Igboeli Nneka U, Adibe Maxwell O, Ukwe Chinwe V, Aguwa Cletus N
Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka, Nigeria.
J Vector Borne Dis. 2018 Jul-Sep;55(3):197-202. doi: 10.4103/0972-9062.249128.
BACKGROUND & OBJECTIVES: : Three doses of intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP) has been adopted as the new recommendation for prevention of malaria in pregnancy. This study evaluated the effectiveness of two-dose versus three-dose of SP for IPTp-SP in the prevention of low birth weight (LBW) and malaria parasitaemia.
: An open, randomized, controlled, longitudinal trial was conducted in a secondary level hospital in Nsukka region of Enugu State, Nigeria. A sample of 210 pregnant women within gestational ages of 16-24 wk were recruited at antenatal clinics and equally randomized to either a two-dose SP or three-dose SP group. The primary endpoints were LBWs, peripheral, and placental parasitaemia, while the secondary endpoints were maternal anaemia, pre-term birth, clinical malaria and adverse effects of SP.
: Among 207 cases followed till delivery, the prevalence of parasitaemia was lower in three-dose group than in two-dose group for both peripheral (9.3% versus 27.8%) and placental (10.6% versus 25.6%) parasitaemia. The adjusted odds ratios (aOR) were 0.15 [95% confidence interval (CI), 0.05 - 0.45] and 0.17 (95% CI, 0.06-0.51), respectively. The prevalence of LBW was also lower in three-dose (3.5%) than in two-dose (12.2%) group (aOR, 0.15; 95% CI, 0.04-0.63); however, the prevalence of maternal anaemia, pre-term births, clinical malaria and SP adverse effects were similar between the two arms of treatment.
INTERPRETATION & CONCLUSION: : Addition of a third SP dose to the standard two-dose SP for IPTp led to improved reductions in the risk of some adverse pregnancy outcomes.
三种剂量的磺胺多辛-乙胺嘧啶间歇性预防治疗（IPTp-SP）已被采纳为预防妊娠疟疾的新建议。本研究评估了两剂与三剂SP用于IPTp-SP预防低出生体重（LBW）和疟疾寄生虫血症的有效性。
在尼日利亚埃努古州Nsukka地区的一家二级医院进行了一项开放、随机、对照、纵向试验。在产前诊所招募了210名孕龄为16-24周的孕妇样本，并将其平均随机分为两剂SP组或三剂SP组。主要终点为低出生体重、外周血和胎盘寄生虫血症，次要终点为孕产妇贫血、早产、临床疟疾和SP的不良反应。
在随访至分娩的207例病例中，三剂组外周血（9.3%对27.8%）和胎盘（10.6%对25.6%）寄生虫血症的患病率均低于两剂组。调整后的优势比（aOR）分别为0.15[95%置信区间（CI），0.05 - 0.45]和0.17（95%CI，0.06 - 0.51）。三剂组（3.5%）的低出生体重患病率也低于两剂组（12.2%）（aOR，0.15；95%CI，0.04 - 0.63）；然而，两组治疗中孕产妇贫血、早产、临床疟疾和SP不良反应的患病率相似。
在IPTp的标准两剂SP中添加第三剂SP可改善某些不良妊娠结局风险的降低情况。
