Decrease of microscopic Plasmodium falciparum infection prevalence during pregnancy following IPTp-SP implementation in urban cities of Gabon.
Six years after the implementation of intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) in Gabon, its impact on placental malaria and pregnancy outcomes remains unknown.



Age, gestational data, use of IPTp-SP and birth weight were recorded during a hospital-based cross-sectional survey performed in 2011 in 387 women at the end of pregnancy.



Malaria prevalence was 6.7 and 5.3% in peripheral and placental blood respectively. Overall, 59.0% women took at least two IPTp-SP doses which was associated with 50% reduction of Plasmodium; (P.) falciparum infection in primigravidae. Previous malaria treatment was a risk factor for peripheral P. falciparum infection, while uptake of IPTp-SP was associated with reduced parasitaemia. Anaemia prevalence was 38.0%, low birth weight and prematurity rates were 6.0 and 12.0% respectively. Young age was associated with a higher frequency of malaria, anaemia, low birth weight and preterm delivery (p<0.01). Birth weight significantly rose with increasing age (p<0.01), parity (p=0.03) and number of SP doses (p=0.03). A birth weight reduction of 230 g in case of peripheral parasitaemia (p=0.02) and of 210 g with placental parasitaemia (p=0.13) was observed.



Microscopic P. falciparum prevalence during pregnancy significantly declined between 2005 and 2011, following IPTp-SP implementation in Gabon. Young women and paucigravidae remain the most susceptible to malaria and associated outcomes.
Department of Parasitology-Mycology, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon Malaria Clinical and Operational Research Unit (MCORU), Centre Hospitalier Regional de l´Estuaire Melen, Libreville, Gabon mariellebouyou@gmail.com.
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Bouyou-Akotet
Department of Parasitology-Mycology, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon Malaria Clinical and Operational Research Unit (MCORU), Centre Hospitalier Regional de l´Estuaire Melen, Libreville, Gabon.
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Mawili-Mboumba
Department of Parasitology-Mycology, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon.
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Kendjo
Department of Gynecology, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon.
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Moutandou Chiesa
Department of Parasitology-Mycology, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon.
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Tshibola Mbuyi
Malaria Clinical and Operational Research Unit (MCORU), Centre Hospitalier Regional de l´Estuaire Melen, Libreville, Gabon.
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Tsoumbou-Bakana
Malaria Clinical and Operational Research Unit (MCORU), Centre Hospitalier Regional de l´Estuaire Melen, Libreville, Gabon.
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Zong
Gynecology and Obstetrics ward, Centre Hospitalier de Libreville, Libreville, Gabon.
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Ambounda
Department of Parasitology-Mycology, Faculty of Medicine, Université des Sciences de la Santé, Libreville, Gabon Malaria Clinical and Operational Research Unit (MCORU), Centre Hospitalier Regional de l´Estuaire Melen, Libreville, Gabon.
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Kombila
D000328:Adult; D000740:Anemia / Q000150:complications / Q000453:epidemiology; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use*; D001724:Birth Weight; D002947:Cities; D003430:Cross-Sectional Studies; D004338:Drug Combinations; D005260:Female; D005681:Gabon; D020073:Gravidity; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000469:parasitology / Q000517:prevention & control*; D018512:Parasitemia / Q000453:epidemiology / Q000469:parasitology / Q000517:prevention & control; D010920:Placenta; D010963:Plasmodium falciparum; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology / Q000469:parasitology / Q000517:prevention & control*; D011256:Pregnancy Outcome; D015995:Prevalence; D011739:Pyrimethamine / Q000008:administration & dosage / Q000627:therapeutic use*; D013413:Sulfadoxine / Q000008:administration & dosage / Q000627:therapeutic use*; D014505:Urban Population; D055815:Young Adult
D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine
Gabon; Intermittent preventive treatment in pregnancy; Plasmodium falciparum; Pregnancy outcomes; Sulfadoxine-pyrimethamine