Malaria in pregnancy before and after the implementation of a national IPTp program in Gabon.
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.
Ramharter
Michael
M
Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon. michael.ramharter@meduniwien.ac.at
Schuster
Katharina
K
Bouyou-Akotet
Marielle K
MK
Adegnika
Ayola A
AA
Schmits
Kristen
K
Mombo-Ngoma
Ghyslain
G
Agnandji
Selidji T
ST
Nemeth
Johannes
J
Afène
Solange Nzenze
SN
Issifou
Saadou
S
Onnas
Isabelle Ndombi
IN
Kombila
Maryvonne
M
Kremsner
Peter G
PG
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