Odoh G U, Agu P U, Ugwu E O, Dim C C, Obi S N, Nnagbo J E, Eze M I, Eleje G U, Ekwuazi K E, Ugwu A O, Ekwueme P C, Anigbo C S
Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu, Nigeria.
Department of Obstetrics and Gynanecology, College of Medicine, University of Nigeria Ituku-Ozalla Campus, Enugu, Nigeria. Email:
West Afr J Med. 2024 Aug 30;41(8):860-867.
There are reports of a high prevalence of maternal peripheral and placental malarial parasitaemia (MP) in southeastern Nigeria following the two-dose regimen of sulphadoxine-pyrimethamine (SP) for intermittent preventive treatment (IPT) of malaria in pregnancy.
To compare the effectiveness of monthly versus two-dose regimens of SP for IPT of malaria in pregnancy in Enugu, south-eastern Nigeria.
A randomized controlled trial involving antenatal clinic attendees at the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria. Pregnant women at gestational ages between 13 - 24 weeks were randomized into two groups; intervention group and control group to receive monthly dosing and a two-dose regimen of IPT-SP respectively. Peripheral and placental malaria parasitaemia (MP) and other outcome measures were compared between the two groups.
Prevalence of placental parasitaemia ( 18% vs. 40.6%; RR: 0.44; 95% CI: 0.27 - 0.72; P < 0.001) and maternal peripheral parasitaemia (10.0% vs. 31.7%; RR: 0.32; 95% CI: 0.16 - 0.61; P < 0.001) were significantly lower in the intervention compared to the control group. Similarly, maternal anaemia (39.0% versus 57.4%, p<0.05), neonatal malaria parasitaemia (5.0% versus 16.8%, p < 0.05) and neonatal anaemia (10.0% versus 23.8%, < 0.05) were all significantly lower in the intervention than the control group. However, the incidence of low birth weight (LBW) did not differ between the two groups (P=1.0).
Monthly IPT-SP is more effective in preventing malaria in pregnancy than the standard two-dose regimen. We recommend the universal adoption of this regimen in all obstetric care units.
有报告称，在尼日利亚东南部，采用两剂周效磺胺-乙胺嘧啶（SP）进行孕期疟疾间歇预防性治疗（IPT）后，孕产妇外周血和胎盘疟疾寄生虫血症（MP）的患病率很高。
比较在尼日利亚东南部埃努古，每月一次给药方案与两剂给药方案的SP用于孕期疟疾IPT的有效性。
一项随机对照试验，纳入了尼日利亚埃努古伊图库-奥扎拉的尼日利亚大学教学医院（UNTH）产前门诊的就诊者。孕周在13-24周之间的孕妇被随机分为两组；干预组和对照组分别接受每月一次给药和两剂给药方案的IPT-SP。比较两组之间的外周血和胎盘疟疾寄生虫血症（MP）及其他结局指标。
与对照组相比，干预组的胎盘寄生虫血症患病率（18%对40.6%；RR：0.44；95%CI：0.27-0.72；P<0.001）和孕产妇外周血寄生虫血症（10.0%对31.7%；RR：0.32；95%CI：0.16-0.61；P<0.001）显著更低。同样，干预组的孕产妇贫血（39.0%对57.4%，p<0.05）、新生儿疟疾寄生虫血症（5.0%对16.8%，p<0.05）和新生儿贫血（10.0%对23.8%，<0.05）均显著低于对照组。然而，两组之间的低出生体重（LBW）发生率没有差异（P=1.0）。
每月一次的IPT-SP在预防孕期疟疾方面比标准的两剂给药方案更有效。我们建议在所有产科护理单位普遍采用该方案。
