Coverage of intermittent prevention treatment with sulphadoxine-pyrimethamine among pregnant women and congenital malaria in Côte d'Ivoire

• Published in: Malaria journal 2011-04, Vol.10 (1), p.105-105, Article 105
• Main Authors: Vanga-Bosson, Henriette A, Coffie, Patrick A, Kanhon, Serge, Sloan, Caroline, Kouakou, Firmin, Eholie, Serge P, Kone, Moussa, Dabis, François, Menan, Hervé, Ekouevi, Didier K
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anemia; Antimalarials; Aquatic insects; Asexuality; Birth weight; Care and treatment; Chemoprevention - methods; Cote d'Ivoire - epidemiology; Cross-Sectional Studies; Drug Combinations; Drug Utilization - statistics & numerical data; Female; Genetic crosses; Health aspects; Health facilities; Health Services Research; HIV; Human diseases; Human immunodeficiency virus; Humans; Infant, Newborn; Infections; Insecticides; Laboratories; Low birth weight; Malaria; Malaria - congenital; Malaria - drug therapy; Malaria - epidemiology; Malaria - prevention & control; Methods; Mosquitoes; Offspring; Organizations; Parasitemia - epidemiology; Parasitemia - prevention & control; Parasites; Parturition; Pharmacy; Placenta; Pregnancy; Pregnancy Complications - drug therapy; Pregnancy Complications - prevention & control; Pregnant Women; Prevention; Public health; Pyrimethamine; Pyrimethamine - administration & dosage; Students; Sulfadoxine - administration & dosage; Surveying; Surveys; Umbilical cord; Urban areas; Vector-borne diseases; Weight; Women; Womens health; Young Adult
• ISSN: 1475-2875; 1475-2875
• DOI: 10.1186/1475-2875-10-105

The World Health Organization (WHO) recommends using insecticide-treated mosquito nets (ITNs) and intermittent preventive treatment with sulphadoxine-pyrimethamine (IPT-SP) to prevent malaria in sub-Saharan Africa. Data on IPT-SP coverage and factors associated with placental malaria parasitaemia and low birth weight (LBW) are scarce in Côte d'Ivoire. A multicentre, cross-sectional survey was conducted in Côte d'Ivoire from March to September 2008 at six urban and semi-urban antenatal clinics. Standardized forms were used to collect the demographic information and medical histories of women and their offspring. IPT-SP coverage (≥2 doses) as well as placental and congenital malaria prevalence parasitaemia were estimated. Regression logistics were used to study factors associated with placental malaria and LBW (birth weight of alive babies < 2,500 grams). Overall, 2,044 women with a median age of 24 years were included in this study. Among them 1017 (49.8%) received ≥2 doses of IPT-SP and 694 (34.0%) received one dose. A total of 99 mothers (4.8%) had placental malaria, and of them, four cases of congenital malaria were diagnosed. Factors that protected from maternal placental malaria parasitaemia were the use of one dose (adjusted odds ratio (aOR), 0.32; 95%CI: 0.19-0.55) or ≥2 doses IPT-SP (aOR: 0.18; 95%CI: 0.10-0.32); the use of ITNs (aOR: 0.47; 95%CI: 0.27-0.82). LBW was associated with primigravidity and placental malaria parasitaemia. IPT-SP decreases the rate of placental malaria parasitaemia and has a strong dose effect. Despite relatively successful IPT-SP coverage in Côte d'Ivoire, substantial commitments from national authorities are urgently required for such public health campaigns. Strategies, such as providing IPT-SP free of charge and directly observing treatment, should be implemented to increase the use of IPT-SP as well as other prophylactic methods.