Article: The effectiveness and perception of the use of sulphadoxine-pyrimethamine in intermittent preventive treatment of malaria in pregnancy programme in Offinso district of Ashanti region, Ghana.[show abstract] [hide abstract]
ABSTRACT: Malaria in pregnant women has been shown to be associated with low birth weight, stillbirth and mortality in newborns. The WHO has adopted the use of sulphadoxine-pyrimethamine (SP) to control malaria, a disease which worsens the plight of pregnant women leading to low birth weight, stillbirths and increased neonatal mortality. The present study assessed the effectiveness of SP and perception of its use in pregnant women in Offinso district (Ashanti Region), Ghana. Pregnant women, gestational age 32 weeks prior to term, were studied from November 2006 to October 2007. Their haemoglobin levels (Hb), parasitaemia and other quantitative determinants were assessed. In-depth interviews (IDIs) and focus group discussions (FGDs) were used to assess the perception of SP usage and its effectiveness. Of the 306 study participants, 92 (30%) took one dose, 100 (33%) two doses and 114 (37%) three doses of SP, respectively. There was significant association between gravidity and SP dosage taken (Pearson χ2 = 18.9, p < 0.001). Although adverse effects were produced in 113 (i.e. 37%) of the pregnant women, no significant difference was observed with regard to the dosage of SP taken (Pearson's χ2 = 2.3, p ≥ 0.32). Peripheral parasitaemia was present in 47 (15%) of the subjects. There was a poor negative relationship of doses of SP with parasitaemia (r = -0.07, p ≥ 0.24). Mean Hb was 11.3 ± 1.6 g/dl, with 118 (39%) of the subjects anaemic (Hb < 11.0 g/dl), whilst 187 (61%) were normal (Hb ≥11.0 g/dl). Significant positive correlation of SP use with Hb level (r = 0.15, p < 0.008) was observed. SP use reduced malaria and anaemia prevalence, contributed to reduced maternal morbidity with mild side effects being reported. This study points to the effectiveness of IPTp using SP as an evidence-based measure for control of malaria and malaria-related anaemia in pregnancy. Therefore, the Ghana Health Service should improve current programme strategies to increase the proportion of pregnant women who take three doses of SP, paying attention to improved face-to-face health education, focussed antenatal care and better social mobilization.Malaria Journal 12/2011; 10:385. · 3.19 Impact Factor
Article: Effect of Sulphadoxine –Pyrimethamine on neonatal birth weight and perceptions on its impact on malaria in pregnancy in an IPTp setting in Offinso District, Ghana.[show abstract] [hide abstract]
ABSTRACT: This study evaluated the effect of sulphadoxine–pyrimethamine (SP) use in intermittent preventive treatment of malaria in pregnancy (IPTp) on birth weights of neonates in a stable malaria transmission area of Ghana, Offinso District. Routine delivery data from six health facilities over the period January 2005 to October 2007 were reviewed. In-depth interviews were conducted for health staff of these facilities to assess the effect of SP use in IPTp in pregnancy. SP–IPTp improved the birth weight of neonates and the effects of age, parity, term of pregnancy and sex of neonate also had significant influence on the birth weight (P < 0.0001). The variation in birth weight of the neonates, however, did not show significant difference (OR = 0.91, 95% CI 0.8–1.1, P ≥ 0.26) over the period and seasonal variations had no effect on birth weight (OR = 0.84, 95% CI 0.7–1.1, P ≥ 0.18). Health personnel attested to the fact that SP–IPTp had reduced the burden of malaria cases in pregnancy and improved birth weight of neonates. This study, thus, shows that successful implementation of the SP–IPTp strategy will improve the birth weight of neonates, and consequently reduce neonatal mortality. © 2011 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.International Health. 01/2011; 3:206-212.
Article: Genetic diversity of Plasmodium falciparum in pregnant women in an IPTp setting in the Offinso District of Ghana[show abstract] [hide abstract]
ABSTRACT: Plasmodium falciparum, the most virulent and deadly of all the malaria species is known to be genetically diverse. This cross–sectional study assessed the genetic diversity of P. falciparum parasites in pregnant women in the Offinso District. Blood samples of pregnant women, irrespective of their intermittent preventive treatment of malaria in pregnancy (IPTp) status, were examined for parasitaemia and species identified, from October 2005 to June 2007. Blood blot filter mats were prepared from each participant’s blood sample and used for parasite DNA extraction and PCR analysis. DNA extraction was carried out for 126 samples using the Tris-EDTA buffer-based method. Nested PCR reactions were performed for each of the three polymorphic markers msp1, msp2 and glurp. PCR amplifications were successful in 22, 43 and 56% of samples for msp1, msp2 and glurp, respectively. The msp1 (11 alleles) and msp2 (16 alleles) revealed considerably greater parasite diversity than glurp (5 alleles). Msp2 allelic families were more diverse in comparison with msp1 and glurp. The diversity of parasites threatens the effectiveness of using sulphadoxine – pyrimethamine (SP) in IPTp, hence, the need for continuous monitoring to promptly capture any development of resistance to SP.Journal of Parasitology and Vector Biology. 01/2011; 3:12-18.
Article: The effect of intermittent preventive treatment using sulphadoxine pyrimethamine in control of malaria in pregnancy: A cross-sectional study in the Offinso district of Ghana[show abstract] [hide abstract]
ABSTRACT: Malaria infection during pregnancy causes maternal anaemia and placental parasitaemia both of which pose substantial risks to the mother, the foetus and the newborn. This study assessed the effects of intermittent preventive treatment (IPTp) using Sulphadoxine-Pyrimethamine (SP) to control malaria in pregnancy in the Offinso district, Ghana. Pregnant women attending antenatal clinics (ANC) between October 2005 and June 2006 in five health facilities in the District were studied. The effects of SP on parasitaemia, haemoglobin level and adverse effects on pregnant women were assessed. Of the 444 pregnant women studied, 190 (43%) took SP. The influence of SP intake on malaria infection was insignificant (r = 0.0008, p = 0.986). However, there was a tendency towards reduced parasitaemia as number of SP doses increased; one dose: 29/82 (35%), two doses: 18/57 (32%) and three doses: 11/57 (22%). The mean Hb level (10.4 ± 1.69 g/dl) for the SP group (all doses combined) was significantly higher than that (9.9 ± 1.64 g/dl) in the no SP group (p = 0.002). Further, there was a significant association between IPTp using SP and haemoglobin level (p = 0.01) with a dose-response relationship. SP usage had no significant adverse effects on the pregnant women. Effective implementation of IPTp using SP is an evidence-based measure for control of malaria-related anaemia in pregnancy.Journal of Public Health and Epidemiology. 01/2010; 2:53-59.