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Kamga SLS, Ali IM, Ngangnang GR, Ulucesme MC, Keptcheu LTD, Keming EM, Tchuenkam VPK, Foyet JV, Aktas M, Noubom M, Payne VK. Uptake of intermittent preventive treatment of malaria in pregnancy and risk factors for maternal anaemia and low birthweight among HIV-negative mothers in Dschang, West region of Cameroon: a cross sectional study. Malar J 2024; 23:6. [PMID: 38178125 PMCID: PMC10768405 DOI: 10.1186/s12936-023-04816-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/06/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Approximately 32 million pregnant women are at risk of malaria with up to 10,000 maternal deaths and 200,000 neonates at risk annually. Intermittent Preventive Treatment (IPT) with sulfadoxine-pyrimethamine (SP) is recommended by the World Health Organization (WHO) to reduce disease in pregnancy and adverse maternal and newborn outcomes. At least three doses of SP should be taken by pregnant women during antenatal consultation (ANC) beginning from the thirteenth week of pregnancy till parturition. The aim of this study was to assess uptake of IPT during pregnancy and risk factors for maternal anaemia and infant birth weight in Dschang, West region of Cameroon. METHODS A total of 380 consenting pregnant women at delivery were recruited in a cross- sectional prospective survey between January to December 2021. Data on ANC attendance, total dose of IPT and history of malaria were abstracted from hospital ANC records while socio-demographic characteristics, bed net use and obstetrics history of each participant were also recorded through an interview. Further, blood samples were collected from the intervillous space for assessment of maternal anaemia and microscopic parasitology. Nested PCR based on amplification of the Plasmodium 18S sRNA was carried out to detect submicroscopic infection. IPTp coverage was calculated per WHO recommendation and the prevalence of anaemia and low birth weight were estimated as proportions in the total sample of pregnant women and live births, respectively. Crude and adjusted odds ratios and their 95% confidence intervals were used to estimate associations between pregnancy outcomes considered and risk factors in specific and general models. A p < 0.05 was considered significant. The R software (V4.1.4) was used for all analyses. RESULTS A majority of pregnant women was aged between 24 and 34 years old (59.2%) and had secondary education (58.8%). Uptake of ≥ 3 IPTp was 64.99% with 77.20% of all who received at least one IPTp doses taking a mix of SP and DP or DP alone in successive ANC contacts. Those with four or more ANC contacts (73.42%) were more likely to have received at least one IPTp. Furthermore, 13.9% of live births had low birthweights (BW < 2500 g) and one in four parturient women with moderate anaemia by WHO criteria. Microscopy (blood smear examination) and PCR-based diagnosis revealed between 0% and 1.57% of parasite-infected placental samples, respectively. Reported malaria in pregnancy predicted maternal anaemia at birth but not birth weight. Only gestational age (< 37 weeks) and bed net use (< 5 months) significantly predicted infant birth weight at delivery. CONCLUSION The uptake of WHO recommended IPT doses during pregnancy was moderately high. Reported malaria in pregnancy, poor bed net coverage, gestational age less than 37 weeks adversely affect maternal haemoglobin levels at birth and infant birth weight. Asymptomatic and submicroscopic placental parasite infections was found at low prevalence. Together these results highlight the importance of maintaining aggressive measures to prevent malaria in pregnancy and protect the health of mother and baby.
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Affiliation(s)
- Sabrina Lynda Simo Kamga
- Research Unit of Biology and Applied Ecology, Department of Animal Biology, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Innocent Mbulli Ali
- Research Unit of Microbiology and Antimicrobial Substances, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon.
- The Biotechnology Centre, University of Yaounde 1, Yaounde, Cameroon.
| | - Ghislain Romeo Ngangnang
- Research Unit of Biology and Applied Ecology, Department of Animal Biology, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Mehmet Can Ulucesme
- Laboratory of Molecular Parasitology, Department of Parasitology, University of Firät, Elazig, Turkey
| | - Leonard T D Keptcheu
- Research Unit of Biology and Applied Ecology, Department of Animal Biology, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Eva Mai Keming
- Research Unit of Microbiology and Antimicrobial Substances, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
- The Biotechnology Centre, University of Yaounde 1, Yaounde, Cameroon
| | - Valery-Pacome Kom Tchuenkam
- Research Unit of Microbiology and Antimicrobial Substances, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
- The Biotechnology Centre, University of Yaounde 1, Yaounde, Cameroon
| | - Juluis Visnel Foyet
- Research Unit of Biology and Applied Ecology, Department of Animal Biology, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Münir Aktas
- Laboratory of Molecular Parasitology, Department of Parasitology, University of Firät, Elazig, Turkey
| | - Michel Noubom
- Department of Clinical Biology, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - Vincent K Payne
- Research Unit of Biology and Applied Ecology, Department of Animal Biology, Faculty of Science, University of Dschang, Dschang, Cameroon.
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Kana MA, Shi M, Ahmed J, Ibrahim JM, Ashir AY, Abdullahi K, Bello-Manga H, Taingson M, Mohammed-Durosinlorun A, Shuaibu M, Tabari AM, London SJ. Biomass fuel use and birth weight among term births in Nigeria. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000419. [PMID: 36962417 PMCID: PMC10022098 DOI: 10.1371/journal.pgph.0000419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 04/22/2022] [Indexed: 11/18/2022]
Abstract
Despite the high burden of household air pollution from biomass fuel in sub-Saharan Africa, the association of prenatal biomass fuel exposure and birth weight as a continuous variable among term births has not been extensively studied. In this study, our primary aim is to estimate the association between biomass cooking fuel and birth weight among term births in Kaduna, northwestern Nigeria. For replication, we also evaluated this association in a larger and nationally representative sample from the 2018 Nigerian Demographic and Health Survey (DHS). Our primary analysis included 1,514 mother-child pairs recruited from Kaduna, in northwestern Nigeria, using the Child Electronic Growth Monitoring System (CEGROMS). Replication analysis was conducted using data from 6,975 mother-child pairs enrolled in 2018 Nigerian DHS. The outcome variable was birth weight, and the exposure was cooking fuel type, categorized in CEGROMS as liquefied petroleum gas, kerosene, or biomass fuel, and in the DHS as low pollution fuel, kerosene, or biomass fuel. We estimated covariate adjusted associations between birth weight and biomass fuel exposure in CEGROMS using linear regression and using linear mixed model in the DHS. In CEGROMS, adjusting for maternal age, education, parity, BMI at birth, and child sex, mothers exposed to biomass fuel gave birth to infants who were on average 113g lighter (95% CI -196 to -29), than those using liquified petroleum gas. In the 2018 Nigeria DHS data, compared to low pollution fuel users, mothers using biomass had infants weighing 50g (95% CI -103 to 2) lower at birth. Exposure to biomass cooking fuel was associated with lower birth weight in our study of term newborns in Kaduna, Nigeria. Data from the nationally representative DHS provide some support for these findings.
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Affiliation(s)
- Musa Abubakar Kana
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, North Carolina, United States of America
- Department of Epidemiology and Community Medicine, Federal University of Lafia, Lafia, Nasarawa State, Nigeria
- College of Medicine, Kaduna State University, Kaduna, Kaduna State, Nigeria
- Barau Dikko Teaching Hospital, Kaduna, Kaduna State, Nigeria
| | - Min Shi
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, North Carolina, United States of America
| | - Jennifer Ahmed
- Barau Dikko Teaching Hospital, Kaduna, Kaduna State, Nigeria
| | - Jimoh Muhammad Ibrahim
- College of Medicine, Kaduna State University, Kaduna, Kaduna State, Nigeria
- Barau Dikko Teaching Hospital, Kaduna, Kaduna State, Nigeria
| | | | | | - Halima Bello-Manga
- College of Medicine, Kaduna State University, Kaduna, Kaduna State, Nigeria
- Barau Dikko Teaching Hospital, Kaduna, Kaduna State, Nigeria
| | - Matthew Taingson
- College of Medicine, Kaduna State University, Kaduna, Kaduna State, Nigeria
- Barau Dikko Teaching Hospital, Kaduna, Kaduna State, Nigeria
| | - Amina Mohammed-Durosinlorun
- College of Medicine, Kaduna State University, Kaduna, Kaduna State, Nigeria
- Barau Dikko Teaching Hospital, Kaduna, Kaduna State, Nigeria
| | - Musa Shuaibu
- College of Medicine, Kaduna State University, Kaduna, Kaduna State, Nigeria
- Barau Dikko Teaching Hospital, Kaduna, Kaduna State, Nigeria
| | - Abdulkadir Musa Tabari
- College of Medicine, Kaduna State University, Kaduna, Kaduna State, Nigeria
- Barau Dikko Teaching Hospital, Kaduna, Kaduna State, Nigeria
| | - Stephanie J. London
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, North Carolina, United States of America
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Outcomes and Disease Spectrum of LBW Neonates in a Secondary Health Facility. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:9974636. [PMID: 35126962 PMCID: PMC8813240 DOI: 10.1155/2022/9974636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 12/23/2021] [Accepted: 01/10/2022] [Indexed: 11/18/2022]
Abstract
Globally, 30 million low birth weight (LBW) babies are born every year and 95% of them are from developing countries. LBW neonates are at a high risk of mortality, morbidity, and long-term disability. The objective of this study is to investigate outcomes and disease spectrum among low birth weight neonates. This is a prospective, observational study conducted on 540 neonates admitted in the Mother and Child Hospital, Akure, Ondo State, Nigeria, from 2017 to 2018. Questionnaire, interview, clinical, and diagnostic procedures were used as research tools. There were 137 low birth weight (LBW) neonates, with the mean mothers’ age of 31.92 ± 6.60. Of the 540 neonates, 69 (50.4%) and 68 (49.6%) were term and preterm, respectively. There were 64 female neonates (46.7%) and 73 male neonates (53.3%). The mean weight of the neonates was 1.82 ± 0.44 kg, and mean number of days on admission was 6.42 ± 6.75 days. Neonatal sepsis (NNS) was the highest morbidity 51 (37.2%) among the LBW neonates, followed by prematurity 47 (34.4%) and neonatal jaundice (NNJ) 18 (13.1%). Sex (χ2 = 3.584,
), mode of delivery (χ2 = 4.669,
), and gestational age (χ2 = 3.904,
) were not a significant determinant of outcome among LBW neonates. Men were 2.36 times more likely to be preterm (OR = 2.36, 95% CL = 1.01–5.54,
) among LBW neonates. Outcomes of LBW neonates who were delivered by SVD were not significant compared to preterm delivered by CS (OR = 0.46, 95% CL = 0.13–1.65,
). Sixty percent (60%) of the mothers had Prolonged Rupture of Membranes (PROM). Morbidities such as hypothermia (72.2%), apnoea (63.6%), haemorrhagic disease of the newborn (HDN) (66.7%), and respiratory distress syndrome (RDS) (66.7%) were more observed with preterm LBW neonates. Importance of qualitative antenatal care (ANC) should be emphasized; anticipation and prevention of LBW births can help mitigate some of the problems they are prone to.
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Zango SH, Lingani M, Valea I, Samadoulougou OS, Bihoun B, Lankoande D, Donnen P, Dramaix M, Tinto H, Robert A. Association of malaria and curable sexually transmitted infections with pregnancy outcomes in rural Burkina Faso. BMC Pregnancy Childbirth 2021; 21:722. [PMID: 34706705 PMCID: PMC8549350 DOI: 10.1186/s12884-021-04205-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 10/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria and curable sexually transmitted infections (STIs) are severe infections associated with poor pregnancy outcomes in sub-Saharan countries. These infections are responsible for low birth weight, preterm birth, and miscarriage. In Burkina Faso, many interventions recommended by the World Health Organization were implemented to control the impact of these infections. After decades of intervention, we assessed the impact of these infections on pregnancy outcomes in rural setting of Burkina Faso. METHODS Antenatal care and delivery data of pregnant women attending health facilities in 2016 and 2017 were collected in two rural districts namely Nanoro and Yako, in Burkina Faso. Regression models with likelihood ratio test were used to assess the association between infections and pregnancy outcomes. RESULTS During the two years, 31639 pregnant women received antenatal care. Malaria without STI, STI without malaria, and their coinfections were reported for 7359 (23.3%), 881 (2.8 %), and 388 (1.2%) women, respectively. Low birth weight, miscarriage, and stillbirth were observed in 2754 (10.5 %), 547 (2.0 %), and 373 (1.3 %) women, respectively. Our data did not show an association between low birth weight and malaria [Adjusted OR: 0.91 (0.78 - 1.07)], STIs [Adjusted OR: 0.74 (0.51 - 1.07)] and coinfection [Adjusted OR: 1.15 (0.75 - 1.78)]. Low birth weight was strongly associated with primigravidae [Adjusted OR: 3.53 (3.12 - 4.00)]. Both miscarriage and stillbirth were associated with malaria [Adjusted OR: 1.31 (1.07 - 1.59)], curable STI [Adjusted OR: 1.65 (1.06 - 2.59)], and coinfection [Adjusted OR: 2.00 (1.13 - 3.52)]. CONCLUSION Poor pregnancy outcomes remained frequent in rural Burkina Faso. Malaria, curable STIs, and their coinfections were associated with both miscarriage and stillbirth in rural Burkina. More effort should be done to reduce the proportion of pregnancies lost associated with these curable infections by targeting interventions in primigravidae women.
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Affiliation(s)
- Serge Henri Zango
- Pôle d'Epidémiologie et biostatistique, Université catholique de Louvain (UCLouvain), Institut de Recherche Expérimentale et Clinique (IREC), Clos Chapelle-aux-Champs, 30 bte B1.30.13, 1200, Brussels, Belgique. .,Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso. .,Centre MURAZ, Institut National de Santé Publique (INSP), Bobo-Dioulasso, Burkina Faso.
| | - Moussa Lingani
- Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso.,École de santé publique, Université Libre de Bruxelles, CP594, route de Lennik 808, 1070, Bruxelles, Belgique
| | - Innocent Valea
- Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso.,Centre MURAZ, Institut National de Santé Publique (INSP), Bobo-Dioulasso, Burkina Faso
| | - Ouindpanga Sekou Samadoulougou
- Pôle d'Epidémiologie et biostatistique, Université catholique de Louvain (UCLouvain), Institut de Recherche Expérimentale et Clinique (IREC), Clos Chapelle-aux-Champs, 30 bte B1.30.13, 1200, Brussels, Belgique
| | - Biebo Bihoun
- Pôle d'Epidémiologie et biostatistique, Université catholique de Louvain (UCLouvain), Institut de Recherche Expérimentale et Clinique (IREC), Clos Chapelle-aux-Champs, 30 bte B1.30.13, 1200, Brussels, Belgique.,Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso
| | - Diagniagou Lankoande
- Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso
| | - Phillipe Donnen
- École de santé publique, Université Libre de Bruxelles, CP594, route de Lennik 808, 1070, Bruxelles, Belgique
| | - Michele Dramaix
- École de santé publique, Université Libre de Bruxelles, CP594, route de Lennik 808, 1070, Bruxelles, Belgique
| | - Halidou Tinto
- Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso.,Centre MURAZ, Institut National de Santé Publique (INSP), Bobo-Dioulasso, Burkina Faso
| | - Annie Robert
- Pôle d'Epidémiologie et biostatistique, Université catholique de Louvain (UCLouvain), Institut de Recherche Expérimentale et Clinique (IREC), Clos Chapelle-aux-Champs, 30 bte B1.30.13, 1200, Brussels, Belgique
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Ifebude J, Idowu C, Awolude O. Use of intermittent preventive therapy and incidence of acute malaria in pregnancy among postpartum women at University College Hospital, Ibadan, Nigeria. NIGERIAN JOURNAL OF MEDICINE 2021. [DOI: 10.4103/njm.njm_155_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kana MA, Safiyan H, Yusuf HE, Musa ASM, Richards-Barber M, Harmon QE, London SJ. Association of intimate partner violence during pregnancy and birth weight among term births: a cross-sectional study in Kaduna, Northwestern Nigeria. BMJ Open 2020; 10:e036320. [PMID: 33268398 PMCID: PMC7716372 DOI: 10.1136/bmjopen-2019-036320] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To determine the association of prenatal exposure to intimate partner violence (IPV) with birth weight as a continuous variable among term births in a Nigerian population. DESIGN Cross-sectional study. SETTING Mother-child pairs recruited when their newborns were brought for BCG or other vaccines shortly after birth at the Child Welfare Clinic of Barau Dikko Teaching Hospital, Kaduna, Nigeria. PARTICIPANTS 293 women with term birth infants. MAIN EXPOSURE AND OUTCOME MEASURES Emotional, physical and sexual IPV were measured postnatally by interview using the Conflict Tactics Scale. Birth weight in grams was the main outcome measure. Linear regression, with adjustment for covariates, was used to estimate associations between birth weight and exposure to the presence, and frequency, of IPV. RESULTS Sixty-seven per cent of mothers experienced at least one of the three forms of IPV during pregnancy. Relative to the 33% of women with no prenatal exposure to any form of IPV, we observed a reduction in birth weight of 94 g (95% CI: -202 to 15) for prenatal exposure to emotional IPV, 162 g (95% CI -267 to -58) for physical IPV and 139 g (95% CI -248 to -30) for sexual IPV. The combination of all three forms of IPV was associated with a 223 g reduction in birth weight (95% CI -368 to -77). Increasing occurrences of each of the three types of IPV were associated with greater reductions in birth weight. For physical IPV, relative to no exposure to any form of IPV, birth weight was lower by 112 g (95% CI -219 to -4) with 1-5 instances and 380 g (95% CI -553 to -206) for >5 instances over the pregnancy. CONCLUSIONS Maternal exposure to IPV was associated with shifting of the birth weight distribution among term newborns. A dose-response relationship was observed between frequency of IPV and birth weight.
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Affiliation(s)
- Musa Abubakar Kana
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, North Carolina, USA
- Department of Epidemiology and Community Medicine, Federal University Lafia, Lafia, Nigeria
- Department of Community Medicine, Kaduna State University, Kaduna, Nigeria
| | - Halima Safiyan
- Department of Social Sciences, Kaduna Polytechnic, Kaduna, Nigeria
| | | | | | | | - Quaker E Harmon
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, North Carolina, USA
| | - Stephanie J London
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, North Carolina, USA
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The Effectiveness of the Revised Intermittent Preventive Treatment with Sulphadoxine Pyrimethamine (IPTp-SP) in the Prevention of Malaria among Pregnant Women in Northern Ghana. J Trop Med 2020; 2020:2325304. [PMID: 33299426 PMCID: PMC7704196 DOI: 10.1155/2020/2325304] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/09/2020] [Accepted: 10/26/2020] [Indexed: 11/28/2022] Open
Abstract
This study investigated the effectiveness of the World Health Organization (WHO)-revised Intermittent Preventive Treatment using Sulphadoxine Pyrimethamine (IPTp-SP) dosage regimen in the prevention of malaria infections in pregnancy. The study involved a prospective cohort of pregnant women who attended the antenatal clinic in four health facilities (Tamale Teaching Hospital, Tamale West Hospital, Tamale Central Hospital, and Tamale SDA Hospital) within the Tamale metropolis. Data collection spanned a period of 12 months, from September 2016 to August 2017, to help account for seasonality in malaria. The study included 1181 pregnant women who attended antenatal clinics in four hospitals within the metropolis. The registers at the facilities served as a sampling frame, and the respondents were randomly sampled out from the number of pregnant women available during each visit. They were enrolled consecutively as they kept reporting to the facility to receive antenatal care. The participants were stratified into three groups; the no IPTp-SP, <3 doses of IPTp-SP, and ≥3 doses of IPTp-SP. The participants were followed up until 36 weeks of gestation, and blood samples were analyzed to detect the presence of peripheral malaria parasites. At the end of the study, 42.4% of the women had taken at least 3 doses of SP based on the revised WHO IPTp-SP policy. Pregnant women who had taken at least 3 doses of IPTp-SP had a malaria prevalence of 16.9% at 36 weeks of gestation, compared to 35.8% of those who had not taken IPTp-SP. In the multivariable logistic regression, those who had taken ≥3 doses of SP were associated with 56% reduced odds (aOR 0.44, CI 0.27–0.70, P = 0.001) of late gestational peripheral malaria, compared with those who did not take SP. IPTp-SP served under three or more doses provided a dose-dependent protection of 56% against maternal peripheral malaria parasitaemia detectable at the later stages of gestation (36 weeks). Since the dose-dependent potency of IPTp-SP depletes with time, there is the need for research into more sustainable approaches that offer longer protection.
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