Uptake of intermittent preventive treatment with sulphadoxine-pyrimethamine for malaria during pregnancy and pregnancy outcomes: a cross-sectional study in Geita district, North-Western Tanzania

Malaria Journal

Research

Dismas Matovelo¹  Humphrey D Mazigo²  Aliyah Dosani³  Filbert J Mpogoro⁴  Sospatro Ngallaba⁴  Moshi Mugono⁴ 

[1] Department of Obstetrics and Gynaecology, Catholic University of Health and Allied Sciences- Bugando, PO Box 1464, Mwanza, Tanzania;Department of Parasitology and Entomology, Catholic University of Health and Allied Sciences- Bugando, PO Box 1464, Mwanza, Tanzania;School of Nursing and Midwifery, Mount Royal University, 4825 Mount Royal Gate SW, T3E 6 K6, Calgary, AB, Canada;School of Public Health, Catholic University of Health and Allied Sciences- Bugando, PO Box 1464, Mwanza, Tanzania;

关键词: Pregnancy;    Intermittent preventive treatment;    Sulphadoxine-pyrimethamine placental malaria;    Pre-term delivery;    Low birth weight;    Tanzania;   

DOI  :  10.1186/1475-2875-13-455

 received in 2014-09-11, accepted in 2014-11-19,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundMalaria infection during pregnancy is associated with adverse outcomes in sub-Saharan Africa (SSA). For this reason, the World Health Organization currently recommends intermittent preventive treatment of malaria in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) at each scheduled antenatal care (ANC) visit. In Tanzania, the revised IPTp policy was adopted in 2013 but the level of uptake and its association with pregnancy outcomes remains unknown.MethodsA cross-sectional study was conducted among singleton pregnant women who delivered in two selected health facilities of Geita district, northwestern Tanzania. Self-reported uptake of SP was verified using the ANC card and was recorded. Placental and peripheral blood was collected for diagnosis of malaria by microscopy and rapid diagnostic tests (RDTs). Gestational age was estimated based on last menstrual period or Ballard score. Infant birth weights were recorded within 24 hours of delivery.ResultsOf 431 participants, 167 (38.75%), 134 (31.09%), 104 (24.23%), and 26 (6.03%) reported taking none, one, two, and ≥ three doses of SP during pregnancy, respectively. The uptake of ≥ three doses of IPTp-SP among delivering women at Geita hospital and Katoro health centre was 9.06% and 1.2%, respectively. The overall prevalence of malaria in pregnancy by RDT, peripheral and placental smears was 19.5%, 29.7% and 37.6% respectively. The prevalence of placental parasitaemia was higher for women who delivered at Katoro Health Centre (41.57%) than those who delivered at Geita hospital (35.09%). The uptake of ≥ three doses of SP was associated with reduced odds of having placental malaria (adjusted odds ratio (AOR) = 0.31, p = 0.039) compared to < three doses. Women with placental parasitaemia were five times more likely to have delivered pre-term (AOR = 4.67, p = 0.002) and had lower mean birth weight infants than their uninfected counterparts (mean difference = 82 g, p = 0.039).ConclusionsThe uptake of ≥ three doses of IPTp-SP is low in the present study area. Placental parasitaemia is prevalent and is associated with adverse birth outcomes. Receipt of ≥ three doses of IPTp-SP reduced the odds of placental parasitaemia. Thus, increased efforts towards scale-up and continuous evaluation of IPTp-SP efficacy is recommended.

【 授权许可】

CC BY   
© Mpogoro et al.; licensee BioMed Central Ltd. 2014