High uptake of Intermittent Preventive Treatment of malaria in pregnancy is associated with improved birth weight among pregnant women in Ghana
Date
2019-12-13
Journal Title
Journal ISSN
Volume Title
Publisher
Scientific Reports
Abstract
Despite the clinically proven advantages of intermittent preventive treatment of malaria in pregnancy
(IPTp) with sulfadoxine-pyrimethamine (SP), utilisation has been low in many African countries. To
increase uptake and achieve the desired effect, the World Health Organization revised the policy to a
monthly administration. Assessing the coverage and impact of the revised policy on pregnancy and
neonatal outcomes is, therefore, a necessity. A 2-parallel cross-sectional hospital-based study was
carried out among pregnant women attending first antenatal care (ANC) and delivery. Maternal and
cord blood samples were assayed for malaria parasites by quantitative PCR targeting both the 18S
rDNA and the acidic terminal segment of Plasmodium falciparum var genes, and plasma SP levels were
measured by liquid chromatography coupled to tandem mass spectrometry. Parasite prevalence was
similar between the two study sites but decreased significantly between the first ANC (9% or 43%) and
delivery (4% or 11%) based on the qPCR target. At delivery, 64.5% of women received ≥3 IPTp-SP dose,
15.5% received 2 doses and 6% had 1 dose. Taking ≥3 IPTp-SP doses was associated with an average
birth weight increase of more than 0.165 kg. IPTp-SP uptake was associated with plasma SP level at
delivery (OR = 32.3, p ≤ 0.005, 95% CI (13.3;78.4) for those that reported ≥3 IPTp-SP doses) while the
same trend of improved birth weight was observed with high plasma SP levels. The new IPTp policy is
well implemented and well utilised by women in the sites considered in this study and translates to the
improved birth weight observed. This study confirms the interest and the clinical benefit expected from
this policy change.
Description
Research Article
Keywords
malaria, African countries, pregnancy, intermittent preventive treatment of malaria in pregnancy (IPTp)