Effect of haematinic supplementation and malaria prevention on maternal anaemia and malaria in western Kenya

van Eijk, Anna, Ayisi, J. G., Slutsker, L., terKuile, Feiko ORCID: https://orcid.org/0000-0003-3663-5617, Rosen, D. H., Otieno, J. A., Shi, Y. P., Kager, P. A., Steketee, R. W. and Nahlen, B. L. (2007) 'Effect of haematinic supplementation and malaria prevention on maternal anaemia and malaria in western Kenya'. Tropical Medicine & International Health, Vol 12, Issue 3, pp. 342-352.

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Abstract

OBJECTIVE To evaluate the effect of routine antenatal haematinic supplementation programmes and intermittent preventive treatment (IPT) with sulphadoxine-pyrimethamine (SP) in Kenya.
METHODS Anaemia [haemoglobin (Hb) < 11 g/dl), severe anaemia (Hb < 8 g/dl) and placental malaria were compared among women with known HIV status who delivered at a provincial hospital after study enrolment in the third trimester during three consecutive periods: period 1, no routine intervention (reference); period 2, routine haematinic supplementation (60 mg elementary iron three times/day, folic acid 5 mg once daily) and period 3, haematinics and IPT with SP.
RESULTS Among 3108 participants, prevalence of placental malaria, anaemia and severe anaemia postpartum was 16.7%, 53.6% and 12.7%, respectively. Compared with period 1, women in period 2 were less anaemic [adjusted odds ratio (AOR), 95% confidence interval anaemia: 0.56, 0.47-0.67; severe anaemia 0.37, 0.28-0.49] and shared a similar prevalence of placental malaria (AOR 1.07, 0.86-1.32). Women in period 3 were also less anaemic (AOR anaemia: 0.43, 0.35-0.53 and severe anaemia: 0.43, 0.31-0.59), and had less placental malaria (AOR 0.56, 0.42-0.73). The effect of intervention did not differ significantly by HIV status.
CONCLUSION The haematinic supplementation programme was associated with significant reductions in anaemia in HIV-seropositive and HIV-seronegative women. The subsequent introduction of IPT was associated with halving of malaria, but no additional haematological benefit over haematinics.

Item Type:	Article
Uncontrolled Keywords:	anaemia pregnancy malaria haematinic supplementation sulphadoxine-pyrimethamine kenya human-immunodeficiency-virus pregnant-women sulfadoxine-pyrimethamine iron supplementation hiv-infection risk-factors disease strategies tanzania
Subjects:	WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria WH Hemic and Lymphatic Systems > Hematologic Diseases. Immunologic Factors. Blood Banks > WH 155 Anemia
Digital Object Identifer (DOI):	https://doi.org/10.1111/j.1365-3156.2006.01787.x
Depositing User:	Ms Julia Martin
Date Deposited:	16 Dec 2010 10:48
Last Modified:	31 May 2018 14:09
URI:	https://archive.lstmed.ac.uk/id/eprint/1292

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