scholarly journals Effects of Intervention Schemes on Sulphadoxine-Pyrimethamine Compliance Among Pregnant Women in a Health Facility in Port Harcourt, Rivers State, Nigeria

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Helen Onoja ◽  
Florence Nduka ◽  
Austin E Abah

Background: Malaria causes diverse adverse effects in the fetus due to the invasion of the placenta by Plasmodium. The use of intermittent preventive treatment (Sulphadoxinepyrimethamine- IPTp-SP) as a control measure for malaria in pregnancy has been recommended and shown to reduce unwanted birth outcomes. Objectives: This work aimed to evaluate the effects of intervention schemes on sulphadoxine-pyrimethamine (SP) compliance and utilization among pregnant women in a health facility in Port Harcourt, Nigeria. Methods: A hospital-based survey was carried out among pregnant women admitted to the Labor ward of Obio-Cottage hospital. The information of mothers was collected using a well-structured and pre-tested questionnaire and from their antenatal care (ANC) records. Results: Time of ANC registration indicated that 87%, 11.33%, and 1.66% of mothers were registered during their first, second, and third trimesters, respectively. Sulphadoxinepyrimethamine was the drug of choice for 93.66% of the women while 6.33% took other drugs. The survey revealed that 97.15% and 2.85% of the women started SP usage in their second and third trimesters, respectively. It was observed that the majority of the women (69.39%) took SP thrice while 24.19% and 6.40% consumed it twice and once, respectively. Regarding knowledge about SP, 89% of the women viewed SP as a preventive drug for malaria while 11% acknowledged it as a therapeutic drug. The birth outcomes of the neonates whose mothers took SP indicated that 1.42% had low birth weight (LBW) while 98.57% had acceptable birth weight. Meanwhile, 10.53% of the babies born to the mothers who did not use SP had LBW, and 89.47% of them had acceptable birth weights. Overall, 98.93% of the neonates of SP-compliant women and 89.48% of the babies of non-compliant women were alive. Non- compliant women had higher prevalence of preterm birth (5.76%) and fetal death (5.26%) than SP-compliant women (0.7% and 0.35%, respectively). Conclusions: Adequate knowledge and compliance with SP usage were high in the studied population, which was associated with favorable birth outcomes.

Pathogens ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. 207 ◽  
Author(s):  
Eulambius M. Mlugu ◽  
Omary Minzi ◽  
Muhammad Asghar ◽  
Anna Färnert ◽  
Appolinary A.R. Kamuhabwa ◽  
...  

Effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) for prevention of malaria and adverse birth outcomes can be compromised by parasites-resistance to sulfadoxine–pyrimethamine. This study prospectively evaluated the effectiveness of IPTp-SP in Southeast Tanzania. From January 2017 to May 2019, HIV-negative and malaria-negative (mRDT) pregnant women attending their first antenatal-care visit in the second or third trimester (n = 500) were enrolled to receive monthly IPTp-SP and followed the protocol till delivery. The primary outcome was the prevalence of histopathological placental malaria. Secondary outcomes were anemia, malaria parasites detected during pregnancy and at delivery, adverse birth outcomes (low-birth-weight [LBW], premature birth, fetal anemia, still birth, and spontaneous abortion). Rates of histopathological placental malaria, any parasitemia at delivery (placental, cord or maternal), and any adverse birth outcome were 9.4%, 20.9%, and 26.5%, respectively. Rates of symptomatic malaria and parasitemia during pregnancy were 2.8% and 16%, respectively. Histopathological placental malaria significantly increased the odds of any adverse birth outcomes, particularly LBW. IPTp-SP with more than or equal to three doses significantly improved birth weight and reduced the risk of LBW by 56% compared to <3 SP doses (p = 0.009). IPTp-SP with more than or equal to three doses is still effective in improving birth weight. However, the detection of histopathological placental-malaria in one-tenth and parasitemia in one-fifth of pregnant women reflects the need to optimize the prevention of malaria during pregnancy.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatima Mahmud Muhammad ◽  
Saharnaz Nedjat ◽  
Haniye Sadat Sajadi ◽  
Mahboubeh Parsaeian ◽  
Abraham Assan ◽  
...  

Abstract Background While the use of sulphadoxine pyrimethamine (SP) is effective in preventing malaria infection during pregnancy, there are challenges limiting its uptake in Nigeria. This study aimed at exploring the barriers to IPTp usage among pregnant women in Kano state - Nigeria. Methods This is a qualitative study. The purposive sampling strategy was used for identification and selection of 14 key informants for interviews. In addition, six focus group discussions (FGDs) were conducted with pregnant women (3 FGDs) and married men (3 FGDs). The conventional content analysis method was used to interpret meaning from the content of the data. MAXQDA 10 software was used for data management and analysis. Results Poor policy implementation, poor antenatal care attendance, inadequate access to intermittent preventive treatment at the community levels, lack of sustainable funding, and poor community engagement emerged as major barriers to IPTp use in Nigeria. Conclusion While the political will to allocate sufficient financial resources could help improve service delivery and IPTp usage among pregnant women, community participation is critical to sustain the gains.


Author(s):  
Helle Hansson ◽  
Daniel T R Minja ◽  
Sofie L Moeller ◽  
John P A Lusingu ◽  
Ib C Bygbjerg ◽  
...  

Abstract Mutations in the Plasmodium falciparum genes Pfdhfr and Pfdhps, particularly the sextuple mutant haplotype threatens the antimalarial effectiveness of sulfadoxine-pyrimethamine as intermittent preventive treatment during pregnancy (IPTp). To explore the impact of sextuple mutant haplotype infections on outcome measures after provision of IPTp-SP, we monitored birth outcomes in women followed from prior to conception or from the first trimester until delivery. Women infected with sextuple haplotypes in early 2 nd trimester specifically, delivered newborns with a lower birth weight (-267g, 95% CI -454; -59, p=0·01) compared to women who did not have malaria during pregnancy and women infected with less SP resistant haplotypes (-461g, 95% CI -877; -44, p=0·03). Thus, sextuple haplotype infections seems to impact the effectiveness of SP for IPTp and directly impact birth outcome by lowering birth weight. Close monitoring and targeted malaria control during early pregnancy is therefore crucial to improve birth outcomes.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fatima Mahmud Muhammad ◽  
Reza Majdzadeh ◽  
Saharnaz Nedjat ◽  
Haniye Sadat Sajadi ◽  
Mahboubeh Parsaeian

Abstract Background Intermittent preventive treatment using Sulphadoxine pyrimethamine (IPTp-SP) for malaria prevention is recommended for all pregnant women in malaria endemic areas. However, there is limited evidence on the level of socioeconomic inequality in IPTp-SP use among pregnant women in Nigeria. Thus, this study aimed to determine the level of socioeconomic inequality in IPTp-SP use among pregnant women in Nigeria and to decompose it into its contributing factors. Methods A secondary data analysis of Nigerian demographic and health survey of 2018 was conducted. A sample of 21,621 pregnant women aged between 15 and 49 years and had live birth in the previous 2 years before the survey were included in this analysis. The study participants were recruited based on a stratified two-stage cluster sampling method. Socioeconomic inequality was decomposed into its contributing factors by concentration index. Result Totally 63.6% of pregnant women took at least one dose of IPTp-SP prophylaxis. Among IPTp-SP users, 35.1% took one dose, 38.6% took two doses and 26.2% took three doses and more. Based on both concentration index of 0.180 (p-value = < 0.001, 95% CI: 0.176 to 0.183) and Erreyger’s normalization concentration index 0.280 (p-value = < 0.001, 95% CI: 0.251 to 0.309), the IPTp-SP utilization was pro-rich. The largest contributors to the inequality in IPTp-SP uptake were wealth index (47.81%) and educational status (28.66%). Conclusion Our findings showed that IPTp-SP use was pro-rich in Nigeria. Wealth index and educational status were the factors that significantly contributed to the inequality. The disparities could be reduced through free IPTp service expansion by targeting pregnant women from low socioeconomic status.


2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Nneka U. Igboeli ◽  
Maxwell O. Adibe ◽  
Chinwe V. Ukwe ◽  
Nze C. Aguwa

Background. In 2005, Nigeria changed its policy on prevention of malaria in pregnancy to intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP). Indicators of impact of effective prevention and control of malaria on pregnancy (MIP) are low birth weight (LBW) and maternal anaemia by parity. This study determined the prevalence of LBW for different gravidity groups during periods of pre- and postpolicy change to IPTp-SP. Methods. Eleven-year data were abstracted from the delivery registers of two hospitals. Study outcomes calculated for both pre- (2000–2004) and post-IPTp-SP-policy (2005–2010) years were prevalence of LBW for different gravidity groups and risk of LBW in primigravidae compared to multigravidae. Results. Out of the 11,496 singleton deliveries recorded within the 11-year period, the prevalence of LBW was significantly higher in primigravidae than in multigravidae for both prepolicy (6.3% versus 4%) and postpolicy (8.6% versus 5.1%) years. The risk of LBW in primigravidae compared to multigravidae increased from 1.62 (1.17–2.23) in the prepolicy years to 1.74 (1.436–2.13) during the postpolicy years. Conclusion. The study demonstrated that both the prevalence and risk of LBW remained significantly higher in primigravidae even after the change in policy to IPTp-SP.


2011 ◽  
Vol 10 (1) ◽  
pp. 196 ◽  
Author(s):  
Gwladys Bertin ◽  
Valérie Briand ◽  
Diana Bonaventure ◽  
Ambre Carrieu ◽  
Achille Massougbodji ◽  
...  

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