Intermittent preventive treatment and malaria amongst pregnant women who give birth at the Centre Hospitalier Régional Paul Moukambi de Koula-Moutou in southeastern Gabon

Abstract

Background Evaluating malaria control strategies for pregnant women is essential. The objective of this study was to determine the factors influencing antenatal care (ANC) visit attendance, complete intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) and its impact on the health of pregnant women and their newborn babies living in semi-urban and rural areas of southeastern Gabon. Methods This transversal study was performed at the Centre Hospitalier Régional Paul Moukambi de Koula-Moutou (CHRPMK). Information regarding age, frequency of prenatal consultations, obstetric history, use of malaria control measures, use of IPTp-SP, malaria diagnostic of women and their newborns, were collected: (i): from birth registers from 1 January, 2018 to 31 December, 2019 and, (ii): a questionnaire from January to April 2020. Results In total, 1,851 and 323 pregnant women were included during the first and the second sub-set of study, respectively. In the first sub-set of data, the mean age was 26.18 ± 7.02 years and 96.54% (1,787/1,851) of pregnant women had attended ANC service but 54.45% had complete ANC visit attendance (at least 4 ANC). The complete ANC visit was linked with age (p < 0.001) and profession (p < 0.001). The complete IPTp-SP (at least 3 doses) was 58.87%. Complete IPTp-SP was linked to profession (aOR = 1.49, 95% CI [1.04–2.18], p < 0.001), ANC visit (aOR = 0.176, 95% CI [0.14–0.22], p < 0.034) and age (p = 0.03). Birth weight was higher for babies whose mothers had received complete IPTp-SP (p < 0,001) but the Apgar score was not influenced by the use of IPTp-SP (p = 0.71). In the second sub-set of data, the prevalence of plasmodial infection was 3.10% (95% IC [1.21–5]) and Plasmodium falciparum was responsible for 100% of infections. The prevalence of plasmodial infection was the same for all age groups (p = 0.69), gravidity (p = 0.13) and domestic control measures (p > 0.05). A low birth weight was statistically linked to the mother’s plasmodial infection (p < 0.01). Furthermore, plasmodial infection was statistically linked to premature birth (p < 0.001). Conclusions It was observed that attendance of women to ANC service and a complete IPTp-SP course is insufficient.

Epidémiology of malaria from 2019 to 2021 in the southeastern city of Franceville, Gabon

“…In sub-Saharan Africa, children under 5 years of age have often been the age group who is most at risk of developing malaria [ 21 ]. In this study, the age group [ 6 – 9 ] years had the highest malaria prevalence (44.3%) in 2019 while the age group [ 10 – 14 ] years had the highest malaria prevalence in 2020 and 2021 (53.8% and 48.9% respectively). These results may indicate a shift in the age group of patients at risk for malaria infection in accordance with study carried-out in Cameroon [ 22 ] or may reflect broader trends in higher prevalence among older children [ 23 , 24 ].…”

Malaria Prevalence in Asymptomatic and Symptomatic Children Living in Rural, Semi-Urban and Urban Areas in Eastern Gabon

“…A total of 35 244 cases of malaria were reported in Gabon in 2017 [ 5 ]. Malaria incidence is also high and estimated at 97.5 per 1,000 people [ 6 ]. This is attributed to the poor implementation of control measures (percentage of use of long-lasting insecticide nets (LLINs): 27%; proportion of pregnant women who received intermittent preventive treatment (IPT): 12%), as well as the decrease in funding to fight malaria, and in preventive care in general [ 6 ].…”

“…In Gabon, the main Plasmodium species that causes malaria is Plasmodium falciparum [ 6 ], which accounts for 99.7% of deaths in the WHO African region (1). Two Anopheles species have been recorded as malaria vectors in Gabon: Anopheles gambiae and Anopheles funestus [ 6 ].…”

“…In Gabon, the main Plasmodium species that causes malaria is Plasmodium falciparum [ 6 ], which accounts for 99.7% of deaths in the WHO African region (1). Two Anopheles species have been recorded as malaria vectors in Gabon: Anopheles gambiae and Anopheles funestus [ 6 ]. In addition, studies have shown that other species of Plasmodium including Plasmodium malariae and Plasmodium ovale are also present in Gabon.…”