Low Birth Weight and Intermittent Preventive Treatment of Malaria in Pregnant Women in Lomé (Togo) in 2021: A Cross-Sectional Study

Background: Since 2012, the World Health Organization has recommended intermittent preventive treatment with sulfadoxine-pyrimethamine (IPT-SP) to prevent malaria-related complications in pregnant women. Ten years following these recommendations, we conducted this study to estimate the coverage for three doses of IPT-SP (IPT3) as well as the prevalence of low birth weight (LBW), and its associated factors in Lomé (Togo) in 2021. Methods: A cross-sectional study was conducted between January and March 2021. An exhaustive recruitment of women and their newborns was carried out in the maternity wards of the Sylvanus Olympio University Hospital Center. Data from antenatal consultations and clinical data of the newborns were collected. Multivariate logistic regression was carried out to determine factors associated with LBW. Results: A total of 252 mother-child pairs were included in this study. Median age of the mothers was 27 years, IQR [24-31]. More than a third (35.3%) of the mothers were primigravida. IPT3 coverage was 66.7% and 14.7% of newborns had a LBW. The prevalence of LBW was 33.3% [23.3-43.4] in women who had received fewer than 3 doses of IPT-SP and 5.4% [2.0-8.8] in those who had received at least 3 doses of IPT-SP (p Conclusion: Ten years following recommendations of the WHO on IPT-SP, malaria prevention based on IPT-SP is not optimal among pregnant women in Lomé, and the proportion of LBW children remains high. Actions to strengthen the three-dose IPT-SP policy are needed to prevent malaria and its consequences among newborns in Togo.

Effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine: An in silico pharmacological model

Objective:To explore the efficacy of intermittent preventive treatment in pregnancy(IPTp)with sulfadoxine and pyrimethamine(SP)against sensitive parasites.Methods:A pharmacological model was used to investigate the effectiveness of the previous recommended at least two-dose regimen,currently recommended three-dose regimen and 4,6,8-weekly regimens with specific focus on the impact of various nonadherence patterns in multiple transmission settings.Results:The effectiveness of the recommended three-dose regimen is high in all the transmission intensities,i.e.>99%,98%and 92%in low,moderate and high transmission intensities respectively.The simulated 4 and 6 weekly IPTp-SP regimens were able to prevent new infections with sensitive parasites in almost all women(>99%)regardless of transmission intensity.However,8 weekly interval dose schedules were found to have 71%and 86%protective efficacies in high and moderate transmission areas,respectively.It highlights that patients are particularly vulnerable to acquiring new infections if IPTp-SP doses are missed.Conclusions:The pharmacological model predicts that full adherence to the currently recommended three-dose regimen should provide almost complete protection from malaria infection in moderate and high transmission regions.However,it also highlights that patients are particularly vulnerable to acquiring new infections if IPTp doses are spaced too widely or if doses are missed.Adherence to the recommended IPTp-SP schedules is recommended.

Knowledge, Attitude and Practice regarding Intermittent Preventive Treatment (IPTs) of Malaria among Pregnant Women Attending for Antenatal Care in Benadir Hospital at Benadir Region, Somalia

Background: Malaria in pregnancy is a preventable public health concern leading to a high prevalence of maternal morbidity, maternal mortality and adverse birth outcomes. Intermittent Preventive Treatment during pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) is one of the main strategies used to prevent malaria in pregnancy. This study was aimed to determine knowledge attitude and practice regarding intermittent preventive treatment IPT of malaria in pregnancy utilization among pregnant women attending antenatal center in benadir hospital wadajir district benadir region somalia during the period of the study from April 2021-July 2021. Methods: The study was descriptive cross-sectional retrospective Hospital based. The sample size was 60 respondents of pregnant women at 20 weeks to 36 weeks of gestation. Data were collected by interview method using structured questionnaire. The data were collected and then entered to Statistical Package for Social Science version 20 for analysis. Results: The study displayed that the majority of the respondents (58%) were in the 25 - 34 years’ age group. A total of 51 (85%) were married, while 17 (28%) had primary school education. 43 (72%) were housewives while only 11 (18%) were employed. A total 32 (53%) were had gravid more than Four times, while the study showed that, the majority of mothers 39 (65%) were had knowledge about Intermittent Preventive Treatment during pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP). The study showed that majority of the respondent 25 (42%) were getting health education awareness towards IPTp were from health care providers at health centers while 8 (13%) from Friends/relatives/neighbors, followed by 4 (6%) from their husband. And 34 (57%) were had convenience IPTp-SP tablet consumption at their current pregnancy while 26 (43%) did not. Conclusion and Recommendations: Inclusion there was good knowledge and positive attitude towards IPT despite poor utilization, the study recommended the ministry of health especially health promotion, maternal and reproductive health and national malaria control programe should intensify strategies and policies to ensure 3 doses of IPTp-SP given at antenatal care centers target coverage in Somalia and provide capacity building for all health care providers. Also, there should be continuous sensitization of pregnant women on the importance of intermittent preventive treatment during each pregnancy by healthcare workers.

Intermittent Preventive Treatment in Pregnancy with Sulphadoxine-Pyrimethamine Does Not Have Effect on Maternal Hemoglobin at Delivery and Birth Weight in Kisangani, Democratic Republic of Congo

Background: The consequences of malaria during pregnancy are different regarding local conditions of malaria transmission. In stable malaria areas, the main complications are maternal anaemia and fetal growth restriction. This study aims to determine if pregnancy-associated malaria is associated with the risk of the above-mentioned complications and to determine if IPTp-sp reduces them in Kisangani. Methods: It is a cross-sectional analytical study conducted in parturients, in 6 medical facilities of Kisangani, from January 1st to September 30th, 2017. At delivery we measured their hemoglobin, we performed the thick blood smear of their peripheral blood and placental apposition;and we weighed their newborns at birth. Results: Risk of anaemia at delivery increased with malaria access during pregnancy (p = 0.0056;OR: 1.4221, 95% CI: 1.0851 - 1.8638) and peripheral parasitaemia at delivery (p = 0.0000;OR: 6.3855, 95% CI: 4.5552 - 8.9512). LBW increased with peripheral parasitaemia at delivery (p = 0.0000;OR: 3.5299, 95% CI: 2.4424 - 5.1015) and placental parasitaemia (p = 0.0000;OR: 18.3247, 95% CI: 12.5141 - 26.8332). IPTp-sp did not have effect on maternal hemoglobin at delivery (p = 0.1546;OR: 0.7553, IC à 95%: 0.4414 - 1.2923) and the birth weight (p = 0.1225;OR: 0.6638, IC à 95%: 0.3375 - 1.3056). Conclusion: In Kisangani, pregnancy-associated malaria is associated with maternal anaemia at delivery and LBW. IPTp-sp does not reduce the risk of these complications. Therefore, studies evaluating IPTp alternatives are required in malaria endemic areas.