title: Prevention of malaria during pregnancy: assessing the effect of the distribution of IPTp through the national policy in Benin.
abstract: The efficiency of malaria prevention during pregnancy was compared between three studies in Benin for malaria infection of the placenta (MIP) and low birth weight (LBW). The first was carried out when chloroquine prophylaxis was still recommended, the second was an intermittent preventive treatment in pregnancy (IPTp) clinical trial comparing sulfadoxine pyrimetamine (SP) versus mefloquine, and the third was an observational study after SP-IPTp national implementation. We showed an association between the use of IPTp and the reduction of LBW (10% with national IPTp and 8.7% in IPTp trial versus 15.7% in pre-trial study). The effect on MIP was better in the trial (2.9% versus 11.2% and 16.7% for national IPTp and pre-trial studies, respectively). In spite of a good overall compliance with the national IPTp (with 84% of women taking at least one dose of SP), there are still failures in adherence to the directly observed therapy (DOT) scheme and needs for better training of health staff.
authors.affiliation: Institut de Recherche pour le Développement (IRD), UMR216, Mère et Enfant Face aux Infections Tropicales, Paris, France. agnesleport@yahoo.fr
authors.forename: Agnès
authors.initials: A
authors.lastname: Le Port
authors.forename: Gilles
authors.initials: G
authors.lastname: Cottrell
authors.forename: Célia
authors.initials: C
authors.lastname: Dechavanne
authors.forename: Valérie
authors.initials: V
authors.lastname: Briand
authors.forename: Aziz
authors.initials: A
authors.lastname: Bouraima
authors.forename: José
authors.initials: J
authors.lastname: Guerra
authors.forename: Isabelle
authors.initials: I
authors.lastname: Choudat
authors.forename: Achille
authors.initials: A
authors.lastname: Massougbodji
authors.forename: Benjamin
authors.initials: B
authors.lastname: Fayomi
authors.forename: Florence
authors.initials: F
authors.lastname: Migot-Nabias
authors.forename: André
authors.initials: A
authors.lastname: Garcia
authors.forename: Michel
authors.initials: M
authors.lastname: Cot
mesh_terms: D000328:Adult; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use*; D001541:Benin / Q000453:epidemiology; D002738:Chloroquine / Q000008:administration & dosage / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D015658:HIV Infections / Q000469:parasitology; D006291:Health Policy; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008288:Malaria / Q000188:drug therapy / Q000517:prevention & control*; D008423:Maternal Age; D015767:Mefloquine / Q000008:administration & dosage / Q000627:therapeutic use*; D015999:Multivariate Analysis; D010920:Placenta / Q000469:parasitology; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000517:prevention & control*; D011739:Pyrimethamine / Q000008:administration & dosage / Q000627:therapeutic use*; D012307:Risk Factors; D013413:Sulfadoxine / Q000008:administration & dosage / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D002738:Chloroquine; D015767:Mefloquine; D011739:Pyrimethamine