1921
Volume 75, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

The World Health Organization recommends that pregnant women in malaria-endemic areas receive ≥ 2 doses of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp/SP) in the second and third trimesters of pregnancy to prevent maternal anemia, placental parasitemia, and low birth weight (LBW). In 2001, a program evaluation in Koupéla District, Burkina Faso demonstrated that despite widespread use of chloroquine chemoprophylaxis, the burden of malaria during pregnancy remained high. In 2003, the Burkina Faso Ministry of Health piloted a program of IPTp/SP (three doses) and accelerated distribution of insecticide-treated nets (ITN) to pregnant women in Koupéla District. In 2004, a follow-up program evaluation was conducted. Coverage with ≥ 1 doses of IPTp/SP was high among women attending antenatal clinics (ANCs) (96.2%) and delivery units (DUs) (93.5%); ITN ownership was moderately high (ANC = 53.9%, DU = 61.6%). In multivariate analysis, ≥ 1 dose of IPTp/SP was associated with a significant reduction in the prevalence of peripheral parasitemia at ANCs (risk ratio [RR] = 0.49, = 0.008), ≥ 2 doses of IPTp/SP were associated with a reduction in the prevalence of placental parasitemia (RR = 0.56, = 0.02), and three doses of IPTp/SP were associated with a reduced risk of LBW (RR = 0.51, = 0.04). The proportions of women at ANCs with peripheral parasitemia and anemia were significantly lower in 2004 than in 2001 (RR = 0.53, = 0.001 and RR = 0.78, = 0.003, respectively). The proportions of women at DUs with peripheral and placental parasitemia were also significantly lower in 2004 than in 2001 (RR = 0.66, < 0.0001 and RR = 0.71, = 0.0002, respectively). These data suggest that a package of IPTp/SP and ITNs is effective in reducing the burden of malaria during pregnancy in Burkina Faso.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2006.75.205
2006-08-01
2017-10-17
Loading full text...

Full text loading...

/deliver/fulltext/14761645/75/2/0750205.html?itemId=/content/journals/10.4269/ajtmh.2006.75.205&mimeType=html&fmt=ahah

References

  1. Newman RD, Hailemariam A, Jimma D, Degifie A, Kebede D, Rietveld AE, Nahlen BL, Barnwell JW, Steketee RW, Parise ME, 2003. Burden of malaria during pregnancy in areas of stable and unstable transmission in Ethiopia during a nonepidemic year. J Infect Dis 187 : 1765–1772.
  2. Steketee RW, Nahlen BL, Parise ME and Menendez C, 2001. The burden of malaria in pregnancy in malaria-endemic areas. Am J Trop Med Hyg 64 : 28–35.
  3. McCormick MC, 1985. The contribution of low birth weight to infant mortality and childhood morbidity. N Engl J Med 312 : 82–90.
  4. WHO, 2004. A Strategic Framework for Malaria Prevention and Control during Pregnancy in the African Region. Brazzaville, Congo: World Health Organization.
  5. Kayentao K, Kodio M, Newman RD, Maiga H, Doumtabe D, Ongoiba A, Coulibaly D, Keita AS, Maiga B, Mungai M, Parise ME, Doumbo O, 2005. Comparison of intermittent preventive treatment with chemoprophylaxis for the prevention of malaria during pregnancy in Mali. J Infect Dis 191 : 109–116.
  6. Njagi JK, Magnussen P, Estambale B, Ouma J and Mugo B, 2003. Prevention of anaemia in pregnancy using insecticide-treated bednets and sulfadoxine-pyrimethamine in a highly malarious area of Kenya: a randomized controlled trial. Trans R Soc Trop Med Hyg 97 : 277–282.
  7. Parise ME, Ayisi JG, Nahlen BL, Schultz LJ, Roberts JM, Misore A, Muga R, Oloo AJ, Steketee RW, 1998. Efficacy of sulfadoxine-pyrimethamine for prevention of placental malaria in an area of Kenya with a high prevalence of malaria and human immunodeficiency virus infection. Am J Trop Med Hyg 59 : 813–822.
  8. Schultz LJ, Steketee RW, Macheso A, Kazembe P, Chitsulo L and Wirima JJ, 1994. The efficacy of antimalarial regimens containing sulfadoxine-pyrimethamine and/or chloroquine in preventing peripheral and placental Plasmodium falciparum infection among pregnant women in Malawi. Am J Trop Med Hyg 51 : 515–522.
  9. Shulman CE, Dorman EK, Cutts F, Kawuondo K, Bulmer JN, Peshu N, Marsh K, 1999. Intermittent sulphadoxine-pyrimethamine to prevent severe anaemia secondary to malaria in pregnancy: a randomised placebo-controlled trial. Lancet 353 : 632–636.
  10. Rogerson SJ, Chaluluka E, Kanjala M, Mkundika P, Mhango C, Molyneux ME, 2000. Intermittent sulfadoxine-pyrimethamine in pregnancy: effectiveness against malaria morbidity in Blantyre, Malawi, in 1997–99. Trans R Soc Trop Med Hyg 94 : 549–553.
  11. van Eijk A, 2004. Effectiveness of intermittent preventive treatment with sulfadoxine-pyrimethamine for control of malaria in pregnancy in western Kenya: A hospital-based study. Trop Med Int Health 9 : 351–360.
  12. Verhoeff FH, Brabin BJ, Chimsuku L, Kazembe P, Russell WB, Broadhead RL, 1998. An evaluation of the effects of intermittent sulfadoxine-pyrimethamine treatment in pregnancy on parasite clearance and risk of low birthweight in rural Malawi. Ann Trop Med Parasitol 92 : 141–150.
  13. Newman RD, Parise ME, Slutsker L, Nahlen B and Steketee RW, 2003. Safety, efficacy and determinants of effectiveness of antimalarial drugs during pregnancy: implications for prevention programmes in Plasmodium falciparum-endemic sub-Saharan Africa. Trop Med Int Health 8 : 488–506.
  14. Ministère de la Santé, 2000. Directives Nationales pour Une Prise en Charge Rationelle des cas de Paludisme au Burkina Faso (Triatement Curatif et Chimioprophylaxie). Ouagadougou, Burkina Faso: Ministère de la Santé.
  15. Sirima SB, Sawadogo R, Moran AC, Konate A, Diarra A, Yameogo M, Parise ME, Newman RD, 2003. Failure of a chloroquine chemoprophylaxis program to adequately prevent malaria during pregnancy in Koupéla District, Burkina Faso. Clin Infect Dis 36 : 1374–1382.
  16. Verhoeff, FH, BJ Brabin, L Chimsuku, P Kazembe and RL Broadhead, 1999. An analysis of the determinants of anaemia in pregnant women in rural Malawi–a basis for action. Ann Trop Med Parasitol 93 : 119–133.
  17. Brabin BJ, 1983. An analysis of malaria in pregnancy in Africa. Bull World Health Organ 61 : 1005–1016.
  18. Steketee RW, Brandling-Bennett AD, Kaseje DC, Schwartz IK and Churchill FC, 1987. In vivo response of Plasmodium falciparum to chloroquine in pregnant and non-pregnant women in Siaya District, Kenya. Bull World Health Org 65 : 885–890.
  19. Steketee RW, Breman JG, Paluku KM, Moore M, Roy J Ma-Disu M, 1988. Malaria infection in pregnant women in Zaire: the effects and the potential for intervention. Ann Trop Med Parasitol 82 : 113–120.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2006.75.205
Loading
/content/journals/10.4269/ajtmh.2006.75.205
Loading

Data & Media loading...

  • Received : 06 Dec 2005
  • Accepted : 26 Mar 2006

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error