Coverage and efficacy of intermittent preventive treatment with sulphadoxine pyrimethamine against malaria in pregnancy in Cote d’Ivoire five years after its implementation

Type Journal Article - Parasites & vectors
Title Coverage and efficacy of intermittent preventive treatment with sulphadoxine pyrimethamine against malaria in pregnancy in Cote d’Ivoire five years after its implementation
Author(s)
Volume 7
Issue 1
Publication (Day/Month/Year) 2014
Page numbers 1-8
URL http://parasitesandvectors.biomedcentral.com/articles/10.1186/s13071-014-0495-5
Abstract
Background: The World Health Organization (WHO) recommends for sub-Saharan Africa a package of prompt and
effective case-management combined with the delivery of insecticide-treated nets (ITN) and intermittent preventive
treatment during pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) through the national antenatal care
(ANC) programs. Implemented in Côte d’Ivoire around 2005, few Data on IPTp coverage and efficacy in the country
are available.
Methods: A multicentre, cross-sectional survey was conducted in Côte d’Ivoire from September 2009 to May 2010
at six urban and rural antenatal clinics. IPTp-sp coverage, Socio-economic and obstetrical data of mothers and neonate
birth weights were documented. Peripheral blood as well as placental and cord blood were used to prepare thick and
thin blood films. In addition, pieces of placental tissues were used to prepare impression smears and maternal
haemoglobin concentration was measured. Regression logistics were used to study factors associated with placental
malaria and LBW (<2.500 grams).
Results: A total of 1317 delivered women were enrolled with a median age of 26 years. A proportion of 43.28% of the
women had received at least two doses of IPTsp during the current pregnancy although a high proportion (90.4%) of
women received antenatal care and made enough visits (=2). Variability in the results was observed depending on the
type of area (rural/urban). Plasmodium falciparum was detected in the peripheral blood of 97 women (7.3%)
and in the placenta of 119 women (9%). LBW infants were born to 18.8% (22/107) of women with placental
malaria and 8.5% (103/1097) of women without placental malaria. LBW was associated with placental malaria.
Conclusions: This study found relative low coverage of IPTp in the study areas which supported findings that
high ANC attendance does not guarantee high IPTp coverage. Urgent efforts are required to improve service
delivery of this important intervention.

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