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

Touré, Offianan André; Kone, Penali L; Coulibaly, M'Lanhoro A A; Ako, Berenger A; Gbessi, Eric A; Coulibaly, Boubacar; Guessan, Landry T N¿; Koffi, David; Beourou, Sylvain; Soumahoro, Adama; Bassinka, Issiaka; Nogbou, Messoun; Swa, Tidjane; Gba, Bernadin; Esmel, Beugre; Bokossa, Ernestine M

doi:10.1186/preaccept-1316351532117712

Cited by 5 publications

(9 citation statements)

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“…The number of ANC visits made is a major determinant of IPTp-SP uptake [ 5 ]. Although a high proportion of pregnant women currently go for ANC services in some communities [ 6 ], in others, many are still unable to make the recommended four or more visits [ 7 ]. Recent studies still show that the level of uptake of two or more doses of SP is still low in some countries even after the new WHO policy.…”

Section: Introductionmentioning

confidence: 99%

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Intermittent preventive treatment of malaria in pregnancy: a cross-sectional survey to assess uptake of the new sulfadoxine–pyrimethamine five dose policy in Ghana

Owusu-Boateng

Anto

2017

Malar J

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BackgroundMalaria in pregnancy poses a great risk to both mother and fetus. In Ghana, malaria accounts for 3.4% of deaths and 16.8% of all hospital admissions in pregnant women. In 2014, Ghana updated her policy on intermittent preventive treatment of malaria in pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) to reflect the updated policy of the WHO. This study determined the level of uptake of sulfadoxine pyrimethamine (SP) to serve as baseline for monitoring progress and also reviewed stock levels of SP, a key factor in the programme implementation.MethodsA cross-sectional hospital-based study was carried out among nursing mothers who had delivered within 12 weeks and were seeking postnatal care at Osu Government Maternity Home in Accra. Antenatal record books of the mothers were reviewed and data collected on number of visits and receipt of IPTp-SP. Mothers were interviewed and data collected on their background characteristics and obstetric history. Data on SP stock levels for the past 6 months were also reviewed. Logistic regression analysis was carried out to determine antenatal indicators on uptake of IPTp-SP using Stata version 12.ResultsThe proportion of uptake of three-five doses of SP were: IPT3 (87.5%), IPT4 (55.7%) and IPT5 (14.5%). The proportion of women who received the first dose of SP at 16 weeks of gestation was 21.3%. Women who made ≥4 visits were more likely to receive ≥3 doses of SP than those who made <4 visits (AOR = 4.57, 95% CI 1.15–18.16, p < 0.05). Women receiving the first dose of SP in the third trimester were less likely to receive ≥3 doses of SP than those who received the drug in the second trimester (AOR = 0.04, 95% CI 0.01–0.16, p < 0.05). Stock levels of SP were adequate to meet the demands by the pregnant women at the Maternity Home for the period under review.ConclusionsThe uptake of ≥3 doses of SP was high in the study area. Frequent visits to the antenatal clinic and early uptake of the first dose of SP by pregnant women are necessary to achieve the new target of five or more doses of SP.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-017-1969-7) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

“…In some cases, the women are given the drug and yet they do not swallow it as it is not always given as directly observed therapy [ 8 ]. Reports of low IPTp-SP coverage in many endemic countries in Africa [ 5 , 6 , 11 ] raise concerns about how to achieve the higher targets set in the new WHO policy.…”

Section: Introductionmentioning

confidence: 99%

Intermittent preventive treatment of malaria in pregnancy: a cross-sectional survey to assess uptake of the new sulfadoxine–pyrimethamine five dose policy in Ghana

Owusu-Boateng

Anto

2017

Malar J

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“…There were also seemingly minor but important reasons for the improper implementation of IPTp, such as distance from the health center, absence of potable water at the health center level for drug administration by DOT, inadequate education of the client about IPTp and drug side effects [ 25 , 41 , 53 ]. Within the health system, this type of situation leads to a domino effect, with several lapses piling up and resulting in system failure for a particular program.…”

Section: Resultsmentioning

confidence: 99%

“…Drug stock outs associated with the slow allocation of quarterly funds to the district and beyond was a constant observation in the studies reviewed [ 20 , 25 , 33 , 38 , 43 , 56 , 57 ]. Drug stock outs have been frequently reported during monitoring and evaluation of programs.…”

Section: Resultsmentioning

confidence: 99%

“…Although this approach to the prevention of malaria in pregnant women appears to be simple, optimal coverage for the ≥3 doses IPTp regimen has been a great challenge. Adherence to the IPTp regimen appears to decrease despite an increase in the number of ANC visits [ 20 , 21 , 22 , 23 , 24 , 25 ]. In 2018, the coverage rate for three doses of IPTp globally was 31% [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

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Impact of Health Systems on the Implementation of Intermittent Preventive Treatment for Malaria in Pregnancy in Sub-Saharan Africa: A Narrative Synthesis

Olaleye

Walker

2020

TropicalMed

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Malaria in pregnancy is a public health challenge with serious negative maternal and newborn consequences. Intermittent preventive treatment (IPTp) with sulphadoxine-pyrimethamine is recommended for the control of malaria during pregnancy within endemic areas, but coverage for the recommended ≥3 doses IPTp regimen has remained suboptimal. We searched PubMed, Cochrane library, and HINARI database from 1 January 2010 to 23 May 2020, for studies investigating the effect of the health system on IPTp implementation. Data extraction was independently performed by two investigators and evaluated for quality and content. Health system barriers and facilitators were explored using thematic analysis and narrative synthesis. Thirty-four out of 1032 screened articles were included. Key health system issues affecting the provision and uptake of IPTp were the ambiguity of policy and guidelines for IPTp administration, human resource shortages, drug stock-outs, conflicting policy implementation on free IPTp provision, hidden costs, unclear data recording and reporting guidelines, and poor quality of care. Factors affecting the supply and demand for IPTp services involve all pillars of the health system across different countries. The success of health programs such as IPTp will thus depend on how well the different pillars of the health system are articulated towards the success of each program.

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Adverse birth outcomes among mothers who received intermittent preventive treatment with Sulphadoxine-Pyrimethamine in the low malaria transmission region

Mikomangwa

Minzi

Aklillu

et al. 2019

BMC Pregnancy Childbirth

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Background Malaria in pregnancy increases the risk of adverse birth outcomes such as low birth weight (LBW), maternal and foetal anemia. In Tanzania, some areas have attained low malaria transmission. However, data on the burden of preterm delivery, LBW, maternal and foetal anemia following substantial reduction of malaria transmission in recent years is still scarce in these settings. Methods A study involving 631 pregnant women was conducted at Mwananyamala referral hospital in Dar es Salaam from April to August, 2018. Study enrollment was done prior to delivery. Structured interview and antenatal clinic cards were used to obtain data including the use of intermittent preventive therapy in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP). Infants birth weights were recorded, maternal venous and cord blood were taken for testing of malaria and determination of haemoglobin (Hb) levels. Chi-square test and regression analysis were done to identify risk factors for preterm delivery, LBW, maternal and foetal anemia. Results The prevalence of malaria among mothers who used at least one dose of IPTp-SP was 0.6% (4/631). Fourteen mothers (2.2%) did not use IPTp-SP and had no malaria infection. The prevalence of maternal anemia, LBW, foetal anemia and preterm delivery was 40.6, 6.5, 5.9 and 9.2% respectively. Participants who were malaria positive had 11 times more risk of LBW compared to those who were negative (AOR, 11; 95%, CI 1.07–132.2; p = 0.04). The risk of delivering babies with LBW was 1.12 times high among mothers who were ≤ 36 weeks of gestation (AOR, 1.12; 95% CI, 0.06–0.25; p = < 0.001). The use of ≥3 doses of IPTp-SP was associated with 83% decrease in risk of LBW compared to those who did not use any dose of IPTp-SP (AOR, 0.17; 95% CI, 0.03–0.88; p = 0.05). Severe anaemia at delivery was associated with seven times increased risk of preterm delivery compared to non-anemic participants (AOR, 6.5; 95% CI, 1.49–28.16; p = 0.013). Conclusion Despite the reduced malaria transmission and use of IPTp-SP, prevalence of preterm delivery, maternal anemia, LBW and foetal anemia is still high in Tanzania. The recommended ≥3 doses of IPTp-SP should continue be provided even in areas with substantial reduction of malaria.

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

Cited by 5 publications

References 20 publications

Intermittent preventive treatment of malaria in pregnancy: a cross-sectional survey to assess uptake of the new sulfadoxine–pyrimethamine five dose policy in Ghana

Intermittent preventive treatment of malaria in pregnancy: a cross-sectional survey to assess uptake of the new sulfadoxine–pyrimethamine five dose policy in Ghana

Impact of Health Systems on the Implementation of Intermittent Preventive Treatment for Malaria in Pregnancy in Sub-Saharan Africa: A Narrative Synthesis

Adverse birth outcomes among mothers who received intermittent preventive treatment with Sulphadoxine-Pyrimethamine in the low malaria transmission region

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