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Intermittent Preventive Treatment with Sulfadoxine-Pyrimethamine against Malaria and Anemia in Pregnant Women
Nana O. Wilson
Nana O. Wilson
Department of Microbiology, Biochemistry and Immunology, and Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia; Department of Obstetrics and Gynecology, and Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana; Department of Biology, Howard University, Washington, District of Columbia; Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Fatou K. Ceesay
Fatou K. Ceesay
Department of Microbiology, Biochemistry and Immunology, and Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia; Department of Obstetrics and Gynecology, and Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana; Department of Biology, Howard University, Washington, District of Columbia; Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Samuel A. Obed
Samuel A. Obed
Department of Microbiology, Biochemistry and Immunology, and Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia; Department of Obstetrics and Gynecology, and Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana; Department of Biology, Howard University, Washington, District of Columbia; Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Andrew A. Adjei
Andrew A. Adjei
Department of Microbiology, Biochemistry and Immunology, and Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia; Department of Obstetrics and Gynecology, and Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana; Department of Biology, Howard University, Washington, District of Columbia; Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Richard K. Gyasi
Richard K. Gyasi
Department of Microbiology, Biochemistry and Immunology, and Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia; Department of Obstetrics and Gynecology, and Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana; Department of Biology, Howard University, Washington, District of Columbia; Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Patricia Rodney
Patricia Rodney
Department of Microbiology, Biochemistry and Immunology, and Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia; Department of Obstetrics and Gynecology, and Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana; Department of Biology, Howard University, Washington, District of Columbia; Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Yassa Ndjakani
Yassa Ndjakani
Department of Microbiology, Biochemistry and Immunology, and Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia; Department of Obstetrics and Gynecology, and Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana; Department of Biology, Howard University, Washington, District of Columbia; Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Winston A. Anderson
Winston A. Anderson
Department of Microbiology, Biochemistry and Immunology, and Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia; Department of Obstetrics and Gynecology, and Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana; Department of Biology, Howard University, Washington, District of Columbia; Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Naomi W. Lucchi
Naomi W. Lucchi
Department of Microbiology, Biochemistry and Immunology, and Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia; Department of Obstetrics and Gynecology, and Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana; Department of Biology, Howard University, Washington, District of Columbia; Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Jonathan K. Stiles
Jonathan K. Stiles
Department of Microbiology, Biochemistry and Immunology, and Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia; Department of Obstetrics and Gynecology, and Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana; Department of Biology, Howard University, Washington, District of Columbia; Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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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.
Author Notes
Financial support: This study was supported by the Centers for Disease Control and Prevention “Reproductive Epidemiological” grant to the Master of Public Health Program, Morehouse School of Medicine; the Minority International Health Disparities Research Training Program at Howard University; National Institutes of Health grants NIH-RCMI (RR03034), NIHNIGM- MBRS (SO6GM08248), and NIH-FIC (R21TW006804-01).
Authors' addresses: Nana O. Wilson and Jonathan K. Stiles, Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, HG Room 350 720 Westview Drive SW, Atlanta, GA 30310, E-mails: nwilson@msm.edu and jstiles@msm.edu. Fatou K. Ceesay, Patricia Rodney, and Yassa Ndjakani, Department of Community Health and Preventive Medicine, Morehouse School of Medicine, 720 Westview Drive SW, Atlanta, GA 30310, E-mails: fceesay@msm.edu, prodney@msm.edu, and yndjakani@msm.edu. Samuel A. Obed, Department of Obstetrics and Gynecology, University of Ghana Medical School, Korle-Bu, Accra, Ghana, E-mail: obedamenyi@yahoo.com. Andrew A. Adjei and Richard K. Gyasi, Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana, E-mails: andrewanthonyadjei@yahoo.com and rkg539us@yahoo.com. Winston A. Anderson, Department of Biology, Howard University, Just Hall, 415 College St NW, Washington, DC 20059, E-mail: wanderson@howard.edu. Naomi W. Lucchi, Malaria Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, E-mail: frd9@cdc.gov.
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