Prevention of Malaria during Pregnancy: Assessing the Effect of the Distribution of IPTp Through the National Policy in Benin

• Published in: The American journal of tropical medicine and hygiene 2011-02, Vol.84 (2), p.270-275
• Main Authors: LE PORT, Agnès, COTTRELL, Gilles, GARCIA, André, COT, Michel, DECHAVANNE, Célia, BRIAND, Valérie, BOURAIMA, Aziz, GUERRA, José, CHOUDAT, Isabelle, MASSOUGBODJI, Achille, FAYOMI, Benjamin, MIGOT-NABIAS, Florence
• Format: Article
• Language: English
• Subjects: Adult; Antimalarials - administration & dosage; Antimalarials - therapeutic use; Benin - epidemiology; Biological and medical sciences; Chloroquine - administration & dosage; Chloroquine - therapeutic use; Drug Combinations; Female; Health Policy; HIV Infections - parasitology; Human protozoal diseases; Humans; Infant, Low Birth Weight; Infant, Newborn; Infectious diseases; Malaria; Malaria - drug therapy; Malaria - prevention & control; Maternal Age; Medical sciences; Mefloquine - administration & dosage; Mefloquine - therapeutic use; Multivariate Analysis; Parasitic diseases; Placenta - parasitology; Pregnancy; Pregnancy Complications, Parasitic - prevention & control; Protozoal diseases; Pyrimethamine - administration & dosage; Pyrimethamine - therapeutic use; Risk Factors; Sulfadoxine - administration & dosage; Sulfadoxine - therapeutic use; Young Adult
• ISSN: 0002-9637; 1476-1645
• DOI: 10.4269/ajtmh.2011.10-0319

The efficiency of malaria prevention during pregnancy was compared between three studies in Benin for malaria infection of the placenta (MIP) and low birth weight (LBW). The first was carried out when chloroquine prophylaxis was still recommended, the second was an intermittent preventive treatment in pregnancy (IPTp) clinical trial comparing sulfadoxine pyrimetamine (SP) versus mefloquine, and the third was an observational study after SP-IPTp national implementation. We showed an association between the use of IPTp and the reduction of LBW (10% with national IPTp and 8.7% in IPTp trial versus 15.7% in pre-trial study). The effect on MIP was better in the trial (2.9% versus 11.2% and 16.7% for national IPTp and pre-trial studies, respectively). In spite of a good overall compliance with the national IPTp (with 84% of women taking at least one dose of SP), there are still failures in adherence to the directly observed therapy (DOT) scheme and needs for better training of health staff.