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A COMPARISON OF SULFADOXINE-PYRIMETHAMINE WITH CHLOROQUINE AND PYRIMETHAMINE FOR PREVENTION OF MALARIA IN PREGNANT NIGERIAN WOMEN

Few studies have documented the effectiveness in west Africa of intermittent preventive treatment of malaria with sulfadoxine-pyrimethamine (SP) in pregnancy. Pregnant Nigerian women were assigned to receive either SP given twice or presumptive chloroquine (CQ) treatment followed by weekly pyrimethamine (CQ + P); 250 were enrolled in each group. Of those completing follow-up, 4 (1.8%) in the SP group and 22 (9.8%) in the CQ + P groups had a febrile illness (P = 0.005). None in the SP group but 11 (4.9%) in the CQ + P group had peripheral parasitemia prior to or during delivery (P = 0.002). Two (1.2%) in the SP group and 9 (5.0%) in the CQ + P group were anemic at delivery (P = 0.04). There were six low birth weight infants in the SP group and eight in the CQ + P group (P = 0.21). Intermittent preventive treatment with SP is superior to CQ + P for prevention of malaria and anemia in pregnant women in Nigeria.

Received August 28, 2006. Accepted for publication October 18, 2006.

Acknowledgments: This work was submitted by Ibrahim U. Tukur as a dissertation in partial fulfillment of the Fellowship in General Medical Practice of the National Postgraduate Medical College of Nigeria. The American Society of Tropical Medicine and Hygiene (ASTMH) assisted with publication expenses.

Financial support: This study was supported in part by a dissertation grant of the Jos University Teaching Hospital. The funding agency had no role in the conduct of the study or the decision to publish the results.

^* Address correspondence to Tom D. Thacher, Department of Family Medicine, Jos University Teaching Hospital, Jos, Nigeria. E-mail: tom{at}thachers.org

Authors’ addresses: Ibrahim U. Tukur, State House Clinic, Aso Rock, Abuja, Nigeria, Telephone: 234-803-452-1194, E-mail: iutukur{at}yahoo.com. Tom D. Thacher and Jeremiah K. A. Madaki, Department of Family Medicine, Jos University Teaching Hospital, PMB 2076, Jos, Nigeria, Telephone: 234-73-452355, Fax: 234-73-455038, E-mails: tom{at}thachers.org and aboikutak{at}yahoo.com. Atiene S. Sagay, Department of Obstetrics and Gynaecology, University of Jos, PMB 2084, Jos, Nigeria, Telephone: 234-803-451-9740, E-mail: atsagay58{at}yahoo.com.