Effect of sulfadoxine-pyrimethamine doses for prevention of malaria during pregnancy in hypoendemic area in Tanzania
Abstract Background Malaria in pregnancy increases the risk of deleterious maternal and birth outcomes. The use of ≥ 3 doses of sulfadoxine-pyrimethamine (SP) for intermittent preventive treatment of malaria (IPTp-SP) is recommended for preventing the consequences of malaria during pregnancy. This s...
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| Format: | Article |
| Language: | English |
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BMC
2020-04-01
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| Series: | Malaria Journal |
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| Online Access: | http://link.springer.com/article/10.1186/s12936-020-03234-4 |
| _version_ | 1819050490829209600 |
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| author | Wigilya P. Mikomangwa Omary Minzi Ritah Mutagonda Vito Baraka Eulambius M. Mlugu Eleni Aklillu Appolinary A. R. Kamuhabwa |
| author_facet | Wigilya P. Mikomangwa Omary Minzi Ritah Mutagonda Vito Baraka Eulambius M. Mlugu Eleni Aklillu Appolinary A. R. Kamuhabwa |
| author_sort | Wigilya P. Mikomangwa |
| collection | DOAJ |
| description | Abstract Background Malaria in pregnancy increases the risk of deleterious maternal and birth outcomes. The use of ≥ 3 doses of sulfadoxine-pyrimethamine (SP) for intermittent preventive treatment of malaria (IPTp-SP) is recommended for preventing the consequences of malaria during pregnancy. This study assessed the effect of IPTp-SP for prevention of malaria during pregnancy in low transmission settings. Methods A cross-sectional study that involved consecutively selected 1161 pregnant women was conducted at Mwananyamala regional referral hospital in Dar es Salaam. Assessment of the uptake of IPTp-SP was done by extracting information from antenatal clinic cards. Maternal venous blood, cord blood, placental blood and placental biopsy were collected for assessment of anaemia and malaria. High performance liquid chromatography with ultraviolet detection (HPLC-UV) was used to detect and quantify sulfadoxine (SDX). Dried blood spots (DBS) of placental blood were collected for determination of sub-microscopic malaria using polymerase chain reaction (PCR). Results In total, 397 (34.2%) pregnant women reported to have used sub-optimal doses (≤ 2) while 764 (65.8%) used optimal doses (≥ 3) of IPTp-SP at the time of delivery. The prevalence of placental malaria as determined by histology was 3.6%. Submicroscopic placental malaria was detected in 1.4% of the study participants. Women with peripheral malaria had six times risk of maternal anaemia than those who were malaria negative (aOR, 5.83; 95% CI 1.10–30.92; p = 0.04). The geometric mean plasma SDX concentration was 10.76 ± 2.51 μg/mL. Sub-optimal IPTp-SP dose was not associated with placental malaria, premature delivery and fetal anaemia. The use of ≤ 2 doses of IPTp-SP increased the risk of maternal anaemia by 1.36-fold compared to ≥ 3 doses (aOR, 1.36; 95% CI 1.04–1.79; p = 0.02). Conclusion The use of < 2 doses of IPTp-SP increased the risk of maternal anaemia. However, sub-optimal doses (≤ 2 doses) were not associated with increased the risk of malaria parasitaemia, fetal anaemia and preterm delivery among pregnant women in low malaria transmission setting. The use of optimal doses (≥ 3 doses) of IPTp-SP and complementary interventions should continue even in areas with low malaria transmission. |
| first_indexed | 2024-12-21T11:48:53Z |
| format | Article |
| id | doaj.art-7bf401209aaa4784b0904cd878e75562 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-21T11:48:53Z |
| publishDate | 2020-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-7bf401209aaa4784b0904cd878e755622022-12-21T19:05:06ZengBMCMalaria Journal1475-28752020-04-0119111110.1186/s12936-020-03234-4Effect of sulfadoxine-pyrimethamine doses for prevention of malaria during pregnancy in hypoendemic area in TanzaniaWigilya P. Mikomangwa0Omary Minzi1Ritah Mutagonda2Vito Baraka3Eulambius M. Mlugu4Eleni Aklillu5Appolinary A. R. Kamuhabwa6Clinical Pharmacy and Pharmacology Department, Muhimbili University of Health and Allied SciencesClinical Pharmacy and Pharmacology Department, Muhimbili University of Health and Allied SciencesClinical Pharmacy and Pharmacology Department, Muhimbili University of Health and Allied SciencesNational Institute for Medical Research, Tanga CentrePharmaceutics and Pharmacy Practice Department, Muhimbili University of Health and Allied SciencesDivision of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital-Huddinge C1:68Clinical Pharmacy and Pharmacology Department, Muhimbili University of Health and Allied SciencesAbstract Background Malaria in pregnancy increases the risk of deleterious maternal and birth outcomes. The use of ≥ 3 doses of sulfadoxine-pyrimethamine (SP) for intermittent preventive treatment of malaria (IPTp-SP) is recommended for preventing the consequences of malaria during pregnancy. This study assessed the effect of IPTp-SP for prevention of malaria during pregnancy in low transmission settings. Methods A cross-sectional study that involved consecutively selected 1161 pregnant women was conducted at Mwananyamala regional referral hospital in Dar es Salaam. Assessment of the uptake of IPTp-SP was done by extracting information from antenatal clinic cards. Maternal venous blood, cord blood, placental blood and placental biopsy were collected for assessment of anaemia and malaria. High performance liquid chromatography with ultraviolet detection (HPLC-UV) was used to detect and quantify sulfadoxine (SDX). Dried blood spots (DBS) of placental blood were collected for determination of sub-microscopic malaria using polymerase chain reaction (PCR). Results In total, 397 (34.2%) pregnant women reported to have used sub-optimal doses (≤ 2) while 764 (65.8%) used optimal doses (≥ 3) of IPTp-SP at the time of delivery. The prevalence of placental malaria as determined by histology was 3.6%. Submicroscopic placental malaria was detected in 1.4% of the study participants. Women with peripheral malaria had six times risk of maternal anaemia than those who were malaria negative (aOR, 5.83; 95% CI 1.10–30.92; p = 0.04). The geometric mean plasma SDX concentration was 10.76 ± 2.51 μg/mL. Sub-optimal IPTp-SP dose was not associated with placental malaria, premature delivery and fetal anaemia. The use of ≤ 2 doses of IPTp-SP increased the risk of maternal anaemia by 1.36-fold compared to ≥ 3 doses (aOR, 1.36; 95% CI 1.04–1.79; p = 0.02). Conclusion The use of < 2 doses of IPTp-SP increased the risk of maternal anaemia. However, sub-optimal doses (≤ 2 doses) were not associated with increased the risk of malaria parasitaemia, fetal anaemia and preterm delivery among pregnant women in low malaria transmission setting. The use of optimal doses (≥ 3 doses) of IPTp-SP and complementary interventions should continue even in areas with low malaria transmission.http://link.springer.com/article/10.1186/s12936-020-03234-4MalariaPregnancyIntermittent-preventive treatmentSulfadoxine-pyrimethamineAnaemiaTanzania |
| spellingShingle | Wigilya P. Mikomangwa Omary Minzi Ritah Mutagonda Vito Baraka Eulambius M. Mlugu Eleni Aklillu Appolinary A. R. Kamuhabwa Effect of sulfadoxine-pyrimethamine doses for prevention of malaria during pregnancy in hypoendemic area in Tanzania Malaria Journal Malaria Pregnancy Intermittent-preventive treatment Sulfadoxine-pyrimethamine Anaemia Tanzania |
| title | Effect of sulfadoxine-pyrimethamine doses for prevention of malaria during pregnancy in hypoendemic area in Tanzania |
| title_full | Effect of sulfadoxine-pyrimethamine doses for prevention of malaria during pregnancy in hypoendemic area in Tanzania |
| title_fullStr | Effect of sulfadoxine-pyrimethamine doses for prevention of malaria during pregnancy in hypoendemic area in Tanzania |
| title_full_unstemmed | Effect of sulfadoxine-pyrimethamine doses for prevention of malaria during pregnancy in hypoendemic area in Tanzania |
| title_short | Effect of sulfadoxine-pyrimethamine doses for prevention of malaria during pregnancy in hypoendemic area in Tanzania |
| title_sort | effect of sulfadoxine pyrimethamine doses for prevention of malaria during pregnancy in hypoendemic area in tanzania |
| topic | Malaria Pregnancy Intermittent-preventive treatment Sulfadoxine-pyrimethamine Anaemia Tanzania |
| url | http://link.springer.com/article/10.1186/s12936-020-03234-4 |
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