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Sulfadoxine-Pyrimethamine–Based Intermittent Preventive Treatment, Bed Net Use, and Antenatal Care during Pregnancy: Demographic Trends and Impact on the Health of Newborns in the Kassena Nankana District, Northeastern Ghana

Abraham R. OduroNavrongo Health Research Center, Navrongo, Ghana; Naval Medical Research Center, Silver Spring, Maryland; Noguchi Memorial Institute for Medical Research, Accra, Ghana

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David J. FryauffNavrongo Health Research Center, Navrongo, Ghana; Naval Medical Research Center, Silver Spring, Maryland; Noguchi Memorial Institute for Medical Research, Accra, Ghana

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Kwadwo A. KoramNavrongo Health Research Center, Navrongo, Ghana; Naval Medical Research Center, Silver Spring, Maryland; Noguchi Memorial Institute for Medical Research, Accra, Ghana

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William O. RogersNavrongo Health Research Center, Navrongo, Ghana; Naval Medical Research Center, Silver Spring, Maryland; Noguchi Memorial Institute for Medical Research, Accra, Ghana

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Francis AntoNavrongo Health Research Center, Navrongo, Ghana; Naval Medical Research Center, Silver Spring, Maryland; Noguchi Memorial Institute for Medical Research, Accra, Ghana

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Frank AtugubaNavrongo Health Research Center, Navrongo, Ghana; Naval Medical Research Center, Silver Spring, Maryland; Noguchi Memorial Institute for Medical Research, Accra, Ghana

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Thomas AnyorigiyaNavrongo Health Research Center, Navrongo, Ghana; Naval Medical Research Center, Silver Spring, Maryland; Noguchi Memorial Institute for Medical Research, Accra, Ghana

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Martin AdjuikNavrongo Health Research Center, Navrongo, Ghana; Naval Medical Research Center, Silver Spring, Maryland; Noguchi Memorial Institute for Medical Research, Accra, Ghana

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Patrick AnsahNavrongo Health Research Center, Navrongo, Ghana; Naval Medical Research Center, Silver Spring, Maryland; Noguchi Memorial Institute for Medical Research, Accra, Ghana

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Abraham HodgsonNavrongo Health Research Center, Navrongo, Ghana; Naval Medical Research Center, Silver Spring, Maryland; Noguchi Memorial Institute for Medical Research, Accra, Ghana

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Francis NkrumahNavrongo Health Research Center, Navrongo, Ghana; Naval Medical Research Center, Silver Spring, Maryland; Noguchi Memorial Institute for Medical Research, Accra, Ghana

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Demographics and health practices of 2,232 pregnant women in rural northeastern Ghana and characteristics of their 2,279 newborns were analyzed to determine benefits associated with intermittent preventive treatment (IPTp), antenatal care, and/or bed net use during pregnancy. More than half reported bed net use, 90% reported at least two antenatal care visits, and > 82% took at least one IPTp dose of sulfadoxine-pyrimethamine. Most used a bed net and IPTp (45%) or IPTp alone (38%). Low birth weight (< 2,500 grams) characterized 18.3% of the newborns and was significantly associated with female sex, Nankam ethnicity, first-born status, and multiple births. Among newborns of primigravidae, IPTp was associated with a significantly greater birth weight, significantly fewer low birth weight newborns, improved hemoglobin levels, and less anemia. Babies of multigravidae derived no benefit to birth weight or hemoglobin level from single or multiple doses of sulfadoxine-pyrimethamine during pregnancy. No differences or benefits were seen when a bed net was the only protective factor.

Author Notes

*Address correspondence to David J. Fryauff, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910. E-mail: david.fryauff@med.navy.mil

Financial support: This study was supported by National Institutes of Health Division of Microbiology and Infectious Diseases Contract #HHSN266200400016C and interagency agreement #Y1-AI-4866.

Authors' addresses: Abraham R. Oduro, Francis Anto, Frank Atuguba, Thomas Anyorigiya, Martin Adjuik, Patrick Ansah, and Abraham Hodgson, Navrongo Health Research Center, Navrongo, Ghana. David J. Fryauff and William O. Rogers, Naval Medical Research Center, Silver Spring, MD, E-mail: david.fryauff@med.navy.mil. Kwadwo A. Koram and Francis Nkrumah, Noguchi Memorial Institute for Medical Research, Accra, Ghana.

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