scholarly journals Intermittent preventive treatment comparing two versus three doses of sulphadoxine pyrimethamine (IPTp-SP) in the prevention of anaemia in pregnancy in Ghana: A cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250350
Author(s):  
Yaa Nyarko Agyeman ◽  
Sam Newton ◽  
Raymond Boadu Annor ◽  
Ellis Owusu-Dabo

In 2012 the World Health Organisation (WHO) revised the policy on Intermittent Preventive Treatment with Sulphadoxine Pyrimethamine (IPTp-SP) to at least three doses for improved protection against malaria parasitaemia and its associated effects such as anaemia during pregnancy. We assessed the different SP dosage regimen available under the new policy to determine the dose at which women obtained optimal protection against anaemia during pregnancy. A cross-sectional study was conducted among pregnant women who attended antenatal clinic at four different health facilities in Ghana. The register at the facilities served as a sampling frame and simple random sampling was used to select all the study respondents; they were enrolled consecutively as they kept reporting to the facility to receive antenatal care to obtain the required sample size. The haemoglobin level was checked using the Cyanmethemoglobin method. Multivariable logistic regression was performed to generate odds ratios, confidence intervals and p-values. The overall prevalence of anaemia among the pregnant women was 62.6%. Pregnant women who had taken 3 or more doses of IPTp-SP had anaemia prevalence of 54.1% compared to 66.6% of those who had taken one or two doses IPTp-SP. In the multivariable logistic model, primary (aOR 0.61; p = 0.03) and tertiary education (aOR 0.40; p = <0.001) decreased the odds of anaemia in pregnancy. Further, pregnant women who were anaemic at the time of enrollment (aOR 3.32; p = <0.001) to the Antenatal Care clinic and had malaria infection at late gestation (aOR 2.36; p = <0.001) had higher odds of anaemia in pregnancy. Anaemia in pregnancy remains high in the Northern region of Ghana. More than half of the pregnant women were anaemic despite the use of IPTp-SP. Maternal formal education reduced the burden of anaemia in pregnancy. The high prevalence of anaemia in pregnancy amid IPTp-SP use in Northern Ghana needs urgent attention to avert negative maternal and neonatal health outcomes.

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 223
Author(s):  
Gayani Amarasinghe ◽  
Vasana Mendis ◽  
Thilini Agampodi

Background: Anaemia in pregnancy, which can lead to adverse maternal and fetal outcomes, is a significant global health problem. Despite Sri Lanka’s strong public health system and commitment towards prevention, maternal anaemia remains a major problem in the country. While prevention is focused on iron deficiency, detailed etiological studies on this topic are scarce. Moreover, estimates of socio demographic and economic factors associated with anaemia in pregnancy, which can provide important clues for anaemia control, are also lacking. This study aims to evaluate the hemoglobin distribution, spatial distribution, etiology and associated factors for anaemia in pregnant women in Anuradhapura, Sri Lanka. Methods: This is a cross sectional study of pregnant women in their first trimester registered for antenatal care from July to September 2019 in the Anuradhapura district. The minimal sample size was calculated to be 1866. Initial data collection has already been carried out in special field clinics for pregnant women between June to October 2019. An interviewer-administered questionnaire, a self-completed dietary questionnaire and an examination checklist were used for data collection. In addition, all participants underwent complete blood count testing. Further investigations are being conducted for predicting the etiology of anaemia based on a developed algorithm (such as high-performance liquid chromatography [HPLC] and peripheral blood film analysis). Discussion: Being the largest study on anaemia during pregnancy in a single geographical area in Sri Lanka, this study will provide important clues about geographical clustering of anaemia cases with similar etiology, associated factors and etiologies which would help to develop interventions to improve the health of pregnant women in the area. The possibility of selection bias is a potential limitation associated with the study design.


Author(s):  
Ilboudo Bernard ◽  
Savadogo G. Léon Blaise ◽  
Kinda Maurice ◽  
Guiguemde T. Robert ◽  
Dramaix-wilmet Michèle ◽  
...  

Objectives: To analyze the factors associated with anemia in pregnancy in the Cascades region in Burkina Faso. Methods: A cross-sectional study was carried out in antenatal clinics of the Cascades region in Burkina Faso during one month from May to June 2012. We collected data on socio-demographics and health characteristics of pregnant women attending these clinics. Hemoglobin was measured to assess anemia. Factors associated with anemia were identified through a multivariate analysis. Results: A total of 1763 pregnant women, irrespectively of pregnancy stage, were enrolled. The mean (SD) hemoglobin level was 10.6 (1.4) g/dl. The prevalence of anemia in pregnancy was 58.9%, 3.2% of them being severe. Factors associated with anemia were the absence of intermittent preventive treatment of malaria with sulfadoxin-pyrimetamin (OR = 1.3, 95% CI: 1.0-1.7), number of pregnancies >6 (OR = 1.4, 95% CI: 1.1-1.9). Moderate consumption of local alcohol extracted from Palmyra was associated with a lower prevalence of anemia (OR = 0.7, 95% CI: 0.5-0.9). Surprisingly, anemia was not associated with supplementation with folic acid + iron (p = 0.60). Conclusions: Interventions which aim to reduce the prevalence of anemia in pregnancy in Burkina Faso should improve the coverage of the intermittent preventive treatment of malaria and support the limitation of births.


2014 ◽  
Vol 6 (2) ◽  
pp. 130-137 ◽  
Author(s):  
Emmanuel O. Ugwu ◽  
Cyril C. Dim ◽  
Benjamin S. Uzochukwu ◽  
Emeka I. Iloghalu ◽  
Angela O. Ugwu

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Otchere Addai-Mensah ◽  
Max Efui Annani-Akollor ◽  
Linda Ahenkorah Fondjo ◽  
Kwadwo Sarbeng ◽  
Enoch Odame Anto ◽  
...  

Background. The World Health Organization (WHO) recommends the use of Insecticide Treated Bed-Nets and Intermittent Preventive Treatment (IPT) with Sulphadoxine-Pyrimethamine (SP) as interventions in curbing malaria during pregnancy. However, increasing evidence shows a gap in coverage where not all pregnant women receive the recommended SP dose. This study evaluated the factors influencing uptake of IPTp-SP among pregnant women in Kumasi, Ghana. Methodology. This cross-sectional study was conducted among 280 pregnant women attending the Kwame Nkrumah University of Science and Technology Hospital in Kumasi, Ghana. Validated structured questionnaires were administered to obtain sociodemographic, medical/reproductive information, and IPTp-SP uptake among participants. Statistical analyses were performed using IBM SPSS 25.0 statistics. Results. The mean age of respondents was 29.7±4.9 years. Of the 280 women interviewed, 74.6% attended the antenatal care (ANC) clinic at least four times with only 31.8% completing the recommended doses. Tertiary education [aOR=3.15, 95% CI (0.94 -10.97), and p=0.042] and ≥ 4 ANC visits [aOR=24.6, 95% CI (5.87-103.07), p<0.0001] had statistically significant higher odds of completing the recommended IPTp-SP dose. However, participants employed by the formal sector [aOR=0.28, 95% CI (0.09 - 0.79), p=0.016] and participants with more than four children [aOR=0.14, 95% CI (0.03 - 0.63), and p=0.011] had statistically significant lower odds of completing the recommended IPT dose. Conclusion. ANC attendance is critical in IPTp uptake. The results emphasize the need for the Health Policy Makers in Kumasi to encourage pregnant women, especially women working in the formal sector and women having more than four children to patronize ANC attendance to ensure high coverage of the recommended IPTp dose.


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ekene K. Nwaefuna ◽  
Richmond Afoakwah ◽  
Verner N. Orish ◽  
Alexander Egyir-Yawson ◽  
Johnson N. Boampong

Malaria infections undetectable by microscopy but detectable by Polymerase Chain Reaction (PCR) (submicroscopic malaria) are common in endemic areas like Ghana. Submicroscopic malaria has been linked with severe pregnancy outcomes as well as contributing to malaria transmission. In this cross-sectional study 872 consenting pregnant women (gestation ≥ 20 weeks) were recruited from 8 hospitals in Central Region, Ghana, between July and December 2009. Malaria infection was detected by microscopy and PCR. Haemoglobin was measured and anaemia was defined as haemoglobin lower than 11 g/dL. Majority of the women, 555 (63.6%), were Intermittent Preventive Treatment in Pregnancy with Sulphadoxine-Pyrimethamine (IPTp-SP) users while 234 (36.4%) were nonusers. The prevalence of malaria by microscopy was 20.9% (182/872) and 9.7% (67/688) of microscopy negative women had submicroscopic malaria. IPTp-SP usage significantly (odds ratio = 0.13, 95% confidence interval = 0.07–0.23,p=0.005) reduced the prevalence of submicroscopic malaria as more nonusers (51/234) than users (16/454) were PCR positive. After controlling for other variables the effect of IPTp-SP remained statistically significant (odds ratio = 0.11, 95% confidence interval = 0.02–0.22,p=0.006). These results suggest that Intermittent Preventive Treatment with Sulphadoxine-Pyrimethamine is useful in the reduction of submicroscopic malaria in pregnancy.


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