[Factors associated with the failure of Intermittent Preventive Treatment for malaria among pregnant women in Yaounde].
BACKGROUND
Intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) is recommended for malaria prevention during pregnancy. We investigated factors associated with the failure of this strategy.


METHODS
We conducted a case-control study in two health care facilities in Yaounde, from 1 May 2014 to 30 April 2015. Pregnant women treated with IPTp-SP, hospitalized for malaria and having a positive Rapid Diagnostic Test (RDT) result (case-subjects) were compared to pregnant women treated with IPTp-SP having a negative RDT result (control-subjects). Epi Info 7 software and SPSS 18.0 software were used with P< 0.05 as significance threshold.


RESULTS
We recruited 234 subjects, 109 (46.6%) case-subjects and 125 control-subjects (53.4%). The associated factors found were: prematurity (P=0.03; OR=1.15; IC= 0.32 - 4.10), the non-use of LLIN (P=0.006; OR= 2.31; IC= 1.26 - 4.25), a history of hospitalization for malaria (P=0.007; OR= 2.19; IC= 1.23 - 3.89), IPTp-SP administration after 28 gestational weeks (P=0.001, OR= 3.55; IC= 1.7 - 7.61). After logistic regression, prematurity (P=0.024; OR=2.01; IC=1.1-3.7) and a history of hospitalization for malaria (P=0.001; OR=2.83; IC=1.50-5.4) remained associated with IPTp-SP failure.


CONCLUSIONS
A history of hospitalization for malaria and prematurity are independent predictor of IPTp-SP failure.
Département de Gynécologie-Obstétrique, Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé, Cameroun; Hôpital Central de Yaoundé (HCY), Cameroun.
Félix
F
Essiben
Département de Gynécologie-Obstétrique, Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé, Cameroun; Hôpital Gynéco-obstétrique et Pédiatrique de Yaoundé, Cameroun.
Pascal
P
Foumane
Institut de Technologie Médicale de Yaoundé
Marcelle Aurelie Tsafack
MA
de Nguefack
Hôpital Central de Yaoundé (HCY), Cameroun; Institut de Technologie Médicale de Yaoundé
Filbert Eko
FE
Eko
Département de Gynécologie-Obstétrique, Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé, Cameroun; Hôpital Central de Yaoundé (HCY), Cameroun.
Philip Nana
PN
Njotang
Département de Gynécologie-Obstétrique, Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé, Cameroun; Hôpital Central de Yaoundé (HCY), Cameroun.
Robinson Mbu
RM
Enow
Département de Gynécologie-Obstétrique, Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé, Cameroun; Hôpital Gynéco-Obstétrique et Pédiatrique de Douala, Cameroun.
Emile Telesphore
ET
Mboudou
D000328:Adult; D000962:Antimalarials / Q000008:administration & dosage* / Q000627:therapeutic use; D002163:Cameroon / Q000453:epidemiology; D016022:Case-Control Studies; D004338:Drug Combinations; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control*; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology / Q000517:prevention & control*; D011739:Pyrimethamine / Q000008:administration & dosage* / Q000627:therapeutic use; D012307:Risk Factors; D013413:Sulfadoxine / Q000008:administration & dosage* / Q000627:therapeutic use; D017211:Treatment Failure; D055815:Young Adult
D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine
Cameroon; Risk factors; intermittent preventive treatment; malaria; sulphadoxine-pyrimethamine