In-vivo parasitological response to sulfadoxine-pyrimethamine in pregnant women in southern Malawi

Msyamboza, K, Amanor, A, Kazembe, P, Brabin, Bernard, Meshnick, S and Mwapasa, V (2007) 'In-vivo parasitological response to sulfadoxine-pyrimethamine in pregnant women in southern Malawi'. Malawi medical journal, Vol 19, Issue 1, pp. 11-13.

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Abstract

BACKGROUND
Malaria in pregnancy is a significant cause of maternal and infant morbidity and mortality. Malawi adopted intermittent preventive treatment with sulfadoxinepyrimethamine (SP) for the control of malaria in pregnancy in 1993. However there is little information on the in-vivo SP efficacy in pregnant women. This study was conducted to determine: prevalence of malaria and anaemia at the first antenatal visit and rate of parasitological failure to SP in pregnancy.

METHODS
A cross-sectional followed by a prospective cohort study was conducted in women attending antenatal care clinic at Montfort Hospital in Lower Shire Valley from June 2004 to February 2005. Women were screened for malaria and anaemia at the first antenatal visit. After taking SP under direct observation, women with malaria parasitaemia were followed up to day 14 to determine parasitological response.

RESULTS
Of 961 women screened, 9% had malaria, 77% had anaemia (HB<11.0g/dl), 24% had moderate anaemia (HB 7.0-8.9g/dl) and 6% had severe anaemia (HB<7.0g/dl). Malaria was significantly more frequent in primigravidae, the second trimester and in the post- rainy season (all p <0.05). Moderate anaemia (Hb < 9.0g/dl) was significantly more common in adolescents and primigravidae (both p <0.05). In the14-day follow up study, loss to follow up was 13%. Of the 74 women who completed the follow up, 89% cleared malaria parasites successfully and 11% had parasitological failure. Parasitological failures were all of the R1 type except for one with R2 failure.

CONCLUSION
Anaemia prevalence was high at first antenatal visit in this population. Rate of parasitological failure to SP in pregnancy increased from 5% in 1996 to 11% in 2004.

Item Type:	Article
Subjects:	QV Pharmacology > Anti-Inflammatory Agents. Anti-Infective Agents. Antineoplastic Agents > QV 256 Antimalarials WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria WH Hemic and Lymphatic Systems > Hematologic Diseases. Immunologic Factors. Blood Banks > WH 155 Anemia WQ Obstetrics > Pregnancy Complications > WQ 240 Pregnancy complications (General) WQ Obstetrics > Pregnancy Complications > WQ 256 Infectious diseases
Faculty: Department:	Groups (2002 - 2012) > Child & Reproductive Health Group
Digital Object Identifer (DOI):	https://doi.org/10.4314/mmj.v19i1.10926
Depositing User:	Martin Chapman
Date Deposited:	15 Jan 2015 11:10
Last Modified:	06 Feb 2018 13:08
URI:	https://archive.lstmed.ac.uk/id/eprint/4750

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