Effectiveness of intermittent preventive treatment with Sulfadoxine-Pyrimethamine in pregnant women in San Pedro, Côte D’Ivoire

ABSTRACT

Malaria remains a major public health issue for pregnant women. Côte d’Ivoire has adopted a series of measures aimed at combatting this plague, and these measures include administering Sulfadoxine-Pyrimethamine (SP) as an intermittent preventive treatment to pregnant women in the second and third terms.

This cross-sectional study included a parturient population after informed written consent. We recruited women from the Terre Rouge maternity ward and the labor room of the Regional Medical Center of San-Pedro. Plasmodial DNA (desoxyribo nucleic acid) was extracted from Whatman filter papers with dried blood samples prepared from the venous, placental, and cord blood, utilizing Chelex 100. The extracts obtained were amplified by nested PCR.

In all, 197 women were included, with an average age of 27-year-old (sd = 6.7 years old). The rates of the placental, venous and cord blood infections were 16, 2%, 15, 2% and 3, 6%, respectively. The women who took three doses of ITP were less infected at the cord (3, 2%), placental (10,6%) and venous level (13,8%). A statistically significant relationship between the number of doses and the rate of placental infection was established (p = 0.042). IPT reduces plasmodial infestation at the placental (OR = 0.4; CI = [0.2–1]), cord (OR = 0.8; CI = [0.2–3.7]) and venous (OR = 0.8; CI = [0.6–2.3]) level.

In conclusion, the low frequency of placental, venous, and cord infestation in pregnant women who consistently followed a preventive treatment strategy clearly showed the efficiency of IPT against malaria during pregnancy.

KEYWORDS:

• Malaria
• Sulfadoxine-Pyrimethamine
• preventive treatment
• pregnancy

Acknowledgments

The authors would like to thank the women who participated in the study and the medical staff, in particular the midwives of the Terre Rouge Maternity Hospital and the CHR of San Pedro. The authors would like to acknowledge useful contributions from the Global Fund and the National Malaria Control Program that initiated this study and also the staff of the Malaria Research and Control Centre.

Disclosure statement

The authors declare that they have no competing interests.