Orish Verner N, Onyeabor Onyekachi S, Boampong Johnson N, Afoakwah Richmond, Nwaefuna Ekene, Acquah Samuel, Sanyaolu Adekunle O, Iriemenam Nnaemeka C
Department of Internal Medicine, Effia-Nkwanta Regional Hospital Sekondi-Takoradi, Sekondi P. O. Box 229, Western Region, Ghana.
The Satcher Health Leadership Institute, Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia, USA.
Afr Health Sci. 2015 Dec;15(4):1087-96. doi: 10.4314/ahs.v15i4.6.
Intermittent preventive treatment in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) has been adopted as policy by most countries in sub-Saharan Africa. This cross-sectional study assessed the prevalence of IPTp-SP usage for prevention of malaria among pregnant women as well as evaluated factors associated with IPTp-SP use during pregnancy in Sekondi-Takoradi region of Ghana.
Pregnant women attending their antenatal-care with either clinical/ultrasound evidence of pregnancy were recruited. Venous blood was screened for malaria using RAPID response antibody kit and Giemsa staining. Haemoglobin estimations were done by cyanmethemoglobin method while Human Immunodeficiency Virus (HIV) screening was performed by the national diagnostic algorithm of two rapid antibody test and western blot confirmation.
Of the 754 consented pregnant women interviewed in this study, 57.8% had received IPTp-SP while 42.2% had not at their first contact with the study personnel. Furthermore, 18.6% (81/436) of those that received IPTp-SP were malaria positive while 81.4% (355/436) were malaria negative. The results also indicated that 47.7% (51/107) of the pregnant women in their third trimester who were meant to have received at least two-doses of SP had received ≥2 doses while 35.5% (38/107) had received 1 dose. In multivariable logistic regression analysis, pregnant women in their third trimester who received ≥2 doses of SP showed decreased likelihoods of malaria (adjusted OR, 0.042; 95% CI, 0.003-0.51; P = 0.013).
IPTp-SP usage among pregnant women in Sekondi-Takoradi reduces malaria and its use for malaria prevention should be strengthened with proper dosage completion and coverage.
在撒哈拉以南非洲的大多数国家，采用周效磺胺-乙胺嘧啶（SP）进行孕期间歇性预防治疗（IPTp）已成为一项政策。这项横断面研究评估了加纳塞康第-塔科拉迪地区孕妇中使用IPTp-SP预防疟疾的流行情况，并评估了孕期使用IPTp-SP的相关因素。
招募有临床/超声妊娠证据且前来进行产前检查的孕妇。使用快速反应抗体试剂盒和吉姆萨染色法对静脉血进行疟疾筛查。采用氰化高铁血红蛋白法进行血红蛋白测定，同时通过两种快速抗体检测和蛋白质印迹确认的国家诊断算法进行人类免疫缺陷病毒（HIV）筛查。
在本研究中接受访谈的754名同意参与的孕妇中，57.8%在首次与研究人员接触时已接受IPTp-SP，而42.2%未接受。此外，接受IPTp-SP的孕妇中有18.6%（81/436）疟疾检测呈阳性，而81.4%（355/436）为疟疾阴性。结果还表明，在孕晚期本应至少接受两剂SP的孕妇中，47.7%（51/107）接受了≥2剂，而35.5%（38/107）接受了1剂。在多变量逻辑回归分析中，孕晚期接受≥2剂SP的孕妇患疟疾的可能性降低（调整后的比值比，0.042；95%置信区间，0.003 - 0.51；P = 0.013）。
塞康第-塔科拉迪地区孕妇使用IPTp-SP可降低疟疾感染率，应通过适当完成剂量和扩大覆盖范围来加强其在疟疾预防中的应用。
