title: Burden of Placental Malaria among Pregnant Women Who Use or Do Not Use Intermittent Preventive Treatment at Mulago Hospital, Kampala.
abstract: Intermittent preventive treatment of malaria in pregnancy with sulphadoxine-pyrimethamine (SP-IPTp) is widely used to reduce the incidence of adverse pregnancy outcomes. As a monitor for continued effectiveness of this intervention amidst SP resistance, we aimed to assess malaria burden among pregnant women who use or do not use SP-IPTp. In a descriptive cohort study at Mulago Hospital, Kampala, 87 women who received two supervised doses of SP-IPTp were followed up until delivery. Controls were pregnant women presenting in early labour without history of SP-IPTp. Histopathological investigation for placental malaria (PM) was performed using the Bulmer classification criterion. Thirty-eight of the 87 women returned for delivery and 33 placentas were successfully collected and processed along with 33 placentas from SP nonusers. Overall, 12% (4/33) of the users had evidence of PM compared to 48% (16/33) of nonusers. Among nonusers, 17/33, 8/33, 2/33, and 6/33 had no placental infection, active infection, active-chronic infection, and past-chronic infection, respectively. Among users, respective proportions were 29/33, 2/33, 0/33, and 2/33. No difference in birth weights was apparent between the two groups, probably due to a higher proportion of infections occurring later in pregnancy. Histological evidence here suggests that SP continues to offer substantial benefit as IPTp.
authors.affiliation: Department of Pharmacology and Therapeutics, School of Biomedical Sciences, Makerere University College of Health Sciences, P.O. Box 7072, Upper Mulago Hill Road, Kampala, Uganda; Department of Pharmacology and Therapeutics, Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda.
authors.forename: Charles Okot
authors.identifier: 0000-0002-0704-5557
authors.initials: CO
authors.lastname: Odongo
authors.affiliation: Department of Pathology, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7062, Kampala, Uganda.
authors.forename: Michael
authors.initials: M
authors.lastname: Odida
authors.affiliation: Department of Pathology, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7062, Kampala, Uganda.
authors.forename: Henry
authors.initials: H
authors.lastname: Wabinga
authors.affiliation: Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
authors.forename: Celestino
authors.initials: C
authors.lastname: Obua
authors.affiliation: Department of Obstetrics and Gynaecology, School of Medicine, College of Health Sciences, Mulago Hospital Complex, P.O. Box 7062, Kampala, Uganda.
authors.forename: Josaphat
authors.initials: J
authors.lastname: Byamugisha