Coverage and effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) on adverse pregnancy outcomes in the Mount Cameroon area, South West Cameroon
Abstract Background Growing concerns about the waning efficacy of IPTp-SP warrants continuous monitoring and evaluation. This study determined coverage of IPTp-SP and compared the effectiveness of the 3-dose to 2-dose regimen on placental malaria (PM) infection and low birth weight (LBW) in the Moun...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-03-01
|
| Series: | Malaria Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12936-020-03155-2 |
| _version_ | 1818990388679016448 |
|---|---|
| author | Judith K. Anchang-Kimbi Laken N. Kalaji Harry F. Mbacham Godlove B. Wepnje Tobias O. Apinjoh Irene U. Ngole Sumbele Jodie Dionne-Odom Alan T. N. Tita Eric A. Achidi |
| author_facet | Judith K. Anchang-Kimbi Laken N. Kalaji Harry F. Mbacham Godlove B. Wepnje Tobias O. Apinjoh Irene U. Ngole Sumbele Jodie Dionne-Odom Alan T. N. Tita Eric A. Achidi |
| author_sort | Judith K. Anchang-Kimbi |
| collection | DOAJ |
| description | Abstract Background Growing concerns about the waning efficacy of IPTp-SP warrants continuous monitoring and evaluation. This study determined coverage of IPTp-SP and compared the effectiveness of the 3-dose to 2-dose regimen on placental malaria (PM) infection and low birth weight (LBW) in the Mount Cameroon area. Methods Consenting pregnant women were enrolled consecutively through a cross-sectional survey at delivery at four antenatal clinics, two each from semi-rural and semi-urban settings from November 2016 to December 2017. Reported IPTp-SP use, demographic and antenatal clinic (ANC) data of the mothers and neonate birth weights were documented. Maternal haemoglobin concentration was measured using a haemoglobinometer and PM infection diagnosed by placental blood microscopy. Logistic regression analysis was used to model study outcomes. Results Among the 465 parturient women enrolled, 47.0% (203), 34.7% (150), 18.3% (79) and 7.1% (33) reported uptake of ≥ 3, 2.1 dose(s) and no SP, respectively. Uptake of ≥ 3 doses varied significantly (p < 0.001) according to type of medical facility, timing of ANC initiation and number of ANC visits. The prevalence of PM was 18.5% where uptake of ≥ 3 SP doses (AOR = 2.36: 95% CI 1.41–4.87), primiparity (AOR = 2.13: 95% CI 1.19–3.81), semi-rural setting (AOR = 1.85: 95% CI 1.12–3.04) increased odds of infection. Also, three or more dosing was associated (p < 0.001) with increased PM density notably among women from semi-urban areas. Compared with third trimester, ANC initiation in the second trimester (AOR: 0.39: 95% CI 0.20–0.74) lower odds of infection. The prevalence of LBW infants was 7.3% and were generally those of anaemic (AOR: 4.6: 95% CI 1.03–20.57) and semi-rural (AOR: 5.29: 95% CI 1.73–16.15) women. Although ≥ 3 (AOR: 0.31: 95% CI 0.11–0.87) and 2 (AOR: 0.32: 95% CI 0.11–0.93) doses of SP was associated with lower odds of LBW, ≥ 3 doses were not associated with additional increase in birth weight nor maternal haemoglobin levels when compared with 2 doses. Conclusion In the Mount Cameroon area, reported uptake of IPTp with ≥ 3 SP doses did not provide observable prophylactic benefits. SP resistance efficacy studies are necessary. |
| first_indexed | 2024-12-20T19:53:35Z |
| format | Article |
| id | doaj.art-3a7db50174f941128199f69bf9c4dc82 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-20T19:53:35Z |
| publishDate | 2020-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-3a7db50174f941128199f69bf9c4dc822022-12-21T19:28:13ZengBMCMalaria Journal1475-28752020-03-0119111210.1186/s12936-020-03155-2Coverage and effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) on adverse pregnancy outcomes in the Mount Cameroon area, South West CameroonJudith K. Anchang-Kimbi0Laken N. Kalaji1Harry F. Mbacham2Godlove B. Wepnje3Tobias O. Apinjoh4Irene U. Ngole Sumbele5Jodie Dionne-Odom6Alan T. N. Tita7Eric A. Achidi8Department of Zoology and Animal Physiology, Faculty of Science, University of BueaDepartment of Zoology and Animal Physiology, Faculty of Science, University of BueaDepartment of Zoology and Animal Physiology, Faculty of Science, University of BueaDepartment of Zoology and Animal Physiology, Faculty of Science, University of BueaDepartment of Biochemistry and Molecular Biology, Faculty of Science, University of BueaDepartment of Zoology and Animal Physiology, Faculty of Science, University of BueaDepartment of Medicine, University of Alabama at BirminghamDepartment of Obstetrics and Gynecology, University of Alabama at BirminghamDepartment of Biochemistry and Molecular Biology, Faculty of Science, University of BueaAbstract Background Growing concerns about the waning efficacy of IPTp-SP warrants continuous monitoring and evaluation. This study determined coverage of IPTp-SP and compared the effectiveness of the 3-dose to 2-dose regimen on placental malaria (PM) infection and low birth weight (LBW) in the Mount Cameroon area. Methods Consenting pregnant women were enrolled consecutively through a cross-sectional survey at delivery at four antenatal clinics, two each from semi-rural and semi-urban settings from November 2016 to December 2017. Reported IPTp-SP use, demographic and antenatal clinic (ANC) data of the mothers and neonate birth weights were documented. Maternal haemoglobin concentration was measured using a haemoglobinometer and PM infection diagnosed by placental blood microscopy. Logistic regression analysis was used to model study outcomes. Results Among the 465 parturient women enrolled, 47.0% (203), 34.7% (150), 18.3% (79) and 7.1% (33) reported uptake of ≥ 3, 2.1 dose(s) and no SP, respectively. Uptake of ≥ 3 doses varied significantly (p < 0.001) according to type of medical facility, timing of ANC initiation and number of ANC visits. The prevalence of PM was 18.5% where uptake of ≥ 3 SP doses (AOR = 2.36: 95% CI 1.41–4.87), primiparity (AOR = 2.13: 95% CI 1.19–3.81), semi-rural setting (AOR = 1.85: 95% CI 1.12–3.04) increased odds of infection. Also, three or more dosing was associated (p < 0.001) with increased PM density notably among women from semi-urban areas. Compared with third trimester, ANC initiation in the second trimester (AOR: 0.39: 95% CI 0.20–0.74) lower odds of infection. The prevalence of LBW infants was 7.3% and were generally those of anaemic (AOR: 4.6: 95% CI 1.03–20.57) and semi-rural (AOR: 5.29: 95% CI 1.73–16.15) women. Although ≥ 3 (AOR: 0.31: 95% CI 0.11–0.87) and 2 (AOR: 0.32: 95% CI 0.11–0.93) doses of SP was associated with lower odds of LBW, ≥ 3 doses were not associated with additional increase in birth weight nor maternal haemoglobin levels when compared with 2 doses. Conclusion In the Mount Cameroon area, reported uptake of IPTp with ≥ 3 SP doses did not provide observable prophylactic benefits. SP resistance efficacy studies are necessary.http://link.springer.com/article/10.1186/s12936-020-03155-2Birth weight outcomeCameroonIPTp-SP (doses) coveragePlacental malaria infectionPregnancy |
| spellingShingle | Judith K. Anchang-Kimbi Laken N. Kalaji Harry F. Mbacham Godlove B. Wepnje Tobias O. Apinjoh Irene U. Ngole Sumbele Jodie Dionne-Odom Alan T. N. Tita Eric A. Achidi Coverage and effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) on adverse pregnancy outcomes in the Mount Cameroon area, South West Cameroon Malaria Journal Birth weight outcome Cameroon IPTp-SP (doses) coverage Placental malaria infection Pregnancy |
| title | Coverage and effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) on adverse pregnancy outcomes in the Mount Cameroon area, South West Cameroon |
| title_full | Coverage and effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) on adverse pregnancy outcomes in the Mount Cameroon area, South West Cameroon |
| title_fullStr | Coverage and effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) on adverse pregnancy outcomes in the Mount Cameroon area, South West Cameroon |
| title_full_unstemmed | Coverage and effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) on adverse pregnancy outcomes in the Mount Cameroon area, South West Cameroon |
| title_short | Coverage and effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) on adverse pregnancy outcomes in the Mount Cameroon area, South West Cameroon |
| title_sort | coverage and effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine pyrimethamine iptp sp on adverse pregnancy outcomes in the mount cameroon area south west cameroon |
| topic | Birth weight outcome Cameroon IPTp-SP (doses) coverage Placental malaria infection Pregnancy |
| url | http://link.springer.com/article/10.1186/s12936-020-03155-2 |
| work_keys_str_mv | AT judithkanchangkimbi coverageandeffectivenessofintermittentpreventivetreatmentinpregnancywithsulfadoxinepyrimethamineiptpsponadversepregnancyoutcomesinthemountcameroonareasouthwestcameroon AT lakennkalaji coverageandeffectivenessofintermittentpreventivetreatmentinpregnancywithsulfadoxinepyrimethamineiptpsponadversepregnancyoutcomesinthemountcameroonareasouthwestcameroon AT harryfmbacham coverageandeffectivenessofintermittentpreventivetreatmentinpregnancywithsulfadoxinepyrimethamineiptpsponadversepregnancyoutcomesinthemountcameroonareasouthwestcameroon AT godlovebwepnje coverageandeffectivenessofintermittentpreventivetreatmentinpregnancywithsulfadoxinepyrimethamineiptpsponadversepregnancyoutcomesinthemountcameroonareasouthwestcameroon AT tobiasoapinjoh coverageandeffectivenessofintermittentpreventivetreatmentinpregnancywithsulfadoxinepyrimethamineiptpsponadversepregnancyoutcomesinthemountcameroonareasouthwestcameroon AT ireneungolesumbele coverageandeffectivenessofintermittentpreventivetreatmentinpregnancywithsulfadoxinepyrimethamineiptpsponadversepregnancyoutcomesinthemountcameroonareasouthwestcameroon AT jodiedionneodom coverageandeffectivenessofintermittentpreventivetreatmentinpregnancywithsulfadoxinepyrimethamineiptpsponadversepregnancyoutcomesinthemountcameroonareasouthwestcameroon AT alantntita coverageandeffectivenessofintermittentpreventivetreatmentinpregnancywithsulfadoxinepyrimethamineiptpsponadversepregnancyoutcomesinthemountcameroonareasouthwestcameroon AT ericaachidi coverageandeffectivenessofintermittentpreventivetreatmentinpregnancywithsulfadoxinepyrimethamineiptpsponadversepregnancyoutcomesinthemountcameroonareasouthwestcameroon |