The efficacy of intermittent preventive therapy in the eradication of peripheral and placental parasitemia in a malaria-endemic environment, as seen in a tertiary hospital in Abuja, Nigeria.
Umemmuo MU; Department of Obstetrics and Gynecology, National Hospital, Abuja, Nigeria.
Agboghoroma CO; Department of Obstetrics and Gynecology, National Hospital, Abuja, Nigeria.
Iregbu KC; Department of Microbiology, National Hospital, Abuja, Nigeria.
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2020 Mar; Vol. 148 (3), pp. 338-343. Date of Electronic Publication: 2020 Jan 17.
Typ publikacji :
Imprint Name(s) :
Publication: 2017- : Malden, MA : Wiley
Original Publication: [New York, NY] Hoeber Medical Division, Harper & Row, [c1969-
MeSH Terms :
Malaria/*prevention & control
Parasitemia/*prevention & control
Pregnancy Complications, Parasitic/*prevention & control
Adolescent ; Adult ; Birth Weight ; Cross-Sectional Studies ; Drug Combinations ; Female ; Humans ; Infant, Newborn ; Nigeria/epidemiology ; Parasitemia/epidemiology ; Pregnancy ; Pregnancy Complications, Parasitic/epidemiology ; Prevalence ; Tertiary Care Centers
WHO. Intermittent preventive treatment in pregnancy (IPTp) Last update: 21 June 2018. https://www.who.int/malaria/areas/preventive_therapies/pregnancy/en/Accessed December 8, 2018.
Desai M, Gutman J, L'lanziva A, et al. Intermittent screening and treatment or intermittent preventive treatment with Dihydroartemisinin-Piperaquine versus intermittent preventive treatment with Sulfadoxine-Pyrimethamine for the control of malaria during pregnancy in western Kenya: An open-label, three-group, randomized controlled superiority trial. Lancet. 2015;386:2507-2519.
Dimasuay KG, Aitken HE, Rosario F, et al. Inhibition of placental mTOR signaling provides a link between placental malaria and reduced birthweight. BMC Med. 2017;15:1.
WHO. 10 facts on malaria. Updated December 2016. https://www.who.int/features/factfiles/malaria/en/. Accessed April 21, 2019.
Offianan AT, Penali LK, Coulibaly MA, et al. Comparative efficacy of uncontrolled and controlled intermittent preventive treatment during pregnancy (IPTp) with combined use of LLTNs in high resistance area to sulfadoxine-pyrimethamine in Côte d'Ivoire. Infect Drug Resist. 2012;5:53-63.
Araoye MO. Research Methodology with Statistics for Health and Social Sciences. Ilorin: Nathadex publishers; 2004.
Uneke C, Iyare F, Sunday-Adeoye I, Ajayi J. An assessment of the impact of placental Plasmodium falciparum malaria on perinatal outcome in Nigeria. IJPD. 2007;3:1-7.
Centers for disease Control and prevention (CDC). DPDx - Laboratory Identification of Parasites of Public Health Concern. https://www.cdc.gov/dpdx/diagnosticprocedures/index.html. Accessed March 29, 2019.
WHO. Malaria Parasite Counting. 2016. http://www.wpro.who.int/mvp/lab_quality/2096_oms_gmp_sop_09_rev1.pdf Accessed February 16, 2019.
Gutman J, Mwandama D, Wiegand RE, Ali D, Mathanga DP, Skarbinski J. Effectiveness of intermittent preventive treatment with sulfadoxine-pyrimethamine during pregnancy on maternal and birth outcomes in Machinga district, Malawi. J Infect Dis. 2013;208:907-916.
Stoner MCD, Vwalika B, Smid M, et al. Dosage of sulfadoxine-pyrimethamine and risk of low birth weight in a cohort of Zambian pregnant women in a low malaria prevalence region. Am J Trop Med Hyg. 2017;96:170-177.
Scott S, D'Alessandro U, Kendall L, et al. Community-based malaria screening and treatment for pregnant women receiving standard intermittent preventive treatment with sulfadoxine-pyrimethamine: A multicenter (The Gambia, Burkina Faso and Benin) cluster randomized controlled trial. Clin Infect Dis. 2018;68:586-596.
Peter AA. Effect of intermittent preventive treatment of malaria on the outcome of pregnancy among women attending antenatal clinic of a new Nigerian teaching hospital, Ado-Ekiti. Niger Med J. 2013;54:170-175.
Idih EE, Ezem BU, Nzeribe EA, Onyegbule AO, Duru BC, Amajoyi CC. The relationship between malaria parasitemia, malaria preventive measures and average birth weight of babies in a tertiary facility in Owerri, Nigeria. Niger Med J. 2016;57:208-212.
Stephens JK, Ofori MF, Quakyi IA, Wilson ML, Akanmori BD. Prevalence of peripheral blood parasitaemia, anaemia and low birthweight among pregnant women in a suburban area in coastal Ghana. Pan Afr Med J. 2014;18:17.
Gutman J, Slutsker L. Intermittent preventive treatment with sulfadoxine-pyrimethamine: More than just an antimalarial? Am J Trop Med Hyg. 2017;96:9-10.
Dingens A, Fairfortune TS, Reed S, Mitchell C. Bacterial vaginosis and adverse outcomes among full-term infants: A cohort study. BMC Pregnancy Childbirth. 2016;16:278.
Batran SE, Salih MM, Elhassan EM, Mohmmed AA, Adam I. CD20, CD3, placental malaria infections and low birth weight in an area of unstable malaria transmission in Central Sudan. Diagn Pathol. 2013;8:189.
Oweisi PW, John CT, Omietimi JE, Aigere EOS, Allagoa DO, Kotingo EL. Placental malaria parasitization at delivery: Experience at a Nigerian Tertiary Hospital. Eur Sci J. 2018;14:1857-7881.
Bassey G, Nyengidiki TK, John CT. Prevalence of placenta Plasmodium parasitemia and pregnancy outcome in asymptomatic patients at delivery in a University Teaching Hospital in Nigeria. Niger J Clin Pact. 2015;18:27-32.
Mohammed AH, Salih MM, Elhassan EM, et al. Submicroscopic Plasmodium falciparum malaria and low birth weight in an area of unstable malaria transmission in Central Sudan. Malaria J. 2013;12:172.
Contributed Indexing :
Keywords: Intermittent preventive therapy; Low birth weight; Malaria; Malaria-endemic environment; Peripheral parasitemia; Placental parasitisation; Sulphadoxine-pyrimethamine
Substance Nomenclature :
0 (Drug Combinations)
37338-39-9 (fanasil, pyrimethamine drug combination)
Entry Date(s) :
Date Created: 20191214 Date Completed: 20200424 Latest Revision: 20200424
Update Code :
Objective: To determine whether intermittent preventive therapy in pregnancy (IPTp) eradicates peripheral and placental malaria and improves birth weight.
Method: A cross-sectional study was conducted of 426 pregnant mothers on IPTp with sulphadoxine-pyrimethamine against malaria who presented in labor, at National Hospital Abuja, Nigeria between January and June 2017. The hospital is within the malaria-endemic zone of West Africa. Consenting pregnant women with uncomplicated singleton term pregnancy who had antenatal care in the hospital and lived in the study area for at least 6 months were consecutively recruited. Peripheral and placental blood were collected and examined for malaria parasite by microscopy. Babies were weighed at birth.
Results: The prevalence of peripheral malaria parasitemia and placental parasitization were 12.9% (95% confidence interval [CI] 10.0-16.6) and 9.4% (95% CI 7.0-12.7), respectively. Parasite density in both peripheral parasitemia and placental parasitization was low among the women that took IPTp, decreasing with increasing doses, with no parasitemia or parasitization in women that took up to three doses. Birth weight was lower in babies of mothers with plasmodium infestation than in those without infestation (P<0.001, P=0.024).
Conclusion: IPTp reduces both peripheral parasitemia and placental parasitization, with the capacity to eliminate or prevent them. IPTp also reduces low birth weight.
(© 2019 International Federation of Gynecology and Obstetrics.)