title: Malaria in pregnancy before and after the implementation of a national IPTp program in Gabon.
abstract: Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine has recently been adopted by many African countries to reduce maternal and neonatal morbidity and mortality associated with malaria in pregnancy. We assessed the impact of a newly established national IPTp program on maternal and neonatal health in Gabon. Data on prevalence of maternal Plasmodium falciparum infection, anemia, premature birth, and birth weight were collected in cross-sectional surveys in urban and rural regions of Gabon before and after the implementation of IPTp in a total of 1403 women and their offspring. After introduction of IPTp, the prevalence of maternal Plasmodium falciparum infection decreased dramatically (risk ratio 0.16, P < 0.001). Whereas only a modest effect on the rate of anemia in pregnant women was observed, there was a marked benefit on the prevalence of low birth weight and premature birth for women adhering to national recommendations. These effects were most pronounced in primi- and secundigravid women.
authors.affiliation: Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon. michael.ramharter@meduniwien.ac.at
authors.forename: Michael
authors.initials: M
authors.lastname: Ramharter
authors.forename: Katharina
authors.initials: K
authors.lastname: Schuster
authors.forename: Marielle K
authors.initials: MK
authors.lastname: Bouyou-Akotet
authors.forename: Ayola A
authors.initials: AA
authors.lastname: Adegnika
authors.forename: Kristen
authors.initials: K
authors.lastname: Schmits
authors.forename: Ghyslain
authors.initials: G
authors.lastname: Mombo-Ngoma
authors.forename: Selidji T
authors.initials: ST
authors.lastname: Agnandji
authors.forename: Johannes
authors.initials: J
authors.lastname: Nemeth
authors.forename: Solange Nzenze
authors.initials: SN
authors.lastname: Afène
authors.forename: Saadou
authors.initials: S
authors.lastname: Issifou
authors.forename: Isabelle Ndombi
authors.initials: IN
authors.lastname: Onnas
authors.forename: Maryvonne
authors.initials: M
authors.lastname: Kombila
authors.forename: Peter G
authors.initials: PG
authors.lastname: Kremsner
mesh_terms: D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000008:administration & dosage* / Q000494:pharmacology*; D003430:Cross-Sectional Studies; D005260:Female; D005681:Gabon / Q000453:epidemiology; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000517:prevention & control*; D010298:Parity; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology / Q000517:prevention & control*; D013997:Time Factors