Programme PAC-CI, Abidjan, Côte d'Ivoire.
Malar J. 2011 Apr 29;10:105. doi: 10.1186/1475-2875-10-105.
The World Health Organization (WHO) recommends using insecticide-treated mosquito nets (ITNs) and intermittent preventive treatment with sulphadoxine-pyrimethamine (IPT-SP) to prevent malaria in sub-Saharan Africa. Data on IPT-SP coverage and factors associated with placental malaria parasitaemia and low birth weight (LBW) are scarce in Côte d'Ivoire.
A multicentre, cross-sectional survey was conducted in Côte d'Ivoire from March to September 2008 at six urban and semi-urban antenatal clinics. Standardized forms were used to collect the demographic information and medical histories of women and their offspring. IPT-SP coverage (≥2 doses) as well as placental and congenital malaria prevalence parasitaemia were estimated. Regression logistics were used to study factors associated with placental malaria and LBW (birth weight of alive babies < 2,500 grams).
Overall, 2,044 women with a median age of 24 years were included in this study. Among them 1017 (49.8%) received ≥2 doses of IPT-SP and 694 (34.0%) received one dose. A total of 99 mothers (4.8%) had placental malaria, and of them, four cases of congenital malaria were diagnosed. Factors that protected from maternal placental malaria parasitaemia were the use of one dose (adjusted odds ratio (aOR), 0.32; 95%CI: 0.19-0.55) or ≥2 doses IPT-SP (aOR: 0.18; 95%CI: 0.10-0.32); the use of ITNs (aOR: 0.47; 95%CI: 0.27-0.82). LBW was associated with primigravidity and placental malaria parasitaemia.
IPT-SP decreases the rate of placental malaria parasitaemia and has a strong dose effect. Despite relatively successful IPT-SP coverage in Côte d'Ivoire, substantial commitments from national authorities are urgently required for such public health campaigns. Strategies, such as providing IPT-SP free of charge and directly observing treatment, should be implemented to increase the use of IPT-SP as well as other prophylactic methods.
世界卫生组织（WHO）建议在撒哈拉以南非洲地区使用经杀虫剂处理的蚊帐（ITNs）和磺胺多辛-乙胺嘧啶间歇性预防治疗（IPT-SP）来预防疟疾。科特迪瓦关于 IPT-SP 覆盖率以及与胎盘疟疾寄生虫血症和低出生体重（LBW）相关的因素的数据很少。
2008 年 3 月至 9 月，在科特迪瓦的六个城市和半城市产前诊所进行了一项多中心、横断面调查。使用标准化表格收集了妇女及其子女的人口统计学信息和病史。估计了 IPT-SP 覆盖率（≥2 剂）以及胎盘和先天性疟疾寄生虫血症的患病率。回归逻辑用于研究与胎盘疟疾和 LBW（活婴出生体重<2500 克）相关的因素。
共有 2044 名中位年龄为 24 岁的妇女参与了这项研究。其中 1017 名（49.8%）接受了≥2 剂 IPT-SP，694 名（34.0%）接受了 1 剂。共有 99 名母亲（4.8%）患有胎盘疟疾，其中 4 例诊断为先天性疟疾。以下因素可预防母体胎盘疟疾寄生虫血症：使用一剂（调整后的优势比（aOR），0.32；95%CI：0.19-0.55）或≥2 剂 IPT-SP（aOR：0.18；95%CI：0.10-0.32）；使用 ITNs（aOR：0.47；95%CI：0.27-0.82）。LBW 与初产妇和胎盘疟疾寄生虫血症有关。
IPT-SP 降低了胎盘疟疾寄生虫血症的发生率，且具有剂量效应。尽管科特迪瓦的 IPT-SP 覆盖率相对较高，但国家当局仍急需做出巨大承诺来开展此类公共卫生运动。应实施 IPT-SP 免费提供和直接观察治疗等策略，以增加 IPT-SP 以及其他预防方法的使用。
