Uptakes of intermittent preventive treatment with sulphadoxine-pyrimethamine for malaria during pregnancy and prevalence of placental malaria in selected heath facilities of Geita District, North Western Tanzania
- Mwanza, Tanzania Catholic University of Health and Allied Sciences CUHAS - Bugando 2014
- xiii; 83 Pages Includes References and Appendices
Abstract:
Background: Plasmodium falciparum malaria infection during pregnancy is associated with adverse pregnancy outcomes. To reduce the risks of adverse consequences, the World Health Organization (WHO) currently recommends intermitted preventive treatment of malaria in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) at each scheduled antenatal care (ANC) visit. The new IPTp regimen has recently been implemented in Tanzania; thus the level of uptake and its association with pregnancy outcomes remains unknown.
Objective: To determine the uptake of intermitted preventive treatment with sulphadoxine-pyrimethamine among pregnant women and its association with adverse pregnancy outcomes in selected health facilities of Geita district.
Methods: A cross-sectional study was conducted among singleton pregnant women who delivered in two selected health facilities of Geita district, North-Western Tanzania. Self-reported uptake of SP verified using the ANC card was recorded. Placental and peripheral blood was collected for diagnosis of malaria by microscopy and rapid diagnosis tests. Gestational age was estimated based on last menstrual period or Ballard score. Infant birth weight were recorded within 24 hours of delivery.
Results: Of 431 participants. 167 (38.75%), 134 (31.09%), 104(24.23%) and 26 (6.03%) reported taking 0, 1, 2, and 3 or more doses of SP during pregnancy respectively. Overall, the prevalence of malaria in pregnancy was 37.59%, 29.70% and 19.49% by placental smear, peripheral smear and mRDT respectively. The uptake of ≥ 3 doses of SP was associated with significant trends towards reduced odds of placental malaria (AOR = 0.31, p=0.039) when compared to <3 doses. Women with placental parasitaemia were five times more likely to deliver preterm (AOR = 4.67, p=0.002) and lower mean birth weight infants than uninfected counterparts (mean difference = -81g, p=0.039)
Conclusion: The uptake of three or more doses of SP during pregnancy is low in the studied population. Placental parasitaemia is prevalent and is associated with adverse birth outcomes. Receipt of three of more doses of IPTp-SP reduced the odds of placental parasitaemia in all gravidae. Increased efforts towards scale-up and continuous monitoring of IPTp-SP efficacy are needed.