Journal articles: 'Intermittent preventive treatment in pregnancy (IPTp)'

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Bina K., Nalongo. "Evaluating the Impact of Community-Based Intermittent Preventive Treatment on Malaria Incidence Among Pregnant Women in Rural Uganda: A Cluster Trial." Research Output Journal of Public Health and Medicine 5, no. 3 (2025): 67–70. https://doi.org/10.59298/rojphm/2025/5316770.

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Malaria remains a major cause of maternal morbidity and adverse pregnancy outcomes in sub-Saharan Africa, with rural Uganda experiencing significant challenges in ensuring effective intermittent preventive treatment during pregnancy (IPTp). Community-based intermittent preventive treatment (C-IPTp) offers a promising approach to overcoming barriers such as healthcare inaccessibility and poor adherence to facility-based IPTp. This review evaluated the impact of C-IPTp on malaria incidence among pregnant women in rural Uganda using evidence from a cluster trial methodology, where villages or health sub-districts were assigned either to the intervention or to standard facility-based IPTp. The review synthesized data on malaria incidence reduction, maternal and neonatal health improvements, and increased IPTp coverage through community health worker (CHW) engagement. Findings indicated that C-IPTp significantly enhances adherence, reduces malaria prevalence, and lowers maternal anemia and low birth weight rates. However, challenges such as drug stockouts, community acceptability, and health system integration must be addressed to optimize implementation. Strengthening CHW support, improving drug supply chains, and enhancing community sensitization are critical for sustainable success. Policymakers should integrate C-IPTp into Uganda’s national malaria strategy, ensuring long-term feasibility and scalability for enhanced maternal health outcomes. Keywords: Community-based intermittent preventive treatment (C-IPTp), Malaria prevention in pregnancy, Maternal health in rural Uganda, Cluster trial methodology, Community health workers (CHWs).

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Odjidja, Emmanuel N., and Predrag Duric. "Evaluation of demand and supply predictors of uptake of intermittent preventive treatment for malaria in pregnancy in Malawi." MalariaWorld Journal 8, no. 20 (2017): 1–7. https://doi.org/10.5281/zenodo.10781315.

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Background. The intermittent preventive treatment (IPTp) policy of Malawi (2002) stipulates that IPTp is administered during antenatal care as a direct observation therapy (DOT). The policy further recommends that IPT should be administered monthly after 16 weeks of pregnancy until delivery. This study assessed both the demand and supply factors contributing to higher dropout of IPT after the first dose. Optimal number of doses was pegged at a minimum of three in accordance with WHO recommendation. Materials and methods. Data were analysed from the Malawi multiple indicator cluster survey (2015) and the service provision assessment (2014) of 6637 women (aged 15– 49 yrs), 763 facilities and 2105 health workers. The sample was made up of pregnant women, health facilities and workers involved in routine antenatal services across all regions of Malawi. A composite indicator was constructed to report integration of IPTp with ANC services and administration of IPTp-SP as DOT. Multivariate and logistic regression were conducted to determine associations. Results. Regression analysis found that: 1. Age of women (women 35–49 yrs, AOR 1.98; 95% CI 1.42 – 2.13, number of children as well as the number of ANC visits were associated with optimal uptake of IPTp. 2. Administering IPT as DOT was higher in facilities in rural areas (AOR 1.86; 95% CI 1.54 – 1.92) than in urban areas. 3. Administration of IPTp as DOT was relatively lower in across all facilities with highest being facilities managed by CHAM (72.8%, AOR 1.40; 95% CI 1.22 – 1.54) Conclusion. Health system bottlenecks were found to present the main cause of low coverage with optimal doses of IPTp. Incorporating these results into strategic policy IPTp formulation could help improve coverage to desired levels. This study could serve as plausible evidence for government and donors when planning malaria in pregnancy interventions, especially in remote parts of Malawi.

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Buh, Amos, Komlan Kota, Ghose Bishwajit, and Sanni Yaya. "Prevalence and Associated Factors of Taking Intermittent Preventive Treatment in Pregnancy in Sierra Leone." Tropical Medicine and Infectious Disease 4, no. 1 (2019): 32. http://dx.doi.org/10.3390/tropicalmed4010032.

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Malaria infection during pregnancy is a major public health problem in sub-Saharan Africa. The World Health Organization (WHO) recommends that gestational and congenital malaria can be prevented by using intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP). IPTp-SP is a full therapeutic course of antimalarial medicine administered during pregnancy as a component of antenatal care. This study’s objective was to assess the prevalence and predictors of IPTp-SP uptake in pregnancy in Sierra Leone. This study was based on the fifth round of the Multiple Indicator Cluster Survey (MICS 5) conducted in Sierra Leone in 2016. Participants were 8526 women aged between 15–49 years. Outcome variables were uptake of IPTp-SP during the last pregnancy. Data were analysed using cross-tabulation and logistic regression methods. Results showed that the prevalence of taking IPTp-SP was 94.81% (92.40, 96.14), and that the prevalence of taking at least three doses was 93.24% (92.50, 94.81). In the multivariate logistic regression, education, parity, and antenatal care (ANC) use were significant predictors of IPTp-SP uptake. Women with higher education had lower odds of taking IPTp-SP (Odds Ratio = 0.647, 95%CI = 0.444, 0.943); having higher parity (>4) was associated with lower odds of taking IPTp-SP (OR = 0.663; 95%CI = 0.442, 0.994) and adequate ANC use increased the odds of taking IPTp-SP in both urban (OR = 1.450, 95%CI = 1.158, 3.128) and rural areas (OR = 1.903, 95%CI = 1.069, 1.966). In contrast, the positive association between ANC visits and adequate doses of taking IPTp-SP was true for rural women only (OR = 1.408, 95%CI = 1.174, 1.689). In conclusion, the use of IPTp-SP is close to being universal, with the prevalence being relatively higher in the rural areas. Based on our findings, promoting adequate antenatal care visits should be regarded as a key strategy to improve the use of IPTp-SP in Sierra Leone. Further studies could focus on exploring other predictors of IPTp-SP uptake that are not captured by MICS in Sierra Leone.

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Patricia, Ogba, Baumann Andrea, Chidwick Hanna, Banfield Laura, and D. DiLiberto Deborah. "Barriers and facilitators to access and uptake of intermittent preventive treatment with sulfadoxine-pyrimethamine among pregnant women in Nigeria: a scoping review." MalariaWorld Journal 13, no. 4 (2022): 1–18. https://doi.org/10.5281/zenodo.8205236.

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Malaria in pregnancy is a significant public health concern in Nigeria. It threatens pregnant women and their unborn babies and undermines the achievement of Sustainable Development Goal 3. The World Health Organization has recommended intermittent preventive treatment with sulfadoxine-pyrimethamine [IPTp-SP] for its control, but there are challenges to its access and uptake. Using the Arksey and O'Malley framework and the cascade of care model, we conducted a scoping review to investigate barriers and facilitators of IPTp-SP access and uptake, including their influence on pregnant women's health-seeking behaviour for the control of malaria in pregnancy in Nigeria. We searched seven scientific databases for papers published from 2005 to date. We included a total of 31 out of 2149 articles in the review. Poor provider knowledge of the IPTp-SP protocol and lack of essential commodities for sulphadoxine-pyrimethamine administration in clinics are significant barriers to IPTp-SP use. Staff shortages and poor remuneration of health care professionals are obstacles to IPTp-SP utilisation. To improve IPTp-SP access and uptake, the government should ensure a continuous supply to clinics and support the employment of additional health care professionals who should be well paid and trained on using the IPTp-SP protocol.

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C.E., Abaribe, Odufowokan M., Dike C., Komolafe F., Ogungbesan J., and Opatunji F. "Uptake of Intermittent Preventive Treatment of Malaria Among Pregnant Women Attending Selected Primary Healthcare Centers in Ogun State, Nigeria." African Journal of Health, Nursing and Midwifery 6, no. 1 (2023): 76–87. http://dx.doi.org/10.52589/ajhnm-1yd6836a.

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Background: Malaria in pregnancy is a major public health concern and one of the leading causes of maternal morbidity and mortality which poses intrauterine and maternal complications during pregnancy. This study assessed the uptake of intermittent preventive treatment of malaria among pregnant women attending primary health care centers in Ikenne Local Government Area. Methods: A quantitative descriptive survey design was employed for this study; researcher-structured questionnaires were used for data collection and a multi-stage sampling technique was used to select one hundred and fifty-one mothers from the primary health centers. Result: It showed that the majority (62.5%) of the participants had average knowledge of malaria in pregnancy, and 54.6% of the participants utilized IPTP. The study found no significant relationship between respondents’ knowledge of malaria in pregnancy and the uptake of IPTP (p-value = 0.888>0.05). Moreso, findings revealed no significant relationship between the time of antenatal initiation and the uptake of intermittent preventive treatment of malaria in pregnancy p-value = 0.281>0.05 (1, X2 = 1.163). In the same vein, no significant relationship was further revealed between the level of education and the uptake of intermittent preventive treatment of malaria in pregnancy p-value = 0.842>0.05 (1, X2 = 0.040). Conclusion: Generally, in Nigeria, the uptake of intermittent preventive treatment for malaria is still low irrespective of the level of the mother's knowledge. Therefore, an increase in awareness and education of women on IPTp with direct observation under uptake was hereby recommended.

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Chishimba, Norris Chileshe, Crecious Phiri, and Gabriel Mpundu. "Identifying Factors Associated with Low Use of Intermittent Malaria Preventive Treatment in Pregnancy: Healthy Moms and Babies Program." International Journal of Science and Healthcare Research 9, no. 4 (2024): 254–62. http://dx.doi.org/10.52403/ijshr.20240432.

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Malaria during pregnancy remains a major public health problem in Sub-Saharan Africa. Current strategies to prevent malaria in pregnancy and promote health include the use of insecticide-treated bed nets and intermittent preventive treatment in pregnancy (IPTp). Despite the availability of IPTp service in all health clinics in Zambia, Lufwanyama district has continued recording low utilisation of this service. The purpose of this study was to determine factors associated with the low utilisation of IPT of malaria among pregnant women attending antenatal (ANC) clinics in Lufwanyama. A cross-sectional study interviewed 382 pregnant women attending ANC clinics in Lufwanyama using simple random sampling. Data was entered and analyzed using SPSS version 20.0 after all variables were coded. Validation of findings was set at 95% CI with a p-value <0.05. This study revealed that the following variables were significantly associated with low IPTp utilisation or completion of the three IPTp doses: knowledge levels about IPTp; number of antenatal visits made; gestational age of pregnancy at first antenatal visit; gestational age of pregnancy; timing of first dose of fansidar; use of traditional medicine; health workers behaviour towards pregnant women; wait times; and perception of fansidar. These factors perpetuated low attendance to ANC schedules and non-adherence towards completion of the three recommended IPTp doses. Healthcare workers should intensify sensitization on IPTp service and benefits through training on effective health promotion strategies. Keywords: Malaria, Pregnant women, Intermittent Preventive Treatments in pregnancy (IPTp), Antenatal care, Insecticide Treated Nets, Sulphadoxine-Pyrimethamine, Health Promotion

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Figueroa-Romero, Antia, Clara Pons-Duran, and Raquel Gonzalez. "Drugs for Intermittent Preventive Treatment of Malaria in Pregnancy: Current Knowledge and Way Forward." Tropical Medicine and Infectious Disease 7, no. 8 (2022): 152. http://dx.doi.org/10.3390/tropicalmed7080152.

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Malaria infection during pregnancy is an important driver of maternal and neonatal health in endemic countries. Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is recommended for malaria prevention at each scheduled antenatal care visit, starting at the second trimester, in areas of high and moderate transmission. However, the increased resistance to SP in some endemic areas challenges its effectiveness. Furthermore, SP is contraindicated in the first trimester of pregnancy and in HIV-infected women on co-trimoxazole prophylaxis due to potential drug–drug interactions. Thus, in recent last decades, several studies evaluated alternative drugs that could be used for IPTp. A comprehensive literature review was conducted to summarize the evidence on the efficacy and safety of antimalarial drugs being evaluated for IPTp. Chloroquine, amodiaquine, mefloquine and azithromycin as IPTp have proven to be worse tolerated than SP. Mefloquine was found to increase the risk of mother-to-child transmission of HIV. Dihydroartemisin-piperaquine currently constitutes the most promising IPTp drug alternative; it reduced the prevalence of malaria infection, and placental and clinical malaria in studies among HIV-uninfected women, and it is currently being tested in HIV-infected women. Research on effective antimalarial drugs that can be safely administered for prevention to pregnant women should be prioritized. Malaria prevention in the first trimester of gestation and tailored interventions for HIV-infected women remain key research gaps to be addressed.

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Godwin, Isaac Okezie, Ifeoma Mercy Ekejindu, George Uchenna Eleje, et al. "Effectiveness of antenatal intermittent preventive treatment for malaria with sulphadoxine-pyrimethamine on peripartum outcomes." Therapeutic Advances in Infectious Disease 9 (January 2022): 204993612211226. http://dx.doi.org/10.1177/20499361221122620.

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Background: Following the World Health Organization (WHO) recommendations for 4-weekly antenatal intermittent preventive treatment of malaria in pregnancy using sulphadoxine-pyrimethamine (IPTp-SP), there is a need to evaluate the drug performance in order to determine their effectiveness as tools in malaria control policy. Objectives: To determine prevalence of cord blood malaria, compliance gap and adverse pregnancy outcomes (anaemia, preterm delivery, spontaneous abortion, intra-uterine foetal death and low birth weight) among antenatal IPTp-SP users compared with non-users. Methods: A cross-sectional analytical study was conducted among consenting 390 participants who were administered a questionnaire, and paired blood samples were collected from the venous blood of participants and neonatal cord immediately after delivery. The participants were categorised as IPTp-SP users and non-users. Adverse pregnancy outcomes were assessed. Neonatal birth weights were also measured within 1 h after delivery. Malaria parasitaemia and anaemia were analysed using standard parasitological and haematological methods of examination. Data were analysed using SPSS version 25 for Windows and p-value of < 0.05 considered significant. Results: Of 390 women, 336 (86.2%) were IPTp-SP users, while 54 (13.8%) were non-users. The compliance gap was 13.8%. Malaria parasitemia in pregnant women (21.7% versus 53.7%; p < 0.001) and their babies (12.2% versus 25.4%; p = 0.002) were observed for IPTp-SP users and non-users, respectively. The prevalence of maternal anaemia was 27(8.0%) in IPTp-SP users and 5 (9.3%) in non-users ( p = 0.789). Mean parasite density was reduced in IPTp-SP users than in non-users ( p < 0.001). Correlation of birth weight according to their sex showed a weak correlation [correlation coefficient ( r) = 0.027; p = 0.736]. Pregnant women with preterm delivery, spontaneous abortion, intra-uterine foetal death, and low birth weight were significantly lower ( p < 0.001, for all) in IPTp-SP users compared with non-users. Conclusion: Although the compliance gap was low, IPTp-SP users had significantly better pregnancy and foetal outcomes compared with non-users. Efforts should be intensified towards achieving total compliance in IPTp-SP usage by pregnant women.

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Anto, Francis, Ibrahim Haruna Agongo, Victor Asoala, Elizabeth Awini, and Abraham Rexford Oduro. "Intermittent Preventive Treatment of Malaria in Pregnancy: Assessment of the Sulfadoxine-Pyrimethamine Three-Dose Policy on Birth Outcomes in Rural Northern Ghana." Journal of Tropical Medicine 2019 (June 2, 2019): 1–10. http://dx.doi.org/10.1155/2019/6712685.

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Background. Intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) decreases placental parasitaemia and improves birth outcomes. Currently, WHO recommends three or more doses of SP given during antenatal care (ANC), spaced one month apart after 16 weeks of gestation till delivery. This study determined the level of uptake of SP and its association with birth outcomes in rural northern Ghana. Methods. A survey was carried out at the War Memorial Hospital in Navrongo, Ghana, among mothers who had delivered within ten weeks and were seeking postnatal care. Data on time of first ANC, number of visits, receipt of IPTp-SP, and birth outcomes were extracted from the antenatal records of 254 mothers. Mothers were interviewed on their background characteristics and obstetric history. Chi-square tests and logistic regression were carried out to determine association between antenatal indicators, uptake of IPTp-SP, and birth outcomes using Stata version 13. Results. Uptake of three-five doses of SP was IPT3 =76.4%, IPT4 =37.3%, and IPT5 = 16.0%. Receipt of first dose of SP at 16, 17-24, and 25-36 weeks of gestation was 16.9%, 56.7%, and 26.4%, respectively. Taking the first dose of SP during the second trimester allowed for taking ≥3 doses of SP compared to taking the first dose during the third trimester (χ2 = 60.1, p<0.001). Women who made ≥4 visits were more likely to receive ≥3 doses of SP compared to those who made <4 visits (χ2 = 87.6, p<0.001). Women who received ≥ 3 doses of SP were more likely (OR = 3.3; 95% CI: 1.69-6.33) to give birth at term and also have normal weight babies (OR =4.0; 95% CI: 1.98-8.06). Conclusion. Uptake of three or more doses of SP contributed to improved pregnancy outcomes. Increased efforts towards improving early ANC attendance could increase uptake of SP and improve pregnancy outcomes.

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Ali, R., M. A. Qadeer, B. Mohammed, and A. Sarki. "Impact of Insecticide Treated Nets and Intermittent Preventive Treatment in Reducing Malaria Morbidity among Pregnant Women in Gombe, Nigeria." Journal of Applied Sciences and Environmental Management 24, no. 7 (2020): 1279–82. http://dx.doi.org/10.4314/jasem.v24i7.22.

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Malaria in pregnancy is a major public health problem affecting women fetuses and new borns. Many studies highlight the critical importance of continuing the use of Insecticide Treated Nets (ITN) and Intermittent Preventive Treatment In Pregnancy (IPTp) among pregnant women to reduce the adverse consequences of malaria in pregnancy. This study was conducted in order to determine malaria prevalence in relation to the use ofITN and IPTp among the pregnant women in the study area. Five (5) ml of blood was obtained from each participant by the use of a sterile syringe and placed in a sterile EDTA container for laboratory analysis. The malaria parasite was detected by microscopic examination of Giemsa-stained thick blood films. Information on the use of ITN and IPTP was collected using administered questionnaire. A high prevalence of 78.4% was observed among the studied population. Although 74.4% of those that use ITN were positive for malaria parasite as against the 83.6% of those that reported not using the ITN, the difference was statistically not significant (p<0.05). 70.0% of those reported using IPTp were positive however, higher percentage was observed for those reported not using IPTp (83.7.0%). The difference was statistically significant in this case. This study has shown the influence of malaria prevention method during pregnancy on malaria infection and the need for targeted preventive starategies when designing and implementing policies aimed at improving uptake of these measures during pregnancy in Gombe. Keywords: malaria, pregnant women, ITN, Gombe, IPTp

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Mlugu, Eulambius M., Omary Minzi, Muhammad Asghar, Anna Färnert, Appolinary A. R. Kamuhabwa, and Eleni Aklillu. "Effectiveness of Sulfadoxine–Pyrimethamine for Intermittent Preventive Treatment of Malaria and Adverse Birth Outcomes in Pregnant Women." Pathogens 9, no. 3 (2020): 207. http://dx.doi.org/10.3390/pathogens9030207.

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Effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) for prevention of malaria and adverse birth outcomes can be compromised by parasites-resistance to sulfadoxine–pyrimethamine. This study prospectively evaluated the effectiveness of IPTp-SP in Southeast Tanzania. From January 2017 to May 2019, HIV-negative and malaria-negative (mRDT) pregnant women attending their first antenatal-care visit in the second or third trimester (n = 500) were enrolled to receive monthly IPTp-SP and followed the protocol till delivery. The primary outcome was the prevalence of histopathological placental malaria. Secondary outcomes were anemia, malaria parasites detected during pregnancy and at delivery, adverse birth outcomes (low-birth-weight [LBW], premature birth, fetal anemia, still birth, and spontaneous abortion). Rates of histopathological placental malaria, any parasitemia at delivery (placental, cord or maternal), and any adverse birth outcome were 9.4%, 20.9%, and 26.5%, respectively. Rates of symptomatic malaria and parasitemia during pregnancy were 2.8% and 16%, respectively. Histopathological placental malaria significantly increased the odds of any adverse birth outcomes, particularly LBW. IPTp-SP with more than or equal to three doses significantly improved birth weight and reduced the risk of LBW by 56% compared to <3 SP doses (p = 0.009). IPTp-SP with more than or equal to three doses is still effective in improving birth weight. However, the detection of histopathological placental-malaria in one-tenth and parasitemia in one-fifth of pregnant women reflects the need to optimize the prevention of malaria during pregnancy.

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Berchie, Gifty Osei, Patience Fakornam Doe, Theodora Dedo Azu, et al. "Uptake and Effectiveness of Intermittent Preventive Treatment with Sulfadoxine-Pyrimethamine during Pregnancy in Africa: A Scoping Review." Diseases 12, no. 9 (2024): 203. http://dx.doi.org/10.3390/diseases12090203.

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Malaria poses a significant threat to pregnant women in sub-Saharan Africa, necessitating effective interventions like the intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP). However, challenges persist in the uptake and effectiveness of this intervention. This scoping review aims to explore IPTp-SP uptake in African countries, identify influencing factors, and assess its effectiveness in preventing malaria and adverse outcomes in pregnancy. This scoping review follows Arksey and O’Malley’s framework, employing the PRISMA-ScR guidelines for reporting. Searches were conducted in PubMed, Embase, Scopus, JSTOR, Web of Science, Google Scholar, and ProQuest, focusing on studies post-2000 published in the English language. The search produced 15,153 records, of which 104 full-text records were eligible and 101 papers were included in this review. The findings suggest varying IPTp-SP uptake rates, spanning from 5.3% to 98.9%, with their effectiveness supported by longitudinal studies, randomised controlled-trials (RCTs), cross-sectional surveys, and mixed-method studies. IPTp-SP demonstrates efficacy in reducing malaria during pregnancy, placental parasitaemia, and anaemia episodes, alongside improved birth outcomes. Common adverse effects of IPTp-SP include prematurity and low birth weight. Facilitators of IPTp-SP uptake include education and ANC attendance, while commonly reported barriers included inadequate knowledge and healthcare system challenges. The findings also suggest adverse effects such as prematurity, low birth weight, and maternal and perinatal mortality associated with IPTp-SP uptake. It is vital to strengthen antenatal care services by integrating comprehensive counselling on IPTp-SP and address healthcare system challenges. Community engagement, women’s empowerment, and context-specific interventions are necessary for promoting IPTp-SP uptake and improving maternal and neonatal health outcomes in Africa.

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Nishan, M. D. Nahid Hassan, and Khadiza Akter. "Coverage and determinants of Intermittent Preventive Treatment in pregnancy (IPTp) in Cameroon, Guinea, Mali, and Nigeria." PLOS ONE 19, no. 11 (2024): e0313087. http://dx.doi.org/10.1371/journal.pone.0313087.

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Introduction Malaria poses a serious issue for pregnant women in African regions. It is crucial to comprehend the various factors that impact receiving IPTp during ANC checkups. These are important for the well-being of both pregnant mothers and their unborn children. Therefore, this study aims to investigate the determinants of IPTp coverage among women in Cameroon, Guinea, Mali, and Nigeria. Methodology This cross-sectional study utilized secondary data from the Malaria Indicator Surveys (MIS) across Cameroon, Guinea, Mali, and Nigeria, focusing on women who received IPTp during pregnancy with IPTp categorized dichotomously as "Yes" for ANC visits and "No" for other visits. Chi-squared tests were used to assess associations, and binary logistic regression was conducted to calculate adjusted odds ratios, confidence intervals, and p-values. Results were summarized in tables. Results We found IPTp coverage during ANC visits was highest in Cameroon (98.6%), followed by Guinea (97.7%), Mali (97.1%), and lowest in Nigeria (95.5%). In Guinea, rural women were less likely to receive IPTp than urban women (AOR: 0.16, 95% CI: 0.07–0.41, p<0.001). In Mali, women who received 3 or more doses were less likely to receive IPTp at ANC (AOR: 0.48, p<0.01). In Nigeria, personal transport increased IPTp uptake (AOR: 1.88, p<0.01). In Cameroon, malaria prevention messages improved IPTp coverage (AOR: 3.12, p<0.05). Conclusions This study highlights significant disparities in IPTp uptake, with rural Mali and Guinea facing lower coverage. In Nigeria, personal transport improved IPTp uptake. Targeted interventions are needed to improve ANC services and ensure equitable IPTp access across the study regions.

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Ramharter, Michael, Matthias Schwab, Ghyslain Mombo-Ngoma, et al. "Population Pharmacokinetics of Mefloquine Intermittent Preventive Treatment for Malaria in Pregnancy in Gabon." Antimicrobial Agents and Chemotherapy 63, no. 2 (2018): e01113-18. http://dx.doi.org/10.1128/aac.01113-18.

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ABSTRACT Mefloquine was evaluated as an alternative for intermittent preventive treatment of malaria in pregnancy (IPTp) due to increasing resistance against the first-line drug sulfadoxine-pyrimethamine (SP). This study determined the pharmacokinetic characteristics of the mefloquine stereoisomers and the metabolite carboxymefloquine (CMQ) when given as IPTp in pregnant women. Also, the relationship between plasma concentrations of the three analytes and cord samples was evaluated, and potential covariates influencing the pharmacokinetic properties were assessed. A population pharmacokinetic analysis was performed with 264 pregnant women from a randomized controlled trial evaluating a single and a split-dose regimen of two 15-mg/kg mefloquine doses at least 1 month apart versus SP-IPTp. Both enantiomers of mefloquine and its carboxy-metabolite (CMQ), measured in plasma and cord samples, were applied for pharmacokinetic modelling using NONMEM 7.3. Both enantiomers and CMQ were described simultaneously by two-compartment models. In the split-dose group, mefloquine bioavailability was significantly increased by 5%. CMQ induced its own metabolism significantly. Maternal and cord blood concentrations were significantly correlated (r2 = 0.84) at delivery. With the dosing regimens investigated, prophylactic levels are not constantly achieved. A modeling tool for simulation of the pharmacokinetics of alternative mefloquine regimens is presented. This first pharmacokinetic characterization of mefloquine IPTp indicates adequate exposure in both mefloquine regimens; however, concentrations at delivery were below previously suggested threshold levels. Our model can serve as a valuable tool for researchers and clinicians to develop and optimize alternative dosing regimens for IPTp in pregnant women.

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Akpa, Christian Obasi, Benedict Ndubueze Azuogu, Winifred Chinwendu Akpa, et al. "Are rural pregnant women disadvantaged in accessing intermittent preventive treatment in pregnancy in Ebonyi State, Nigeria?" PLOS ONE 17, no. 11 (2022): e0269305. http://dx.doi.org/10.1371/journal.pone.0269305.

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Introduction Adequate intermittent preventive treatment (IPTp) uptake (≥3 doses) routinely delivered at antenatal clinics is effective in preventing malaria during pregnancy. Whereas, low IPTp uptake (24.0%) had been reported among pregnant women in Ebonyi State, there is paucity of studies comparing the uptake and its predictors in the urban and rural areas of Ebonyi State. We determined IPTp uptake and its predictors in the urban and rural areas of Ebonyi State. Methods We conducted a cross-sectional comparative study among 864 reproductive age women selected using multistage sampling. Using a structured interviewer-administered questionnaire, we collected data on respondent’s socio-demographic characteristics and IPTp uptake. Uptake was adjudged adequate if ≥3 doses were taken, otherwise inadequate. We estimated the proportion of women with adequate IPTp uptake and determined the factors associated with adequate uptake in rural and urban areas using chi square and multiple logistic regression at 5% level of significance. Results The mean ages of respondents in the urban and rural areas were 28.5±4.6 and 27.4±5.0 years respectively. Adequate IPTp uptake was 82.5% and 60.8% in the urban and rural respectively (p<0.001). In the urban area, women whose husbands had attained ≥ secondary education (aOR:2.9; 95%CI:1.2–7.4; p = 0.02) and those who paid for sulfadoxine/pyrimethamime (aOR:0.2; 95%CI: 0.1–0.6; p = 0.01) were 2.9 times more likely and 5 times less likely to take adequate IPTp respectively compared to respondents whose husbands had attained ≤ primary education and those who had sulfadoxine/pyrimethamine free. In the rural area, women who had attended ANC <4 times (aOR:0.4; 95%CI: 0.3–0.7; p<0.001) were 2.5 times less likely to take adequate IPTp compared to women that had attended ANC ≥4 times. Conclusion Uptake of IPTp was more in the urban than rural areas of Ebonyi State. Interventions that reinforce the importance of health professionals carrying out actions aimed at pregnant women and their partners (spousal) in order to guide them on preventive actions against malaria and other diseases are recommended in Ebonyi State.

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Musoke, David, Rawlance Ndejjo, Solomon Tsebeni Wafula, Simon Kasasa, Jessica Nakiyingi-Miiro, and Miph Boses Musoke. "Malaria health seeking practices for children, and intermittent preventive treatment in pregnancy in Wakiso District, Uganda." African Health Sciences 21, no. 4 (2021): 1722–32. http://dx.doi.org/10.4314/ahs.v21i4.28.

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Background: Timely health care among children with suspected malaria, and intermittent preventive treatment (IPTp) in pregnancy avert related morbidity and mortality in endemic regions especially in sub-Saharan Africa. Malaria burden has steadily been declining in endemic countries due to progress made in scaling up of such important interventions. Objectives: The study assessed malaria health seeking practices for children under five years of age, and IPTp in Wakiso district, Uganda. Methods: A structured questionnaire was used to collect data from 727 households. Chi-square and Fisher’s exact tests were performed in STATA to ascertain factors associated with the place where treatment for children with suspected malaria was first sought (government versus private facility) and uptake of IPTp. Results: Among caretakers of children with suspected malaria, 69.8% sought care on the day of onset of symptoms. The place where treatment was first sought for the children (government versus private) was associated with participants’ (household head or other adult) age (p < 0.001), education level (p < 0.001) and household income (p = 0.011). Among women who had a child in the five years preceding the study, 179 (63.0%) had obtained two or more IPTp doses during their last pregnancy. Uptake of two or more IPTp doses was associated with the women’s education level (p = 0.006), having heard messages about malaria through mass media (p = 0.008), knowing the recommended number of IPTp doses (p < 0.001), and knowing the drug used in IPTp (p < 0.001).  Conclusion: There is need to improve malaria health seeking practices among children and pregnant women particularly IPTp through programmes aimed at increasing awareness among the population. Keywords: Health seeking behaviour; intermittent preventive treatment; malaria; children; pregnancy; Uganda.

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Ogbe, Anthonia C., Ursula C. Nnabueze, Osmond C. Ene, et al. "Utilization of Intermittent Preventive Treatment of Malaria in Pregnancy In Rural Areas of Enugu State." International Journal of Medical Science and Health Research 06, no. 04 (2022): 39–61. http://dx.doi.org/10.51505/ijmshr.2022.6403.

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Objective: This study focused on the utilization of intermittent preventive treatment of malaria in pregnancy in rural areas of Enugu State Methods: A descriptive survey was conducted among booked pregnant women (younger & older) in thirteen (13) rural Local Government Areas of Enugu State. Data were collected using a self-structured questionnaire titled “Predictors of Utilization of Intermittent Preventive Treatment of Malaria in Pregnancy Questionnaire (PUIPTPQ)”.The research questions were answered using mean scores and standard deviations. In testing the hypotheses at.05 level of significance set for this study, z-test statistic was used. Results: The responses of the respondents on how parity predicts utilization of IPTp showed that the cluster mean was 2.80 with a corresponding standard deviation of 0.82.The responses of the respondents on how level of education predicts utilization of IPTp showed that their cluster mean was 3.02 with a corresponding standard deviation of .83. The responses of the respondents on how employment predicts utilization of IPTp showed that their cluster mean was 3.00 with a corresponding standard deviation of .81.The responses of the respondents on how marital status predicts utilization of IPTp showed that their cluster mean was 3.03 with a corresponding standard deviation of .82. The responses of the respondents on how antenatal visits predict utilization of IPTp showed that their cluster mean was 2.91 with a corresponding standard deviation of .80. The responses of the respondents on how gestational age at booking predicts the utilization of IPTp showed that their cluster mean was 2.95 with a corresponding standard deviation of .83. Conclusion: The study concluded that factors like parity, level of education, employment status, marital status, scheduled antenatal visits and gestational age at booking affect the utilization of intermittent preventive treatment of malaria among pregnant women in rural areas in Enugu State. Also the hypothesis tested showed that there is no significant difference between the mean ratings of younger and older pregnant women in rural areas of Enugu State on the utilization of IPTp based on parity, level of education, employment status, marital status, scheduled antenatal visits and gestational age of pregnancy at booking.

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Benjamin, Afaayo. "Assessment of Implementation of Malaria Control Strategies among Pregnant Mothers Attending Antenatal Care at Bumanya Health Centre IV in Kaliro District." IAA Journal of Biological Sciences 12, no. 1 (2024): 20–31. http://dx.doi.org/10.59298/iaajb/2024/121.2031.11.

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Although a high proportion of pregnant women had an antenatal care (ANC) visit at least once during pregnancy, the coverage level of intermittent preventive treatment of malaria in pregnancy (IPTp-SP) and insecticide-treated bednets (ITNs) remains low in Sub-Saharan Africa. A hospital-based descriptive cross-sectional study was carried out. The outcome of the survey revealed that the majority of participants, 79%, were above 20 years old, with a mean (+/-SD) age of 25.6 (+/-SD) years. The survey also revealed that 62.67% of the participants knew about IPTp; the biggest number of participants (86.67%) reported utilizing IPTp during their current pregnancy, while 13.33% did not take IPTp. Occupation, gestational age, several ANC visits, and information about IPTp were significantly associated with IPTp uptake. The current study explored malaria IPTp uptake among pregnant women attending ANC at Bumanya HCIV. It established that an increased number of ANC visits, providing IPTp information to pregnant women, and the gestational age of pregnancy resulted in increased uptake of IPTp and thus reduced incidences of malaria cases. Keywords: Pregnancy, Women, ANC, IPTp, Malaria, Gestational age.

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CC Duru, SD Lawson, SO Enyinnaya, and L Sapira-Ordu. "Impact of malaria prophylaxis on Plasmodium Parasitemia among pregnant women receiving care at Federal Medical Centre, Owerri." World Journal of Advanced Research and Reviews 13, no. 1 (2022): 655–59. http://dx.doi.org/10.30574/wjarr.2022.13.1.0073.

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Background: Malaria during pregnancy harms the baby's health. As personal protection and chemoprevention therapy, insecticide-treated nets (ITN) and intermittent preventive treatment (IPTps) of malaria during pregnancy are recommended. According to the World Health Organization, the introduction of IPTp and ITN constituted a defining moment in malaria prevention in endemic areas during pregnancy. The purpose of this research was to see if there was an association between the usage of IPTp and ITNs and maternal malaria prophylaxis. Methods: A cross-sectional study was conducted on 327 pregnant women who presented at the federal medical center in Owerri. Participants' blood samples were taken for microscopic inspection to detect malaria parasites using established procedures. Pregnant women provided information on their use of IPTp and ITN. Descriptive statistics were used to characterize the independent variables, and chi-square was used for categorical variables as needed using Microsoft Excel 2016. Results: There was a significant association between IPTp use in the prevention of malaria in pregnancy (P-Value = <0.001) and ITN use in the prevention of malaria in pregnancy respectively (P-Value = <0.001). Conclusions: Maternal Malaria is a major public health issue that poses severe danger to pregnant women and their fetuses. IPTp and ITN use are beneficial in malaria prevention among this population.

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Nwaefuna, Ekene K., Richmond Afoakwah, Verner N. Orish, Alexander Egyir-Yawson, and Johnson N. Boampong. "Effectiveness of Intermittent Preventive Treatment in Pregnancy with Sulphadoxine-Pyrimethamine against SubmicroscopicfalciparumMalaria in Central Region, Ghana." Journal of Parasitology Research 2015 (2015): 1–6. http://dx.doi.org/10.1155/2015/959427.

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Malaria infections undetectable by microscopy but detectable by Polymerase Chain Reaction (PCR) (submicroscopic malaria) are common in endemic areas like Ghana. Submicroscopic malaria has been linked with severe pregnancy outcomes as well as contributing to malaria transmission. In this cross-sectional study 872 consenting pregnant women (gestation ≥ 20 weeks) were recruited from 8 hospitals in Central Region, Ghana, between July and December 2009. Malaria infection was detected by microscopy and PCR. Haemoglobin was measured and anaemia was defined as haemoglobin lower than 11 g/dL. Majority of the women, 555 (63.6%), were Intermittent Preventive Treatment in Pregnancy with Sulphadoxine-Pyrimethamine (IPTp-SP) users while 234 (36.4%) were nonusers. The prevalence of malaria by microscopy was 20.9% (182/872) and 9.7% (67/688) of microscopy negative women had submicroscopic malaria. IPTp-SP usage significantly (odds ratio = 0.13, 95% confidence interval = 0.07–0.23,p=0.005) reduced the prevalence of submicroscopic malaria as more nonusers (51/234) than users (16/454) were PCR positive. After controlling for other variables the effect of IPTp-SP remained statistically significant (odds ratio = 0.11, 95% confidence interval = 0.02–0.22,p=0.006). These results suggest that Intermittent Preventive Treatment with Sulphadoxine-Pyrimethamine is useful in the reduction of submicroscopic malaria in pregnancy.

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Oppong, Felix Boakye, Stephaney Gyaase, Charles Zandoh, et al. "Intermittent preventive treatment of pregnant women in Kintampo area of Ghana with sulphadoxine-pyrimethamine (SP): trends spanning 2011 and 2015." BMJ Open 9, no. 6 (2019): e027946. http://dx.doi.org/10.1136/bmjopen-2018-027946.

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ObjectiveIn Ghana, intermittent preventive treatment during pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) is recommended for the prevention of malaria-related adverse outcomes. This study demonstrates the coverage of IPTp-SP use among pregnant women over a period (2011–2015) and the impact of various sociodemographic groups on the uptake of IPTp-SP.DesignRetrospective analysis using data from all pregnant women in the Kintampo Health and Demographic Surveillance System area on the uptake of IPTp-SP.SettingKintampo North Municipality and Kintampo South District of Ghana.ParticipantsAll pregnant women in the Kintampo Health and Demographic Surveillance System area.Primary and secondary outcome measuresThe number of doses of IPTp-SP taken by pregnant women were examined. Logistic regression was used to assess the determinant of uptake of IPTp-SP while adjusting for within-subject correlation from women with multiple pregnancies.ResultsData from 2011 to 2015 with a total of 17 484 pregnant women were used. The coverage of the recommended three or more doses of IPTp-SP among all pregnant women was 40.6%, 44.0%, 45.9%, 20.9% and 32.4% in 2011, 2012, 2013, 2014 and 2015, respectively. In the adjusted analysis, age, household size, education, religion, number of antenatal care visits, ethnicity, marital status, wealth index and place of residence were significantly associated with the uptake of three or more doses of IPTp-SP. Having middle school education or higher, aged 20 years and above, visiting antenatal care five times or more (OR 2.83, 95% CI 2.64 to 3.03), being married (OR 1.10, 95% CI 1.02 to 1.19) and those in higher wealth quintiles were significantly more likely to take three or more doses of IPTp-SP.ConclusionThe uptake of the recommended three or more doses of IPTp-SP is low in the study area. We recommend a community-based approach to identify women during early pregnancy and to administer IPTp-SP.

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Zhang, Karen, Di Liang, Donglan Zhang, Jun Cao, and Jiayan Huang. "Were Women Staying on Track with Intermittent Preventive Treatment for Malaria in Antenatal Care Settings? A Cross-Sectional Study in Senegal." International Journal of Environmental Research and Public Health 19, no. 19 (2022): 12866. http://dx.doi.org/10.3390/ijerph191912866.

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A significant gap exists between high rates of antenatal care attendance and low uptake of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) in Senegal. This study aims to investigate whether IPTp-SP is delivered per Senegal’s national guidelines and to identify factors affecting the delivery of IPTp-SP at antenatal care visits. A secondary analysis was conducted using the 2014 and 2016 Senegal’s Service Provision Assessment. The study sample consists of 1076 antenatal care across 369 health facilities. Multiple logit regression models were used to estimate the probability of receiving IPTp-SP during the antenatal care visit based on prior receipt of IPTp-SP and gestational age during the current pregnancy. At an antenatal care visit, the probability of receiving IPTp-SP is 84% (95% CI = [83%, 86%]) among women with no IPTp-SP history and 85% (95% CI = [79%, 92%]) among women with one prior dose. Women who visit a facility in the top quintile of the proportion of IPTp trained staff have a nearly 4-fold higher odds of receiving IPTp compared to those who visit a facility in the bottom quintile (95% CI = [1.54, 9.80]). The dose and timing of IPTp-SP provided in antenatal care settings in Senegal did not always conform with the national guideline. More training for providers and patient engagement is warranted to improve the uptake of IPTp-SP in antenatal care visits.

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Natuhamya, Charles, Edson Mwebesa, and Nazarius Mbona Tumwesigye. "Effect of knowledge of sulfadoxine-pyrimethamine (SP) as prophylaxis for malaria on its uptake for intermittent preventive treatment of malaria in pregnancy (IPTp): Application of inverse probability weighted regression adjustment (IPWRA) technique." PLOS ONE 20, no. 4 (2025): e0320893. https://doi.org/10.1371/journal.pone.0320893.

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Introduction Malaria still remains a global health issue. In response, the World Health Organisation has continuously recommended the use of Sulfadoxine-Pyrimethamine (SP) for Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) as a malaria preventive measure for the mother and fetus, which has been implemented by the Ugandan government. In collaboration with partners, the government has created awareness of using SP for IPTp (SP-IPTp) among women mainly through media. Studies have investigated the effect of a woman’s education attainment on SP-IPTp. However, the effect of knowledge of SP as prophylaxis for malaria on SP-IPTp has not been studied. Notably, education does not necessarily have an effect on knowledge of SP for malaria prevention, and knowledge of SP as prophylaxis may not result in its significant uptake for IPTp. The purpose of this study, therefore, was to ensure baseline covariate balance and determine the effect of knowledge of SP as preventive chemotherapy on its uptake for IPTp. Methods The study utilised the Ugandan Malaria Indicator Survey dataset of 2018–19. Women aged 15–49 years who indicated their uptake status of SP during their last pregnancy formed the sample of this study. The inverse Probability Weighted Regression Adjustment technique was applied to assess the study objective. Results The findings revealed a positive and significant effect of knowledge of SP as malaria prophylaxis on its uptake for IPTp (Average Treatment Effect of the Treated or ATET = 0.163; 95% CI = 0.138–0.188). Conclusion Ensuring covariate balance while applying IPWRA resulted in more precise estimates of treatment effects. Programmes and policies that create awareness of using SP as malaria prophylaxis may serve as effective interventions towards SP-IPTp in Uganda.

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Dosoo, David Kwame, Kezia Malm, Felix Boakye Oppong, et al. "Effectiveness of intermittent preventive treatment in pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) in Ghana." BMJ Global Health 6, no. 8 (2021): e005877. http://dx.doi.org/10.1136/bmjgh-2021-005877.

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IntroductionGhana adopted the revised WHO recommendation on intermittent preventive treatment in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) in 2012. This study has assessed the effectiveness and safety of this policy in Ghana.MethodsA total of 1926 pregnant women enrolled at antenatal care (ANC) clinics were assessed for birth outcomes at delivery, and placental histology results for malaria infection were obtained from 1642 participants. Association of reduced placental or peripheral malaria, anaemia and low birth weight (LBW) in women who received ≥4 IPTp-SP doses compared with 3 or ≤2 doses was determined by logistic regression analysis.ResultsAmong the 1926 participants, 5.3% (103), 19.2% (369), 33.2% (640) and 42.3% (817) of women had received ≤1, 2, 3 or ≥4 doses, respectively. There was no difference in risk of active placental malaria (PM) infection in women who received 3 doses compared with ≥4 doses (adjusted OR (aOR) 1.00, 95% CI 0.47 to 2.14). The risk of overall PM infection was 1.63 (95% CI 1.07 to 2.48) in 2 dose group and 1.06 (95% CI 0.72 to 1.57) in 3 dose group compared with ≥4 dose group. The risk of LBW was 1.55 (95% CI 0.97 to 2.47) and 1.06 (95% CI 0.68 to 1.65) for 2 and 3 dose groups, respectively, compared with the ≥4 dose group. Jaundice in babies was present in 0.16%, and 0% for women who received ≥4 doses of SP.ConclusionThere was no difference in the risk of PM, LBW or maternal anaemia among women receiving 3 doses compared with ≥4 doses. Receiving ≥3 IPTp-SP doses during pregnancy was associated with a lower risk of overall PM infection compared with 2 doses. As there are no safety concerns, monthly administration of IPTp-SP offers a more practical opportunity for pregnant women to receive ≥3 doses during pregnancy.

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Kalu, Godwin Okeke, Joel Msafiri Francis, Latifat Ibisomi, Tobias Chirwa, and Juliana Kagura. "Factors associated with the uptake of Intermittent Preventive Treatment (IPTp-SP) for malaria in pregnancy: Further analysis of the 2018 Nigeria Demographic and Health Survey." PLOS Global Public Health 3, no. 2 (2023): e0000771. http://dx.doi.org/10.1371/journal.pgph.0000771.

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Pregnancy-associated malaria is preventable and curable with intermittent preventive treatment with Sulfodoxine-Pyrimethamine (IPTp-SP). However, despite the effectiveness of IPTp-SP against malaria in pregnancy, the uptake among pregnant women in Nigeria remains very low. Thus, this study aimed to establish the factors associated with the uptake of at least one dose and optimal doses of IPTp-SP among pregnant women aged 15 to 49 years living in Nigeria in 2018. The study included 12,742 women aged 15 to 49 years with live births two years before or during the 2018 Nigeria Demographic Health Survey (NDHS) in the analysis. Descriptive analysis was carried out to determine the prevalence of IPTp-SP uptake. Multivariable logistic regression was used to establish the factors associated with receiving IPTp-SP during pregnancy, adjusting for possible confounding factors. Given the complex survey design, all analyses are adjusted for sampling weight, stratification, and clustering. The p-value of <0.05 was considered significant. In 2018, the prevalence of at least one dose of IPTp-SP was 63.6% (95% CI:62.0–65.1), and optimal doses of IPTp-SP were 16.8% (95% CI:15.8–17.8) during pregnancy. After the multivariable analysis, age group, region, frequency of ANC visits, belief in IPTp-SP effectiveness, and morbidity caused by malaria predicted the uptake of at least one IPTp-SP dose. Similar maternal characteristics, including household wealth index, spouse’s educational level, and media exposure were significantly associated with taking optimal IPTp-SP doses. For instance, women in the wealthiest households whose husbands had secondary education predicted a four-fold increase in uptake of at least one IPTp-SP dose (aOR:4.17; 95% CI:1.11–8.85). The low prevalence and regional variations of IPTp-SP uptake in the study area imply that most pregnant women in Nigeria are at substantial risk of pregnancy-associated malaria. Therefore, stakeholders should explore context-specific strategies to improve the IPTp-SP coverage across the regions in Nigeria.

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CC, Duru, Lawson SD, Enyinnaya SO, and Sapira-Ordu L. "Impact of malaria prophylaxis on Plasmodium Parasitemia among pregnant women receiving care at Federal Medical Centre, Owerri." World Journal of Advanced Research and Reviews 13, no. 1 (2022): 655–59. https://doi.org/10.5281/zenodo.5919323.

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Background: Malaria during pregnancy harms the baby's health. As personal protection and chemoprevention therapy, insecticide-treated nets (ITN) and intermittent preventive treatment (IPTps) of malaria during pregnancy are recommended. According to the World Health Organization, the introduction of IPTp and ITN constituted a defining moment in malaria prevention in endemic areas during pregnancy. The purpose of this research was to see if there was an association between the usage of IPTp and ITNs and maternal malaria prophylaxis. Methods: A cross-sectional study was conducted on 327 pregnant women who presented at the federal medical center in Owerri. Participants' blood samples were taken for microscopic inspection to detect malaria parasites using established procedures. Pregnant women provided information on their use of IPTp and ITN. Descriptive statistics were used to characterize the independent variables, and chi-square was used for categorical variables as needed using Microsoft Excel 2016. Results: There was a significant association between IPTp use in the prevention of malaria in pregnancy (P-Value = <0.001) and ITN use in the prevention of malaria in pregnancy respectively (P-Value = <0.001). Conclusions: Maternal Malaria is a major public health issue that poses severe danger to pregnant women and their fetuses. IPTp and ITN use are beneficial in malaria prevention among this population.

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Chukwu, Chinedu, Herbert Onuoha, Kwala Adline Katty Okorafor, Oluwaseun Ojomo, Olugbenga A. Mokuolu, and Michael Ekholuenetale. "Geopolitical zones differentials in intermittent preventive treatment in pregnancy (IPTp) and long lasting insecticidal nets (LLIN) utilization in Nigeria." PLOS ONE 16, no. 7 (2021): e0254475. http://dx.doi.org/10.1371/journal.pone.0254475.

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Background The coverage of long lasting insecticidal nets (LLIN) and intermittent preventive treatment of malaria in pregnancy (IPTp) uptake for the prevention of malaria commonly vary by geography. Many sub-Saharan Africa (SSA) countries, including Nigeria are adopting the use of LLIN and IPTp to fight malaria. Albeit, the coverage of these interventions to prevent malaria across geographical divisions have been understudied in many countries. In this study, we aimed to explore the differentials in LLIN and IPTp uptake across Nigerian geopolitical zones. Methods We analyzed data from Nigeria Multiple Indicator Cluster Survey (MICS) 2016–17. The outcome variables were IPTp and LLIN uptake among women of childbearing age (15–49 years). A total sample of 24,344 women who had given birth were examined for IPTp use and 36,176 women for LLIN use. Percentages, Chi-square test and multivariable logit models plots were used to examine the geopolitical zones differentials in IPTp and LLIN utilization. Data was analyzed at 5% level of significance. Results The overall prevalence of IPTp was 76.0% in Nigeria. Moreover, there were differences across geopolitical zones: North Central (71.3%), North East (76.9%), North West (78.2%), South East (76.1%), South South (79.7%) and South West (72.4%) respectively. Furthermore, the prevalence of LLIN was 87.7%% in Nigeria. Also, there were differences across geopolitical zones: North Central (89.1%), North East (91.8%), North West (90.0%), South East (77.3%), South South (81.1%) and South West (69.8%) respectively. Women who have access to media use, married, educated and non-poor were more likely to uptake IPTp. On the other hand, rural dwellers and those with media use were more likely to use LLIN. Conversely, married, educated, non-poor and women aged 25–34 and 35+ were less likely to use LLIN. Conclusion Though the utilization of IPTp and LLIN was relatively high, full coverage are yet to be achieved. There was geopolitical zones differentials in the prevalence of IPTp and LLIN in Nigeria. Promoting the utilization of IPTp and LLINs across the six geopolitical zones through intensive health education and widespread mass media campaigns will help to achieve the full scale IPTp and LLIN utilization.

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Katsayal, U. A., S. K. Musa, A. A. Otu, I. H. Suleiman, and F. Adiri. "Assessment of the Intermittent Preventive Treatment for Prevention of malaria in pregnancy (IPTp)." International Journal of Infectious Diseases 21 (April 2014): 400. http://dx.doi.org/10.1016/j.ijid.2014.03.1246.

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Bukison, Emmanuel Humpani, D. M. Dibal, and M. C. Emere. "Prevention Strategies in Reducing the Burden of Cerebral Malaria among Children in Zaria, Kaduna State." Sahel Journal of Life Sciences FUDMA 3, no. 1 (2025): 181–89. https://doi.org/10.33003/sajols-2025-0301-21.

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Cerebral malaria, a severe and often fatal manifestation of Plasmodium falciparum infection, poses a significant health threat to children living in malaria-endemic regions. This abstract provides a concise overview of the critical role of prevention strategies in reducing the burden of cerebral malaria among children. Prevention measures include vector control interventions, such as insecticide-treated nets and indoor residual spraying, as well as chemoprevention strategies like intermittent preventive treatment in pregnancy (IPTp), intermittent preventive treatment in infants (IPTi), and seasonal malaria chemoprevention (SMC). These strategies have profoundly impacted reducing the incidence and severity of cerebral malaria, protecting vulnerable populations, and improving overall healthcare systems. Challenges and future directions are also briefly discussed, emphasizing the importance of ongoing research and innovation in the global effort to combat cerebral malaria among children in malaria-endemic areas. This paper sets the stage for a deeper exploration of these prevention strategies, their successes, challenges, and the path forward in safeguarding the well-being of Zaria's children from the devastating impact of cerebral malaria.

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Asem, Livingstone, Abdul-Gafaru Abdulia, Patrick Opoku Assuming, and Gordon Abeka-Nkrumah. "The demand for intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine in the Volta Region of Ghana." PLOS ONE 19, no. 9 (2024): e0308321. http://dx.doi.org/10.1371/journal.pone.0308321.

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Background Malaria in pregnancy (MiP) is a preventable condition leading to maternal and neonatal morbidity and mortality. Invariably, with all the knowledge about the serious consequences of MiP for the woman, the unborn child, and the neonate, the uptake of Intermittent Preventive Treatment of Malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) is low in most malaria-endemic countries, including Ghana. This study sought to examine the uptake and service user predictors of the implementation of IPTp-SP after the policy upgrade in 2014. Methods This cross-sectional survey was carried out in two selected districts in the Volta Region. The study participants were randomly selected from communities within Nkwanta North and North Tongu District. A total of 438 mothers who have delivered in the past 24 months were selected for the study. The women were interviewed on their background, knowledge, and attitude toward the use of IPTp-SP using a structured questionnaire. Multiple logistic regression was done to determine the factors that influence the demand for IPTp-SP. The results were presented in the form of tables. Results The mean number of antenatal care (ANC) attendance was 5 (SD:2.6) visits per client, with 262 (59.82%) of them getting the 3+ doses of IPTp-SP. Also, a significant 44 (10.1%) of the mothers did not receive any dose of IPTp-SP. Respondents who attended antenatal clinics 4–7 times had 7 (CI:3.9–12.3) times higher uptake of 3+ doses of IPTp-SP as compared to others who attended less than 4 visits. Similarly, women who had 8 or more visits had a 16.1 (CI: 5.9–43.6) times higher chance of getting more than 2 doses of IPTp-SP compared with others who had fewer than 4 attendances. Conclusion The uptake of 3+ doses of IPTp-SP is still lower than the global target of 80%. Thus, the need for innovative interventions aimed at improving antenatal attendance and early booking for IPTp-SP are recommended.

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Kiyuka, Patience Kerubo, Mark Muricho, Nelson Ouma, et al. "Investigating the dynamics of Plasmodium falciparum gametocyte carriage in expectant women under intermittent preventive treatment with sulfadoxine-pyrimethamine in Kilifi, study protocol." Open Research Europe 5 (April 11, 2025): 60. https://doi.org/10.12688/openreseurope.19356.2.

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Introduction Malaria in pregnancy remains a public health problem. The World Health Organization (WHO) recommends intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) to all pregnant women in moderate to high malaria transmission areas. Kenya's Ministry of Health recommends at least three doses of IPTp-SP (IPTp-SP3 +) to pregnant women in regions where malaria is endemic. Although SP remains cost-effective and effective for IPTp, there are two main challenges with the use of SP: i) widespread use of SP can lead to an increase in the prevalence of drug resistance molecular markers, including those encoding for Plasmodium falciparum dihydrofolate reductase (dhfr) and Pf dihydropteroate synthase (dhps) and ii) SP, used either for curative or preventive treatment, is associated with microscopic and sub microscopic gametocytaemia, both of which contribute to sustained malaria transmission. Our study aims to investigate the dynamics of Plasmodium falciparum gametocyte carriage in pregnant women under intermittent preventive treatment with sulfadoxine-pyrimethamine in Kilifi. Methods This will be a cross-sectional study and will recruit (N=462) expectant women attending antenatal care (ANC) clinics in four health facilities within the Kilifi Health and Demographic Surveillance Sites: Njunju, Pingilikani, Ngerenya, and Kilifi County Teaching and Referral Hospital (KCTRH). To be recruited into our study, women will need to be in their first or second pregnancy when they are more likely to have malaria and should have had at least one dose of sulfadoxine-pyrimethamine. Expected application of results Our study will provide information on the current status of malaria during pregnancy in Kilifi and the prevalence of gametocytes among expectant mothers on IPT-SP. The results of this study may help inform new interventions to prevent malaria during pregnancy, including adding a third drug to SP with probable gametocytocidal effects.

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Kiyuka, Patience Kerubo, Mark Muricho, Nelson Ouma, et al. "Investigating the dynamics of Plasmodium falciparum gametocyte carriage in expectant women under intermittent preventive treatment with sulfadoxine-pyrimethamine in Kilifi, study protocol." Open Research Europe 5 (March 3, 2025): 60. https://doi.org/10.12688/openreseurope.19356.1.

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Introduction Malaria in pregnancy remains a public health problem. The World Health Organization (WHO) recommends intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) to all pregnant women in moderate to high malaria transmission areas. Kenya's Ministry of Health recommends at least three doses of IPTp-SP (IPTp-SP3 +) to pregnant women in regions where malaria is endemic. Although SP remains cost-effective and effective for IPTp, there are two main challenges with the use of SP: i) widespread use of SP can lead to an increase in the prevalence of drug resistance molecular markers, including those encoding for Plasmodium falciparum dihydrofolate reductase (dhfr) and Pf dihydropteroate synthase (dhps) and ii) SP, used either for curative or preventive treatment, is associated with microscopic and sub microscopic gametocytaemia, both of which contribute to sustained malaria transmission. Our study aims to investigate the dynamics of Plasmodium falciparum gametocyte carriage in pregnant women under intermittent preventive treatment with sulfadoxine-pyrimethamine in Kilifi. Methods This will be a cross-sectional study and will recruit (N=462) expectant women attending antenatal care (ANC) clinics in four health facilities within the Kilifi Health and Demographic Surveillance Sites: Njunju, Pingilikani, Ngerenya, and Kilifi County Teaching and Referral Hospital (KCTRH). To be recruited into our study, women will need to be in their first or second pregnancy when they are more likely to have malaria and should have had at least one dose of sulfadoxine-pyrimethamine. Expected application of results Our study will provide information on the current status of malaria during pregnancy in Kilifi and the prevalence of gametocytes among expectant mothers on IPT-SP. The results of this study may help inform new interventions to prevent malaria during pregnancy, including adding a third drug to SP with probable gametocytocidal effects.

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Loyce, Natukwasa. "Assessing the Impact of Intermittent Preventive Treatment in Reducing Malaria Incidence among Pregnant Women in High-Risk Areas." RESEARCH INVENTION JOURNAL OF BIOLOGICAL AND APPLIED SCIENCES 4, no. 2 (2024): 56–59. https://doi.org/10.59298/rijbas/2024/425659.

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Malaria poses significant health risks for pregnant women, especially in high-transmission areas such as sub-Saharan Africa. Physiological and immunological changes during pregnancy increase vulnerability to malaria-related complications, including maternal anemia, low birth weight, and preterm delivery, which can severely impact maternal and neonatal health. To combat these risks, the World Health Organization (WHO) recommended Intermittent Preventive Treatment in Pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) as a proactive measure to reduce malaria incidence in this population. IPTp-SP, administered at regular intervals starting from the second trimester, has shown promising outcomes, such as reduced malaria prevalence, improved maternal hemoglobin levels, and lower incidence of placental malaria. This narrative review synthesized current literature on IPTp’s effectiveness, challenges, and future directions, analyzing studies across multiple high-risk regions to highlight both successes and barriers in IPTp implementation. Key challenges identified include rising SP resistance, limited healthcare infrastructure, and socio-cultural obstacles impacting adherence. To address these, alternative strategies such as introducing alternative antimalarial drugs like dihydroartemisinin-piperaquine (DP), expanding antenatal care (ANC) services, and utilizing community health workers (CHWs) to improve IPTp delivery are examined. Emerging mobile health (mHealth) tools are also explored as potential solutions for enhancing adherence. Recommendations for policy included investment in ANC infrastructure, community-based outreach, and increased support for research on SP alternatives. The findings underscored IPTp’s essential role in protecting maternal and child health, while highlighting areas for innovation and policy reform to optimize its impact in malaria-endemic regions. Keywords: Intermittent Preventive Treatment (IPTp), Malaria, Pregnant Women, Sulfadoxine-Pyrimethamine (SP), Public Health.

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Olaleye, Atinuke O., and Oladapo Walker. "Impact of Health Systems on the Implementation of Intermittent Preventive Treatment for Malaria in Pregnancy in Sub-Saharan Africa: A Narrative Synthesis." Tropical Medicine and Infectious Disease 5, no. 3 (2020): 134. http://dx.doi.org/10.3390/tropicalmed5030134.

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Malaria in pregnancy is a public health challenge with serious negative maternal and newborn consequences. Intermittent preventive treatment (IPTp) with sulphadoxine-pyrimethamine is recommended for the control of malaria during pregnancy within endemic areas, but coverage for the recommended ≥3 doses IPTp regimen has remained suboptimal. We searched PubMed, Cochrane library, and HINARI database from 1 January 2010 to 23 May 2020, for studies investigating the effect of the health system on IPTp implementation. Data extraction was independently performed by two investigators and evaluated for quality and content. Health system barriers and facilitators were explored using thematic analysis and narrative synthesis. Thirty-four out of 1032 screened articles were included. Key health system issues affecting the provision and uptake of IPTp were the ambiguity of policy and guidelines for IPTp administration, human resource shortages, drug stock-outs, conflicting policy implementation on free IPTp provision, hidden costs, unclear data recording and reporting guidelines, and poor quality of care. Factors affecting the supply and demand for IPTp services involve all pillars of the health system across different countries. The success of health programs such as IPTp will thus depend on how well the different pillars of the health system are articulated towards the success of each program.

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Badirou, Aguemon, Damien Barikissou Georgia, Padonou Sètondji Géraud Roméo, Kouwanou Modeste Luc, and Ouendo Edgard Marius. "Adherence to Intermittent Preventive Treatment of Malaria in Pregnancy with Sulfadoxine–Pyrimethamine and Associated Factors: A Cross-Sectional Survey in Benin’s Public Hospitals." Open Public Health Journal 11, no. 1 (2018): 28–36. http://dx.doi.org/10.2174/1874944501811010028.

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Background: Gestational malaria is a public health problem, thus responsible for morbidity and mortality risk to both the foetus and the mother. The intermittent preventive treatment with sulfadoxine-pyrimethamine during pregnancy (IPTp-SP) is one of the strategies recommended by the WHO to prevent this pathology and its consequences during pregnancy. In Benin, the adherence rate remains below the programmatic targets. This study aimed to identify the factors associated to the adherence to at least two IPTp-SP doses for postpartum women of the University Hospital HKM of Cotonou (CNHU-HKM) and the University Hospital for Mother and Child (CHU-MEL) of Cotonou. Methods: A cross-sectional hospital-based study was conducted over a 3-month-period, from July to September 2015 in the field of gynaecology and obstetrics departments of the two hospitals. All the mothers who had delivered and were still hospitalized at the time of the study were enrolled. Results: During their last pregnancy, 63.11% of women had taken at least two doses of IPTp-SP. Four determinants of adherence to the two IPTp-SP doses were associated to the adherence to two doses of IPTp-SP: i) adequate knowledge of the number of doses of SP to be taken during the pregnancy (p-value<0.0001), ii) participation in communication for social and behavioural change on IPTp-SP (p-value<0.0001), iii) adequate knowledge of the number of tablets per dose of SP (p-value=0.0100), and iv) comprehensive knowledge of malaria prevention measures during pregnancy (p-value=0.0200). Conclusion: Raising and improving women's knowledge on malaria are necessary to achieve ITPp-SP adherence. Particular emphasis should therefore be placed on communication for social and behavioural change for pregnant women, family decision-makers, community leaders and healthcare workers.

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Odongo, Charles Okot, Michael Odida, Henry Wabinga, Celestino Obua, and Josaphat Byamugisha. "Burden of Placental Malaria among Pregnant Women Who Use or Do Not Use Intermittent Preventive Treatment at Mulago Hospital, Kampala." Malaria Research and Treatment 2016 (December 13, 2016): 1–7. http://dx.doi.org/10.1155/2016/1839795.

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Intermittent preventive treatment of malaria in pregnancy with sulphadoxine-pyrimethamine (SP-IPTp) is widely used to reduce the incidence of adverse pregnancy outcomes. As a monitor for continued effectiveness of this intervention amidst SP resistance, we aimed to assess malaria burden among pregnant women who use or do not use SP-IPTp. In a descriptive cohort study at Mulago Hospital, Kampala, 87 women who received two supervised doses of SP-IPTp were followed up until delivery. Controls were pregnant women presenting in early labour without history of SP-IPTp. Histopathological investigation for placental malaria (PM) was performed using the Bulmer classification criterion. Thirty-eight of the 87 women returned for delivery and 33 placentas were successfully collected and processed along with 33 placentas from SP nonusers. Overall, 12% (4/33) of the users had evidence of PM compared to 48% (16/33) of nonusers. Among nonusers, 17/33, 8/33, 2/33, and 6/33 had no placental infection, active infection, active-chronic infection, and past-chronic infection, respectively. Among users, respective proportions were 29/33, 2/33, 0/33, and 2/33. No difference in birth weights was apparent between the two groups, probably due to a higher proportion of infections occurring later in pregnancy. Histological evidence here suggests that SP continues to offer substantial benefit as IPTp.

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Nyaaba, Gertrude N., Atinuke O. Olaleye, Mary O. Obiyan, Oladapo Walker, and Dilly O. C. Anumba. "A socio-ecological approach to understanding the factors influencing the uptake of intermittent preventive treatment of malaria in pregnancy (IPTp) in South-Western Nigeria." PLOS ONE 16, no. 3 (2021): e0248412. http://dx.doi.org/10.1371/journal.pone.0248412.

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Malaria in pregnancy (MiP) remains a key cause of poor maternal and neonatal health outcomes, particularly in the African region. Two strategies globally promoted to address MiP require pregnant women in malaria-endemic regions to sleep under insecticide-treated bed nets (ITNs) and take at least three doses of intermittent preventive treatment (IPTp) during pregnancy. Yet, several multilevel factors influence the effective uptake of these strategies. This study explored the factors for the poor uptake of IPTp and use of ITNs in lower socio-economic communities in Nigeria. We conducted semi-structured interviews (SSI) and focus group discussions (FGD) with a total of 201 key stakeholders in six communities in Ogun State, South-Western Nigeria. Twelve SSIs were conducted with traditional birth attendants (TBAs), faith-based birth attendants and healthcare providers operating in public health facilities. Community leaders (7), pregnant women (30) and 20 caregivers were individually interviewed. Sixteen FGDs were conducted with multi- and first-time pregnant women grouped by location and pregnancy experiences. A thematic approach was used for data analysis. At the individual and social levels, there is a high general awareness of MiP, its consequences and ITNs but low awareness of IPTp, with type of antenatal care (ANC) provider being a key factor influencing access to IPTp. The choice of ANC provider, which facilitates access to IPTp and ITNs, is influenced by the experiences of women, relatives and friends, as well as the attitudes of ANC providers and community perceptions of the type of ANC providers. Concurrent use of multiple ANC providers and ANC providers’ relationships further influence acceptability and coverage for IPTp and ITN use. At the health sector level, there is low awareness about preventive malarial strategies including IPTp among TBAs and faith-based birth attendants, in contrast to high IPTp awareness among public healthcare providers. The findings highlight several factors that influence the utilisation of IPTp services and call for greater synergy and collaboration between the three groups of healthcare providers towards enhancing access to and acceptability of IPTp for improving maternal and child outcomes.

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Cirera, Laia, Charfudin Sacoor, Martin Meremikwu, et al. "Cost-effectiveness of community-based distribution of intermittent preventive treatment of malaria in pregnancy in Madagascar, Mozambique, Nigeria, and the Democratic Republic of Congo." BMJ Global Health 8, no. 7 (2023): e010238. http://dx.doi.org/10.1136/bmjgh-2022-010238.

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IntroductionMalaria in pregnancy is a major driver of maternal and infant mortality in sub-Saharan Africa. The WHO recommends the administration of intermittent preventive treatment with sulfadoxine pyrimethamine (IPTp-SP) at antenatal care (ANC) visits. Despite being a highly cost-effective strategy, IPTp-SP coverage and uptake remains low. A pilot project was conducted to assess the cost-effectiveness (CE) of community-based delivery of IPTp (C-IPTp) in addition to ANC delivery to increase IPTp uptake in the Democratic Republic of Congo (DRC), Madagascar (MDG), Mozambique (MOZ) and Nigeria (NGA).MethodsCosts and CE estimates of C-IPTp were calculated according to two scenarios: (1) costs in ‘programmatic mode’ (ie, costs if C-IPTp was to be implemented by national health systems) and (2) costs from the pilot project. The effectiveness of C-IPTp was obtained through estimates of the averted disability-adjusted life-years (DALYs) associated with maternal clinical malaria and anaemia, low birth weight and neonatal mortality.ResultsNet incremental costs of C-IPTp ranged between US$6138–US$47 177 (DRC), US$5552–US$31 552 (MDG), US$10 202–US$53 221 (MOZ) and US$667–US$28 645 (NGA) per 1000 pregnant women, under scenarios (1) and (2), respectively. Incremental cost-effectiveness ratios (ICERs) ranged between US$15–US$119 in DRC, US$9–US$53 in MDG, US$104–US$543 in MOZ and US$2–US$66 in NGA per DALY averted, under scenarios (1) and (2), respectively. ICERs fall below the WHO recommended CE threshold based on the gross domestic product per capita.ConclusionFindings suggest that C-IPTp is a highly cost-effective intervention. Results can inform policy decisions on adopting and optimising effective interventions for preventing malaria in pregnancy.

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Agyeman, Yaa Nyarko, Sam Newton, Raymond Boadu Annor, and Ellis Owusu-Dabo. "Intermittent preventive treatment comparing two versus three doses of sulphadoxine pyrimethamine (IPTp-SP) in the prevention of anaemia in pregnancy in Ghana: A cross-sectional study." PLOS ONE 16, no. 4 (2021): e0250350. http://dx.doi.org/10.1371/journal.pone.0250350.

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In 2012 the World Health Organisation (WHO) revised the policy on Intermittent Preventive Treatment with Sulphadoxine Pyrimethamine (IPTp-SP) to at least three doses for improved protection against malaria parasitaemia and its associated effects such as anaemia during pregnancy. We assessed the different SP dosage regimen available under the new policy to determine the dose at which women obtained optimal protection against anaemia during pregnancy. A cross-sectional study was conducted among pregnant women who attended antenatal clinic at four different health facilities in Ghana. The register at the facilities served as a sampling frame and simple random sampling was used to select all the study respondents; they were enrolled consecutively as they kept reporting to the facility to receive antenatal care to obtain the required sample size. The haemoglobin level was checked using the Cyanmethemoglobin method. Multivariable logistic regression was performed to generate odds ratios, confidence intervals and p-values. The overall prevalence of anaemia among the pregnant women was 62.6%. Pregnant women who had taken 3 or more doses of IPTp-SP had anaemia prevalence of 54.1% compared to 66.6% of those who had taken one or two doses IPTp-SP. In the multivariable logistic model, primary (aOR 0.61; p = 0.03) and tertiary education (aOR 0.40; p = <0.001) decreased the odds of anaemia in pregnancy. Further, pregnant women who were anaemic at the time of enrollment (aOR 3.32; p = <0.001) to the Antenatal Care clinic and had malaria infection at late gestation (aOR 2.36; p = <0.001) had higher odds of anaemia in pregnancy. Anaemia in pregnancy remains high in the Northern region of Ghana. More than half of the pregnant women were anaemic despite the use of IPTp-SP. Maternal formal education reduced the burden of anaemia in pregnancy. The high prevalence of anaemia in pregnancy amid IPTp-SP use in Northern Ghana needs urgent attention to avert negative maternal and neonatal health outcomes.

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Asem, Livingstone, Abdul-Gafaru Abdulia, Patrick Opoku Assuming, and Gordon Abeka-Nkrumah. "Knowledge, and attitude of service user of intermittent preventive treatment of malaria in pregnancy using sulfadoxine pyrimethamine in the Volta Region of Ghana." PLOS ONE 19, no. 9 (2024): e0309340. http://dx.doi.org/10.1371/journal.pone.0309340.

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Background Malaria in pregnancy (MiP) is a condition that can be prevented by using intermittent preventive treatment using Sulfadoxine-pyrimethamine. However, despite all the effort to reduce the consequences of MiP for the woman, the unborn child, and the neonate, the knowledge of Intermittent Preventive Treatment of Malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) is low in most malaria-endemic countries, including Ghana. Thus, the need to examine knowledge, and attitude of service users of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine. Methods The study was a cross-sectional survey of two selected districts in the Volta Region of Ghana. The study participants were randomly selected from communities within Nkwanta North and North Tongu District. In all a total of 438 mothers who have delivered in the past 24 months were selected for the study. The women were interviewed using a structured questionnaire and the bivariate and multivariable logistic regression results presented in tables. Results The level of knowledge, and attitude were reported as 45.9% and 58.9% respectively. Knowledge of the service user is determined by the level of education of the women. The attitude of the service user is determined by making 4–7 visits during ANC, Gestational age at booking for ANC is 4–7 weeks, income level between 100 to 999, partner educational level above Middle/JHS/JSS, and age of a partner is above 40 years. Conclusion The findings from the present studies highlighted important factor such as number of antenatal visits that affect both knowledge of services and attitude to use IPTp-SP. Therefore, a community-based health promotion programmes to help to increase knowledges and improved attitude on timely and regular antenatal attendance to promote the benefit of IPTp-SP should be encouraged.

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Wini, Lyndes, Bridget Appleyard, Albino Bobogare, and Junilyn Pikacha. "Intermittent preventive treatment with sulfadoxine-pyrimethamine versus weekly chloroquine prophylaxis for malaria in pregnancy in Honiara, Solomon Islands: a randomised trial." MalariaWorld Journal 4, no. 12 (2013): 1–9. https://doi.org/10.5281/zenodo.10894954.

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Background. Solomon Islands is a malarious nation in the Pacific with all four human Plasmodium species present. Although chloroquine prophylaxis is recommended for pregnant women, its effectiveness is uncertain because of chloroquine resistance. Methods. We conducted a parallel-group, open label, individually randomised superiority trial comparing weekly chloroquine prophylaxis (CQ) with intermittent preventive treatment (IPTp) with sulfadoxine-pyrimethamine (SP) between August 2009- June 2010 among pregnant women aged 15 to 49 years. Participants were randomised at the first antenatal visit using a computer-generated sequence and followed until delivery. Data on mosquito avoidance measures, and pregnancy outcomes were collected. Results. Because of the low prevalence of malaria, enrolment was prematurely terminated. Among 660 participants (336 in CQ arm, and 324 in IPTp), 68% used a bednet, 53% used window-screens, and 26% lived in a house sprayed in the last 6 months; 91% used at least one of these methods. Peripheral parasitemia at enrolment was 1.5%. At delivery there were no differences between weekly CQ and IPTp in placental parasitemia (0/259 vs. 1/254) or peripheral parasitemia (2/281 vs. 1/267). There were no differences in maternal anaemia, birth outcomes or serious adverse events. A self-reported sulfa-allergy required non-inclusion for 199 of 771 ineligible women (26%). Conclusions. The use of SP for IPTp is not suitable for prevention of malaria in pregnancy in Solomon Islands, given the low malaria prevalence and the possible high prevalence of sulfa-allergy. Scaling up of transmission-reducing interventions has probably contributed to the malaria reduction in Honiara.

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Staalsoe, Trine, Caroline E. Shulman, Edgar K. Dorman, Ken Kawuondo, Kevin Marsh, and Lars Hviid. "Intermittent Preventive Sulfadoxine-Pyrimethamine Treatment of Primigravidae Reduces Levels of Plasma Immunoglobulin G, Which Protects against Pregnancy-Associated Plasmodium falciparum Malaria." Infection and Immunity 72, no. 9 (2004): 5027–30. http://dx.doi.org/10.1128/iai.72.9.5027-5030.2004.

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ABSTRACT Pregnancy-associated malaria (PAM) is an important cause of maternal and neonatal suffering. It is caused by Plasmodium falciparum capable of inhabiting the placenta through expression of particular variant surface antigens (VSA) with affinity for proteoglycans such as chondroitin sulfate A. Protective immunity to PAM develops following exposure to parasites inhabiting the placenta, and primigravidae are therefore particularly susceptible to PAM. The adverse consequences of PAM in primigravidae are preventable by intermittent preventive treatment (IPTp), where women are given antimalarials at specified intervals during pregnancy, but this may interfere with acquisition of protective PAM immunity. We found that Kenyan primigravidae receiving sulfadoxine-pyrimethamine IPTp had significantly lower levels of immunoglobulin G (IgG) with specificity for the type of parasite-encoded VSA—called VSAPAM—that specifically mediate protection against PAM than did women receiving a placebo. VSAPAM-specific IgG levels depended on the number of IPTp doses received and were sufficiently low to be of clinical concern among multidose recipients. Our data suggest that IPTp should be extended to women of all parities, in line with current World Health Organization recommendations.

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Alonso, Yara, Wade Lusengi, Manu F. Manun’Ebo, et al. "The social dimensions of community delivery of intermittent preventive treatment of malaria in pregnancy in Madagascar, Mozambique, Nigeria and the Democratic Republic of the Congo." BMJ Global Health 7, no. 11 (2022): e010079. http://dx.doi.org/10.1136/bmjgh-2022-010079.

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IntroductionIntermittent preventive treatment in pregnancy with sulphadoxine pyrimethamine (IPTp) is a key malaria prevention strategy in sub-Saharan African countries. We conducted an anthropological study as part of a project aiming to evaluate a community-based approach to the delivery of IPTp (C-IPTp) through community health workers (CHWs) in four countries (the Democratic Republic of Congo, Madagascar, Mozambique and Nigeria), to understand the social context in order to identify key factors that could influence C-IPTp acceptability.MethodsA total of 796 in-depth interviews and 265 focus group discussions were undertaken between 2018 and 2021 in the four countries with pregnant women, women of reproductive age, traditional and facility-based healthcare providers, community leaders, and relatives of pregnant women. These were combined with direct observations (388) including both community-based and facility-based IPTp delivery. Grounded theory guided the overall study design and data collection, and data were analysed following a combination of content and thematic analysis.ResultsA series of key factors were found to influence acceptability, delivery and uptake of C-IPTp in project countries. Cross-cutting findings include the alignment of the strategy with existing social norms surrounding pregnancy and maternal health-seeking practices, the active involvement of influential and trusted actors in implementation activities, existing and sustained trust in CHWs, the influence of husbands and other relatives in pregnant women’s care-seeking decision-making, the working conditions of CHWs, pregnant women’s perceptions of SP for IPTp and persistent barriers to facility-based antenatal care access.ConclusionsThe findings provide evidence on the reported acceptability of C-IPTp among a wide range of actors, as well as the barriers and facilitators for delivery and uptake of the intervention. Overall, C-IPTp was accepted by the targeted communities, supporting the public health value of community-based interventions, although the barriers identified should be examined if large-scale implementation of the intervention is considered.

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Obeagu, Emmanuel Ifeanyi, and Getrude Uzoma Obeagu. "Protecting maternal health: Strategies against HIV and malaria in pregnancy." Medicine 103, no. 36 (2024): e39565. http://dx.doi.org/10.1097/md.0000000000039565.

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Maternal health remains a global priority, with particular emphasis on combating infectious diseases such as HIV and malaria during pregnancy. Despite significant progress in prevention and treatment efforts, both HIV and malaria continue to pose significant risks to maternal and fetal well-being, particularly in resource-limited settings. The prevention of mother-to-child transmission (PMTCT) programs for HIV and intermittent preventive treatment (IPTp) for malaria represent cornerstone strategies in mitigating the impact of these infections on pregnancy outcomes. PMTCT programs focus on early HIV diagnosis, antiretroviral therapy initiation, and promoting safe infant feeding practices to reduce the risk of mother-to-child transmission. Similarly, IPTp involves the administration of antimalarial medication to pregnant women in malaria-endemic regions to prevent maternal and fetal complications associated with malaria infection. Integration of HIV and malaria prevention and treatment services within existing maternal and child health programs is crucial for maximizing impact and minimizing healthcare system strain. Strengthening health systems, improving access to antenatal care services, and enhancing community engagement are essential components of comprehensive maternal health strategies. Furthermore, promoting awareness, education, and empowerment of pregnant women and communities are vital in fostering health-seeking behaviors and adherence to preventive measures against HIV and malaria. In conclusion, protecting maternal health from the dual threat of HIV and malaria requires a multifaceted approach that encompasses prevention, screening, treatment, and community engagement.

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Sinyange, Danny, Nawa Mukumbuta, Lwito Salifya Mutale, Hudson Mumbole, Busiku Hamainza, and Cephas Sialubanje. "Uptake of four or more doses of sulfadoxine pyrimethamine for intermittent preventive treatment of malaria during pregnancy in Zambia: findings from the 2018 malaria in pregnancy survey." BMJ Open 13, no. 5 (2023): e073287. http://dx.doi.org/10.1136/bmjopen-2023-073287.

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ObjectiveTo determine the prevalence and predictors of the uptake of four or more doses of sulfadoxine pyrimethamine (IPTp-SP 4+) in Zambia.DesignA cross-sectional study using secondary data from the malaria in pregnancy survey (Malaria Indicator Survey) data set conducted from April to May 2018.SettingThe primary survey was conducted at community level and covered all the 10 provinces of Zambia.ParticipantsA total of 3686 women of reproductive age (15–45 years) who gave birth within the 5 years before the survey.Primary outcomeProportion of participants with four or more doses of IPTp-SP.Statistical analysisAll analyses were conducted using RStudio statistical software V.4.2.1. Descriptive statistics were computed to summarise participant characteristics and IPTp-SP uptake. Univariate logistic regression was carried out to determine association between the explanatory and outcome variables. Explanatory variables with a p value less than 0.20 on univariate analysis were included in the multivariable logistic regression model and crude and adjusted ORs (aORs) along with their 95% CIs were computed (p<0.05).ResultsOf the total sample of 1163, only 7.5% of participants received IPTp-SP 4+. Province of residence and wealth tertile were associated with uptake of IPTp-SP doses; participants from Luapula (aOR=8.72, 95% CI (1.72 to 44.26, p=0.009)) and Muchinga (aOR=6.67, 95% CI (1.19 to 37.47, p=0.031)) provinces were more likely to receive IPTp-SP 4+ compared with to those from Copperbelt province. Conversely, women in the highest wealth tertile were less likely to receive IPTp-SP 4+ doses compared with those in the lowest quintile (aOR=0.32; 95% CI (0.13 to 0.79, p=0.014)).ConclusionThese findings confirm a low uptake of four or more doses of IPTp-SP in the country. Strategies should focus on increased coverage of IPTp-SP in provinces with much higher malaria burden where the risk is greatest and the ability to afford healthcare lowest.

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Tzitiridou-Chatzopoulou, Maria, Georgia Zournatzidou, Eirini Orovou, et al. "Intermittent Preventive Treatment of Malaria in Pregnancy and the Impact on Neonates in African Countries as Assessed by Entropy Weight and TOPSIS Methods." Journal of Clinical Medicine 13, no. 20 (2024): 6231. http://dx.doi.org/10.3390/jcm13206231.

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Background/Objectives: In regions of Africa with a high prevalence of malaria, pregnant women in their first or second trimester should be administered intermittent preventive treatment in pregnancy (IPTp). However, infants may contract malaria despite the IPTp therapy that their mothers have received. The objective of the present investigation was to assess the symptoms and various treatments for neonatal malaria. Methods: Entropy weight and TOPSIS were used to achieve the study goal. The TOPSIS multi-attribute decision-making system was used to assess newborn malaria symptoms and select the optimal treatment, even for mothers receiving IPTp medication during pregnancy. The entropy weight approach calculated TOPSIS attribute weights. The present research used UNICEF data for 14 African nations in 2023. Results: The results indicated that neonates whose mothers received IPTp therapy ultimately contracted malaria, with diarrhea being the primary symptom. It is important to note that health providers administer a combination of zinc and oral rehydration solution (ORS) to infants as the most effective treatment for malaria symptoms, thereby abandoning the first-line treatment for malaria, artemisinin-based combination therapy (ACT). Conclusions: The most effective treatment for neonatal malaria is a combination of zinc and ORS, although less than half of children in Africa have access to ORS. Therefore, the findings of this study may encourage African countries to prioritize co-pack therapy in their procurement and supply, healthcare provider training, and expenditures. This therapy will also help alleviate the symptoms of malaria in neonates.

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Abubakar, H., A. Y. Bala, H. M. Bandiya, and M. U. Imam. "Molecular Epidemiology of Single Nucleotide Polymorphisms (SNPs) in Plasmodium falciparum Dihydropteroate Synthase and P. falciparum Dihydrofolate Reductase Genes among Pregnant Women in Sokoto Metropolis, Sokoto, Nigeria." Sahel Journal of Life Sciences FUDMA 2, no. 3 (2024): 112–21. https://doi.org/10.33003/sajols-2024-0203-15.

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Malaria continues to cause significant morbidity and mortality in pregnant women despite the implementation of various interventions. Currently, the World Health Organization (WHO) recommends Sulfadoxine/Pyrimethamine (SP) for intermittent preventive treatment during pregnancy (SP-IPTp) in the second and third trimesters. However, the efficacy of SP is threatened by the emergence of Plasmodium falciparum dihydropteroate synthase (Pfdhps)and Plasmodium falciparum dihydrofolate reductase (Pfdhfr) genes that confer resistance against sulfadoxine and pyrimethamine respectively. This research was aimed to determine the prevalence of Pfdhps and Pfdhfr genes among pregnant women attending antenatal care (ANC) in the Sokoto metropolis. Thirty-two (32) blood samples of malaria-infected pregnant women who came for ANC between April and July 2024 were evaluated for single nucleotide polymorphisms of Pfdhps and Pfdhfr genes via polymerase chain reaction (PCR) protocol. It was interesting to note that, none of the antimalarial drug-resistant genes was detected from the isolates tested. This finding has validated the efficacy of Sulfadoxine/Pyrimethamine for intermittent preventive treatment of malaria during pregnancy in Sokoto metropolis. It is therefore recommended that health facilities should continue to issue SP for IPTp in line with WHO guidelines.

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Igboeli, Nneka U., Maxwell O. Adibe, Chinwe V. Ukwe, and Nze C. Aguwa. "Prevalence of Low Birth Weight before and after Policy Change to IPTp-SP in Two Selected Hospitals in Southern Nigeria: Eleven-Year Retrospective Analyses." BioMed Research International 2018 (2018): 1–5. http://dx.doi.org/10.1155/2018/4658106.

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Background. In 2005, Nigeria changed its policy on prevention of malaria in pregnancy to intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP). Indicators of impact of effective prevention and control of malaria on pregnancy (MIP) are low birth weight (LBW) and maternal anaemia by parity. This study determined the prevalence of LBW for different gravidity groups during periods of pre- and postpolicy change to IPTp-SP. Methods. Eleven-year data were abstracted from the delivery registers of two hospitals. Study outcomes calculated for both pre- (2000–2004) and post-IPTp-SP-policy (2005–2010) years were prevalence of LBW for different gravidity groups and risk of LBW in primigravidae compared to multigravidae. Results. Out of the 11,496 singleton deliveries recorded within the 11-year period, the prevalence of LBW was significantly higher in primigravidae than in multigravidae for both prepolicy (6.3% versus 4%) and postpolicy (8.6% versus 5.1%) years. The risk of LBW in primigravidae compared to multigravidae increased from 1.62 (1.17–2.23) in the prepolicy years to 1.74 (1.436–2.13) during the postpolicy years. Conclusion. The study demonstrated that both the prevalence and risk of LBW remained significantly higher in primigravidae even after the change in policy to IPTp-SP.

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Agyeman, Yaa Nyarko, Sam Kofi Newton, Raymond Boadu Annor, and Ellis Owusu-Dabo. "The Effectiveness of the Revised Intermittent Preventive Treatment with Sulphadoxine Pyrimethamine (IPTp-SP) in the Prevention of Malaria among Pregnant Women in Northern Ghana." Journal of Tropical Medicine 2020 (November 23, 2020): 1–9. http://dx.doi.org/10.1155/2020/2325304.

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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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Yusuf, Oyindamola B., Joshua O. Akinyemi, Adeniyi F. Fagbamigbe, IkeOluwapo O. Ajayi, and al. et. "Controlling malaria in pregnancy: how far from the Abuja targets?" MalariaWorld Journal 7, no. 7 (2016): 1–8. https://doi.org/10.5281/zenodo.10798318.

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Background. The Roll Back Malaria (RBM) initiative recommended that all pregnant women receive Intermittent Preventive Treatment (IPTp) and that by 2010 at least 80% of people at risk of malaria (including pregnant women) use insecticide-treated bednets (ITN) in areas with stable transmission. We evaluated ITN/IPTp coverage, explored its associated factors, and estimated the number of pregnancies protected from malaria. Materials and methods. This analysis was based on data from the 2012 National HIV/AIDS and Reproductive Health Survey (NARHS Plus). To assess ITN coverage, we used the population of women that was pregnant (n=22,438) at the time of the survey. For IPTp coverage, we used women that had a live birth in the 5 years preceding the survey (n= 118,187) and extracted the population of pregnant women that, during their last pregnancy, received drugs for protection against malaria. We estimated the number of live births using the projected population of females in each state, population of women of child -bearing age and the total fertility rate. The estimated number of pregnancies covered/protected by ITN and IPTp was obtained from a product of the estimated live births and the reported coverage. Multivariate logistic regression was used to determine factors associated with ITN and IPTp use. Results. We estimated that there were 5,798,897 live births in Nigeria in 2012, of which 3,537,327 and 2,302,162 pregnancies were protected by ITN and IPTp, respectively. Four of 36 states achieved the 80% RBM target for ITN coverage. No state achieved the 100% target for IPTp. Education and socio-economic status were associated with IPTp use. Conclusion. ITN cover age was higher than in previous estimates even though it is still below the RBM targets. However, IPTp coverage remained low in 2012 and was not likely to increase to match the 2015 target coverage of 100%.

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Journal articles on the topic 'Intermittent preventive treatment in pregnancy (IPTp)'

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