Godwin Isaac Okezie, Ekejindu Ifeoma Mercy, Eleje George Uchenna, Ezeagwuna Dorothy Amauche, Okafor Chigozie Geoffrey, Onwuegbuna Arinze Anthony, Umeononihu Osita Samuel, Godwin Prisca Obiageli, Ogelle Onyecherelam Monday, Ikechebelu Joseph Ifeanyichukwu
Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi, Nigeria.
Effective Care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka (Nnewi Campus), P.M.B. 5001, Nnewi, Anambra State, Nigeria.
Ther Adv Infect Dis. 2022 Sep 6;9:20499361221122620. doi: 10.1177/20499361221122620. eCollection 2022 Jan-Dec.
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.
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.
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 -value of < 0.05 considered significant.
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% 53.7%; < 0.001) and their babies (12.2% 25.4%; = 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 ( = 0.789). Mean parasite density was reduced in IPTp-SP users than in non-users ( < 0.001). Correlation of birth weight according to their sex showed a weak correlation [correlation coefficient () = 0.027; = 0.736]. Pregnant women with preterm delivery, spontaneous abortion, intra-uterine foetal death, and low birth weight were significantly lower ( < 0.001, for all) in IPTp-SP users compared with non-users.
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.
遵循世界卫生组织（WHO）关于使用磺胺多辛-乙胺嘧啶进行孕期疟疾 4 周一次产前间歇性预防治疗（IPTp-SP）的建议，有必要评估该药物性能，以确定其作为疟疾控制政策工具的有效性。
确定与未使用 IPTp-SP 的孕妇相比，使用 IPTp-SP 的孕妇脐带血疟疾患病率、依从性差距及不良妊娠结局（贫血、早产、自然流产、宫内胎儿死亡和低出生体重）。
对 390 名同意参与的参与者进行了一项横断面分析研究，向他们发放问卷，并在分娩后立即从参与者静脉血和新生儿脐带采集配对血样。参与者被分为 IPTp-SP 用户和非用户。评估不良妊娠结局。分娩后 1 小时内还测量了新生儿出生体重。使用标准寄生虫学和血液学检查方法分析疟疾寄生虫血症和贫血情况。使用适用于 Windows 的 SPSS 25 版软件分析数据，P 值<0.05 被认为具有统计学意义。
在 390 名女性中，336 名（86.2%）为 IPTp-SP 用户，而 54 名（13.8%）为非用户。依从性差距为 13.8%。IPTp-SP 用户和非用户的孕妇疟疾寄生虫血症分别为 21.7%（53.7%；P<0.001）和其婴儿为 12.2%（25.4%；P = 0.002）。IPTp-SP 用户中孕产妇贫血患病率为 27 例（8.0%），非用户中为 5 例（9.3%）（P = 0.789）。IPTp-SP 用户的平均寄生虫密度低于非用户（P<0.001）。根据性别划分的出生体重相关性显示为弱相关性[相关系数（r）= 0.027；P = 0.736]。与非用户相比，IPTp-SP 用户中早产、自然流产、宫内胎儿死亡和低出生体重的孕妇显著更少（所有 P<0.001）。
尽管依从性差距较低，但与非用户相比，IPTp-SP 用户的妊娠和胎儿结局显著更好。应加大力度促使孕妇在使用 IPTp-SP 时实现完全依从。
