◽

Preventive Treatment ◽

Sample Design ◽

Complex Survey ◽

Factors Associated ◽

Limited Effectiveness ◽

Malaria During Pregnancy ◽

Survey Sample ◽

To Receive ◽

Sulphadoxine Pyrimethamine

Abstract Background This study aimed to estimate the proportion of and identify factors associated with uptake of ≥ 3 doses of Intermittent preventive treatment of malaria during pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) among pregnant women in Malawi after adoption of the 2012 updated WHO IPTp-SP policy. Methods The 2015–16 Malawi Demographic and Health Survey dataset was re-analysed. Only 1069 women were included in the analysis from 1219 women who had live births, born after July 2015. Logistic regression was used in data analysis considering complex survey sample design. Results Of the 1069 women, 447 (42%) received ≥3 doses (optimal) of IPTp-SP, while 47% managed to attend ≥4 antenatal care (ANC) clinics. Only 52% received optimal SP doses among those who made ≥4 ANC visits. The number of ANC visits was associated with the optimal uptake of SP. Women who attended ANC three times only and those who visited ANC at most twice were less likely to receive optimal doses than those who managed to attend ANC ≥4 times during pregnancy (AOR = 0.71, 95% CI 0.49–1.02) and (AOR = 0.12, 95% CI 0.06–0.21) respectively. Conclusions There is low uptake of optimal SP doses in Malawi. This seems to be associated with the number of ANC visits. However, there is limited effectiveness of increased number of ANC visits on the uptake of optimal SP doses. Key messages Increased number of ANC visits is not enough to increase uptake of optimal doses of IPTp-SP. There is need for continued and varied efforts.

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Parasitologic Assessment of Two-Dose and Monthly Intermittent Preventive Treatment of Malaria during Pregnancy with Sulphadoxine-Pyrimethamine (IPTP-SP) in Lagos, Nigeria

Malaria Research and Treatment ◽

10.4061/2011/932895 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Chimere O. Agomo ◽

Wellington A. Oyibo ◽

Funke Odukoya-Maije

Keyword(s):

Pregnant Women ◽

Malaria Infection ◽

Continuous Monitoring ◽

Intermittent Preventive Treatment ◽

Preventive Treatment ◽

Significant Difference ◽

Malaria During Pregnancy ◽

Monthly Dosing ◽

Monthly Dose ◽

Sulphadoxine Pyrimethamine

Intermittent preventive treatment of malaria with sulphadoxine-pyrimethamine (IPTP-SP) is a key strategy in the control of malaria in pregnancy. However, reports of increasing level of resistance to SP using nonpregnant populations have made it imperative for the continuous monitoring of the efficacy of SP in pregnant women. This study assessed using microscopy, monthly dosing and the standard two-dose regimen among 259 pregnant women attending antenatal clinics in Lagos, Nigeria that consented 122 in the two-dose arm (Arm A) and 137 in the monthly dose arm (Arm B). Baseline parasitaemia in the two groups was 5 (4.1%) and 3 (2.2%) in Arms A and B, respectively. Few of the women developed parasitaemia after the initial SP dose in Arms A 4 (3.3%) and B 2 (1.5%). However, none of the women had malaria infection after the second dose in both Arms. Although IPTP-SP is suggestive of protecting the women from malaria infection, there was no significant difference observed between the two dosing schemes.

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Uptake of Intermittent Preventive Treatment for Malaria during Pregnancy with Sulphadoxine-Pyrimethamine (IPTp-SP) in Malawi after adoption of updated World Health Organization policy: An Analysis of Demographic and Health Survey 2015-2016

10.21203/rs.2.20575/v1 ◽

2020 ◽

Author(s):

Steven Chifundo Azizi

Keyword(s):

Health Survey ◽

Intermittent Preventive Treatment ◽

Preventive Treatment ◽

Malaria Prevention ◽

Demographic And Health Survey ◽

World Health ◽

Limited Effectiveness ◽

Malaria During Pregnancy ◽

Health Organization ◽

Sulphadoxine Pyrimethamine

Abstract Background Malawi adopted the 2012 updated Word Health Organization (WHO) Intermittent preventive treatment of malaria during pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) policy in 2013. This study aimed to estimate the proportion of and identify factors associated with the uptake of at least three doses of IPTp-SP among pregnant women in Malawi after the adoption of updated WHO IPTp-SP policy.Methods The 2015-16 Malawi Demographic and Health Survey dataset was used. Of 1,219 women aged 15-49 years who had live births and the children were born after date of July 2015, 1,069 women were included in the analysis. Bivariate and multiple logistic regression were used in data analysis. The statistical analysis took into account complex survey sample design.Results Of the 1,069 women, 447 (42%, 95% CI: 38.1-45.6) received three (optimal) or more doses of IPTp-SP. Less than half (47%) managed to attend at least four antenatal care (ANC) clinics. Only 52% received optimal SP doses among those who made at least four ANC visits. Only the number of ANC visits was associated with the optimal uptake of SP. Women who attended ANC three times only and those who visited ANC once or twice only were less likely to receive at least three doses of SP than those who managed to attend ANC at least four times during pregnancy (AOR=0.71, 95% CI 0.49-1.02) and (AOR=0.12, 95% CI 0.06-0.21) respectively.Conclusions To achieve effective malaria prevention in pregnancy, IPTP-SP is used alongside other interventions. However, there is low uptake of optimal SP doses in Malawi, and this seems to be associated with the number of ANC visits. There is limited effectiveness of increased number of ANC visits on the uptake of optimal SP doses. Further research should be done to explore health systems factors affecting uptake of optimal IPTp-SP doses during pregnancy.

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Uptake of Intermittent Preventive Treatment for Malaria during Pregnancy with Sulphadoxine-Pyrimethamine in Malawi after adoption of updated World Health Organization policy: An Analysis of Demographic and Health Survey 2015-2016

10.21203/rs.2.20575/v2 ◽

2020 ◽

Author(s):

Steven Chifundo Azizi

Keyword(s):

Health Survey ◽

Intermittent Preventive Treatment ◽

Preventive Treatment ◽

Malaria Prevention ◽

Demographic And Health Survey ◽

World Health ◽

Limited Effectiveness ◽

Malaria During Pregnancy ◽

Health Organization ◽

Sulphadoxine Pyrimethamine

Abstract Background Malawi adopted the 2012 updated Word Health Organization (WHO) Intermittent preventive treatment of malaria during pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) policy in 2013. This study aimed to estimate the proportion of and identify factors associated with the uptake of at least three doses of IPTp-SP among pregnant women in Malawi after the adoption and operationalisation of updated WHO IPTp-SP policy. Methods The 2015-16 Malawi Demographic and Health Survey dataset was used. Of 1,219 women aged 15-49 years who had live births and the children were born after date of July 2015, 1,069 women were included in the analysis. Bivariate and multiple logistic regression were used in data analysis. The statistical analysis took into account complex survey sample design. Results Of the 1,069 women, 447 (42%, 95% CI: 38.1-45.6) received three (optimal) or more doses of IPTp-SP. Less than half (47%) managed to attend at least four antenatal care (ANC) clinics. Only 52% received optimal SP doses among those who made at least four ANC visits. Only the number of ANC visits was associated with the optimal uptake of SP. Women who attended ANC three times only and those who visited ANC once or twice only were less likely to receive at least three doses of SP than those who managed to attend ANC at least four times during pregnancy (AOR=0.71, 95% CI 0.49-1.02) and (AOR=0.12, 95% CI 0.06-0.21) respectively. Conclusions To achieve effective malaria prevention in pregnancy, IPTP-SP is used alongside other interventions. However, there is low uptake of optimal SP doses in Malawi, and this seems to be associated with the number of ANC visits. There is limited effectiveness of increased number of ANC visits on the uptake of optimal SP doses. Further research should be done to explore health systems factors affecting uptake of optimal IPTp-SP doses during pregnancy.

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