title: Coverage and efficacy of intermittent preventive treatment with sulphadoxine pyrimethamine against malaria in pregnancy in Côte d'Ivoire five years after its implementation.
abstract: BACKGROUND
  The World Health Organization (WHO) recommends for sub-Saharan Africa a package of prompt and effective case-management combined with the delivery of insecticide-treated nets (ITN) and intermittent preventive treatment during pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) through the national antenatal care (ANC) programs. Implemented in Côte d'Ivoire around 2005, few Data on IPTp coverage and efficacy in the country are available.
  
  
  METHODS
  A multicentre, cross-sectional survey was conducted in Côte d'Ivoire from September 2009 to May 2010 at six urban and rural antenatal clinics. IPTp-sp coverage, Socio-economic and obstetrical data of mothers and neonate birth weights were documented. Peripheral blood as well as placental and cord blood were used to prepare thick and thin blood films. In addition, pieces of placental tissues were used to prepare impression smears and maternal haemoglobin concentration was measured. Regression logistics were used to study factors associated with placental malaria and LBW (<2.500 grams).
  
  
  RESULTS
  A total of 1317 delivered women were enrolled with a median age of 26 years. A proportion of 43.28% of the women had received at least two doses of IPTsp during the current pregnancy although a high proportion (90.4%) of women received antenatal care and made enough visits (≥2). Variability in the results was observed depending on the type of area (rural/urban). Plasmodium falciparum was detected in the peripheral blood of 97 women (7.3%) and in the placenta of 119 women (9%). LBW infants were born to 18.8% (22/107) of women with placental malaria and 8.5% (103/1097) of women without placental malaria. LBW was associated with placental malaria.
  
  
  CONCLUSIONS
  This study found relative low coverage of IPTp in the study areas which supported findings that high ANC attendance does not guarantee high IPTp coverage. Urgent efforts are required to improve service delivery of this important intervention.
authors.affiliation: Malariology Department, Institut Pasteur of Côte d'Ivoire, P.O. Box 490, Abidjan, 01, Côte d'Ivoire. andre_offianan@yahoo.fr.
authors.forename: Offianan A
authors.initials: OA
authors.lastname: Toure
authors.affiliation: Malariology Department, Institut Pasteur of Côte d'Ivoire, P.O. Box 490, Abidjan, 01, Côte d'Ivoire. lou.penali@gmail.com.
authors.forename: Penali L
authors.initials: PL
authors.lastname: Kone
authors.affiliation: Malariology Department, Institut Pasteur of Côte d'Ivoire, P.O. Box 490, Abidjan, 01, Côte d'Ivoire. mlanhoroaristide@yahoo.fr.
authors.forename: M'Lanhoro A A
authors.initials: MA
authors.lastname: Coulibaly
authors.affiliation: Malariology Department, Institut Pasteur of Côte d'Ivoire, P.O. Box 490, Abidjan, 01, Côte d'Ivoire. smart.aab@gmail.com.
authors.forename: Berenger A A
authors.initials: BA
authors.lastname: Ako
authors.affiliation: Malariology Department, Institut Pasteur of Côte d'Ivoire, P.O. Box 490, Abidjan, 01, Côte d'Ivoire. ericadji@yahoo.fr.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Gbessi
authors.affiliation: Malariology Department, Institut Pasteur of Côte d'Ivoire, P.O. Box 490, Abidjan, 01, Côte d'Ivoire. coulnbaba2008@yahoo.fr.
authors.forename: Baba
authors.initials: B
authors.lastname: Coulibaly
authors.affiliation: Malariology Department, Institut Pasteur of Côte d'Ivoire, P.O. Box 490, Abidjan, 01, Côte d'Ivoire. landrytiacoh@yahoo.fr.
authors.forename: Landry T
authors.initials: LT
authors.lastname: N' Guessan
authors.affiliation: Malariology Department, Institut Pasteur of Côte d'Ivoire, P.O. Box 490, Abidjan, 01, Côte d'Ivoire. davidkoffi82@gmail.com.
authors.forename: David
authors.initials: D
authors.lastname: Koffi
authors.affiliation: Malariology Department, Institut Pasteur of Côte d'Ivoire, P.O. Box 490, Abidjan, 01, Côte d'Ivoire. be_sylvain@yahoo.fr.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Beourou
authors.affiliation: Malariology Department, Institut Pasteur of Côte d'Ivoire, P.O. Box 490, Abidjan, 01, Côte d'Ivoire. soumahoroa@yahoo.fr.
authors.forename: Adama
authors.initials: A
authors.lastname: Soumahoro
authors.affiliation: Malariology Department, Institut Pasteur of Côte d'Ivoire, P.O. Box 490, Abidjan, 01, Côte d'Ivoire. issiakbass@yahoo.fr.
authors.forename: Issiaka
authors.initials: I
authors.lastname: Bassinka
authors.affiliation: PMI of Yopougon Abidjan, P.O. Box 1351, Abidjan, 23, Côte d'Ivoire. messounn@yahoo.fr.
authors.forename: Messoun
authors.initials: M
authors.lastname: Nogbou
authors.affiliation: PMI of Yopougon Abidjan, P.O. Box 1351, Abidjan, 23, Côte d'Ivoire. tidjaneswa@yahoo.fr.
authors.forename: Tidjane
authors.initials: T
authors.lastname: Swa
authors.affiliation: Maternity Service, Bonoua Hospital, P.O. Box 25, Bonoua, Côte d'Ivoire. bernadin.gba@yahoo.fr.
authors.forename: Bernadin
authors.initials: B
authors.lastname: Gba
authors.affiliation: CHU Cocody, Boulevard de l'Université, P.O. Box v13, Abidjan, Côte d'Ivoire. beugresmel@hotmail.fr.
authors.forename: Beugre
authors.initials: B
authors.lastname: Esmel
authors.affiliation: CHU Cocody, Boulevard de l'Université, P.O. Box v13, Abidjan, Côte d'Ivoire. bokassae@yahoo.fr.
authors.forename: Ernestine M
authors.initials: EM
authors.lastname: Bokossa
mesh_terms: D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000008:administration & dosage*; D001769:Blood / Q000469:parasitology; D018890:Chemoprevention / Q000379:methods*; D007560:Cote d'Ivoire; D003430:Cross-Sectional Studies; D004338:Drug Combinations; D004363:Drug Utilization; D005260:Female; D006302:Health Services Research; D006801:Humans; D007231:Infant, Newborn; D016778:Malaria, Falciparum / Q000175:diagnosis / Q000517:prevention & control*; D008297:Male; D010963:Plasmodium falciparum / Q000302:isolation & purification; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D011739:Pyrimethamine / Q000008:administration & dosage*; D013413:Sulfadoxine / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine