Effectiveness of intermittent preventive treatment in pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) in Ghana

Bibliographic Data

ID21879588
AuthorsDavid Kwame Dosoo (0000-0001-5152-462X, London School of Hygiene & Tropical Medicine, corresponding author), Kezia Malm (Ghana Health Service), Felix Boakye Oppong (0000-0002-3146-9958, Kintampo Health Research Centre), Richard K Gyasi (University of Ghana), Richard Gyasi (Department of Pathology, University of Ghana College of Health Sciences, Accra, Ghana), Abraham Oduro (0000-0002-4191-7419, Navrongo Health Research Centre), John Allen Williams (0000-0001-5127-4608, Dodowa Health Research Centre, Research and Development Division, Ghana Health Service, Dodowa, Ghana), John E Williams (0000-0002-1353-2685, Dodowa Health Research Centre), Dorcas Atibilla (0000-0002-0462-0499, Kintampo Health Research Centre), Nana Yaw Peprah (0000-0003-1633-7911, Ghana Health Service), Mieks Twumasi (Kintampo Health Research Centre), Seth Owusu-Agyei (Department of Disease Control, London School of Hygiene and Tropical Medicine, Faculty of Infectious and Tropical Diseases, London, UK), Seth Owusu‐Agyei (0000-0002-0807-1781, University of Health and Allied Sciences), Brad Greenwood (0000-0001-5725-9118, London School of Hygiene & Tropical Medicine), Brian Greenwood (Department of Disease Control, London School of Hygiene and Tropical Medicine, Faculty of Infectious and Tropical Diseases, London, UK), Daniel Chandramohan (0000-0002-6974-5620, London School of Hygiene & Tropical Medicine), Kwaku Poku Asante (0000-0001-9158-351X, London School of Hygiene & Tropical Medicine)
Year2021
Volume6
Issue8
Pagese005877
Publication date2021-08-01
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2021-005877
PMID34417272
OpenAlexW3195927099
LanguageEN
Citations received2
References cited25

INTRODUCTION: Ghana adopted the revised WHO recommendation on intermittent preventive treatment in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) in 2012. This study has assessed the effectiveness and safety of this policy in Ghana. METHODS: A total of 1926 pregnant women enrolled at antenatal care (ANC) clinics were assessed for birth outcomes at delivery, and placental histology results for malaria infection were obtained from 1642 participants. Association of reduced placental or peripheral malaria, anaemia and low birth weight (LBW) in women who received ≥4 IPTp-SP doses compared with 3 or ≤2 doses was determined by logistic regression analysis. RESULTS: Among the 1926 participants, 5.3% (103), 19.2% (369), 33.2% (640) and 42.3% (817) of women had received ≤1, 2, 3 or ≥4 doses, respectively. There was no difference in risk of active placental malaria (PM) infection in women who received 3 doses compared with ≥4 doses (adjusted OR (aOR) 1.00, 95% CI 0.47 to 2.14). The risk of overall PM infection was 1.63 (95% CI 1.07 to 2.48) in 2 dose group and 1.06 (95% CI 0.72 to 1.57) in 3 dose group compared with ≥4 dose group. The risk of LBW was 1.55 (95% CI 0.97 to 2.47) and 1.06 (95% CI 0.68 to 1.65) for 2 and 3 dose groups, respectively, compared with the ≥4 dose group. Jaundice in babies was present in 0.16%, and 0% for women who received ≥4 doses of SP. CONCLUSION: There was no difference in the risk of PM, LBW or maternal anaemia among women receiving 3 doses compared with ≥4 doses. Receiving ≥3 IPTp-SP doses during pregnancy was associated with a lower risk of overall PM infection compared with 2 doses. As there are no safety concerns, monthly administration of IPTp-SP offers a more practical opportunity for pregnant women to receive ≥3 doses during pregnancy

Biology · Chloroquine · Gynecology · Jaundice · Logistic regression · Low birth weight · Malaria · Obstetrics · Pregnancy · Pyrimethamine · Sulfadoxine · Sulfadoxine/pyrimethamine · Malaria Research and Control · Medicine · Parasites and Host Interactions · Trypanosoma species research and implications · Immunology · Internal Medicine

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