Efficacy of Intermittent Preventive Treatment of Malaria with Sulphadoxine-pyrimethamine in Preventing Anaemia in Pregnancy among Nigerian Women

Obe, O. O.; Onayade, Adedeji; Fatusi, Adesegun O.; Ijadunola, Kayode T.; Abiona, T.C.

doi:10.1007/s10995-008-0319-3

Cited by 25 publications

(32 citation statements)

References 16 publications

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“…2 Malaria as a cause of anaemia in our study is rather unlikely because during antenatal care, all women in our study received malaria intermittent prophylaxis with sulphadoxinepyrimethamine regimen, were given insecticide-treated bednets, and received prompt and active treatment of acute malaria cases. In support of this argument, Asa et al 24 observed that a sulphadoxine-pyrimethamine regimen is an effective, practicable strategy to decrease the risk of anaemia in women of low parity residing in areas endemic for malaria. Though a statistically significant relationship was found only between women's education and SR (P ¼ 0.032), booking status correlated with SR and haemoglobin groupings in our study.…”

Section: Discussionmentioning

confidence: 97%

Haemoglobin and ferritin concentrations of pregnant women at term

Adediran

Gbadegesin²,

Adeyemo

et al. 2011

Obstet Med

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SummaryBackground: Anaemia in pregnancy is defined as haemoglobin (Hb) concentrations of less than 11 g/dL while low ferritin is defined as serum ferritin (SR) levels of less than 10 mg/L. Hb and ferritin concentrations of pregnant women at term were determined to establish their mean values and to determine the prevalence of anaemia in our locality. Methods: Haemoglobin and ferritin levels of 170 non-smoking and HIV-negative pregnant women were determined at term. The majority 143 of 170 (84.1%) of the pregnant women recruited for the study, booked at the beginning of the second trimester and received 200 mg elemental iron in three divided doses and 5 mg folic acid daily which were commenced at booking. Five millilitres of blood were collected from each patient at term into EDTA bottles for full blood count analysis and another 5 mL into plain bottles for SR assay. Results: The mean Hb and ferritin values were 10.9 + 1.9 and 47.84 + 98.39 mg/L, respectively. The prevalence of anaemia at term was 46.4%. Only 11.2% (19 of 170) of pregnant women at term had low SR (iron stores). A statistically significant relationship was found between women's education and SR (P ¼ 0.032). Booking status also correlated directly with SR and haemoglobin concentrations, while increasing age and parity did not. Conclusion: About half of the patients were anaemic. Iron deficiency is not the major cause of anaemia in pregnancy in this study because the majority of the pregnant women had normal iron stores. Education and booking status are possible factors that contribute to anaemia.

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Section: Discussionmentioning

confidence: 97%

Haemoglobin and ferritin concentrations of pregnant women at term

Adediran

Gbadegesin²,

Adeyemo

et al. 2011

Obstet Med

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“…25 Although anemia remains a major challenge in sub-Sahara Africa, malaria is an important contributor to maternal and perinatal morbidity and mortality in these countries. 10 The WHO currently recommends that each pregnant woman should receive IPTp-SP at each ANC visit after quickening, which in practice leads to two or three doses during the course of the pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…10,15,17,18,27,28 This policy has been adopted by most countries in Africa, but implementation has been suboptimal. 29 Furthermore, the spread of SP-resistant P. falciparum reinforces the importance of investigating the ongoing effectiveness of IPTp-SP.…”

Section: Discussionmentioning

confidence: 99%

“…9 Malaria prevention in pregnancy with chemoprophylaxis is associated with reduced incidence of malaria episodes, higher mean maternal hemoglobin levels, and reduced incidence of LBW babies. [10][11][12] However, chemoprophylaxis has some potential drawbacks such as poor compliance, high cost, and impairment of natural immunity to malaria. 10 The previous anti-malarial drug policy in Ghana promoted chloroquine chemoprophylaxis during pregnancy and six weeks post-partum.…”

Section: Introductionmentioning

confidence: 99%

“…[10][11][12] However, chemoprophylaxis has some potential drawbacks such as poor compliance, high cost, and impairment of natural immunity to malaria. 10 The previous anti-malarial drug policy in Ghana promoted chloroquine chemoprophylaxis during pregnancy and six weeks post-partum. 11 However, compliance was low (11.6%).…”

Section: Introductionmentioning

confidence: 99%

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Intermittent Preventive Treatment with Sulfadoxine-Pyrimethamine against Malaria and Anemia in Pregnant Women

Wilson

Ceesay²,

Obed³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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Abstract. The effectiveness of intermittent preventive treatment during pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) against malaria and anemia is unclear because of the spread of SP-resistant Plasmodium falciparum . This study evaluates the effectiveness of IPTp-SP among pregnant women attending the antenatal clinic at Korle-Bu Teaching Hospital in Accra, Ghana. A cross-sectional study comparing malaria and anemia prevalence among pregnant women using IPTp-SP with non-IPTp-SP users was conducted during June-August 2009. A total of 363 pregnant women (202 of IPTp users and 161 non-IPTp users) were recruited. A total of 15.3% of IPTp users had malaria compared with 44.7% of non-IPTp users ( P < 0.001). A total of 58.4% of non-IPTp users were anemic compared with 22.8% of IPTp users ( P < 0.001). When we controlled for other variables, the difference in the prevalence of malaria (odds ratio = 0.18, 95% confidence interval = 0.08-0.37) and anemia (odds ratio = 0.20, 95% confidence interval = 0.12-0.34) remained significant. The recommended IPTp-SP regimen is useful in preventing malaria and anemia among pregnant women in Ghana.

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Drugs for preventing malaria in pregnant women in endemic areas: any drug regimen versus placebo or no treatment

Radeva-Petrova

Kayentao

Kuile

et al. 2014

Cochrane Database of Systematic Reviews

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Background Pregnancy increases the risk of malaria and this is associated with poor health outcomes for both the mother and the infant, especially during the first or second pregnancy. To reduce these effects, the World Health Organization recommends that pregnant women living in malaria endemic areas sleep under insecticide‐treated bednets, are treated for malaria illness and anaemia, and receive chemoprevention with an effective antimalarial drug during the second and third trimesters. Objectives To assess the effects of malaria chemoprevention given to pregnant women living in malaria endemic areas on substantive maternal and infant health outcomes. We also summarised the effects of intermittent preventive treatment with sulfadoxine‐pyrimethamine (SP) alone, and preventive regimens for Plasmodium vivax. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL, MEDLINE, EMBASE, LILACS, and reference lists up to 1 June 2014. Selection criteria Randomized controlled trials (RCTs) and quasi‐RCTs of any antimalarial drug regimen for preventing malaria in pregnant women living in malaria‐endemic areas compared to placebo or no intervention. In the mother, we sought outcomes that included mortality, severe anaemia, and severe malaria; anaemia, haemoglobin values, and malaria episodes; indicators of malaria infection, and adverse events. In the baby, we sought foetal loss, perinatal, neonatal and infant mortality; preterm birth and birthweight measures; and indicators of malaria infection. We included regimens that were known to be effective against the malaria parasite at the time but may no longer be used because of parasite drug resistance. Data collection and analysis Two review authors applied inclusion criteria, assessed risk of bias and extracted data. Dichotomous outcomes were compared using risk ratios (RR), and continuous outcomes using mean differences (MD); both are presented with 95% confidence intervals (CI). We assessed the quality of evidence using the GRADE approach. Main results Seventeen trials enrolling 14,481 pregnant women met our inclusion criteria. These trials were conducted between 1957 and 2008, in Nigeria (three trials), The Gambia (three trials), Kenya (three trials), Mozambique (two trials), Uganda (two trials), Cameroon (one trial), Burkina Faso (one trial), and Thailand (two trials). Six different antimalarials were evaluated against placebo or no intervention; chloroquine (given weekly), pyrimethamine (weekly or monthly), proguanil (daily), pyrimethamine‐dapsone (weekly or fortnightly), and mefloquine (weekly), or intermittent preventive therapy with SP (given twice, three times or monthly). Trials recruited women in their first or second pregnancy (eight trials); only multigravid women (one trial); or all women (eight trials). Only six trials had adequa...

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Efficacy of Intermittent Preventive Treatment of Malaria with Sulphadoxine-pyrimethamine in Preventing Anaemia in Pregnancy among Nigerian Women

Abstract: The IPT regime with sulphadoxine-pyrimethamine is an effective, practicable strategy to decrease risk of anaemia in women of low parity residing in areas endemic for malaria.

Cited by 25 publications

References 16 publications

Haemoglobin and ferritin concentrations of pregnant women at term

Haemoglobin and ferritin concentrations of pregnant women at term

Intermittent Preventive Treatment with Sulfadoxine-Pyrimethamine against Malaria and Anemia in Pregnant Women

Drugs for preventing malaria in pregnant women in endemic areas: any drug regimen versus placebo or no treatment

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