The effect of intermittent preventive treatment using sulphadoxine pyrimethamine in the control of malaria in pregnancy: A cross-sectional study in the Offinso district of Ghana

Emmanuel Osei Tutu^{1, 2*}, Easmon Otupiri², John Larbi¹, Charles Brown³, Edmund Browne² and Bernard Lawson¹

¹Department of Theoretical and Applied Biology, Faculty of Biosciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

²Department of Community Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

³Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.

*Corresponding author. E-mail: oseitutu17@yahoo.com. Tel: +233 0243 451631, +233 0265 525825.

Accepted 15 April , 2010

   Abstract

Malaria infection during pregnancy causes maternal anaemia and placental parasitaemia both of which pose substantial risks to the mother, the foetus and the newborn. This study assessed the effects of intermittent preventive treatment (IPTp) using sulphadoxine-pyrimethamine (SP) to control malaria in pregnancy in the Offinso district, Ghana. Pregnant women attending antenatal clinics (ANC) between October 2005 and June 2006 in five health facilities in the District were studied. The effects of SP on parasitaemia, haemoglobin level and adverse effects on pregnant women were assessed. Of the 444 pregnant women studied, 190 (43%) took SP. The influence of SP intake on malaria infection was insignificant (r = 0.0008, p = 0.986). However, there was a tendency towards reduced parasitaemia as number of SP doses increased; one dose: 29/82 (35%), two doses: 18/57 (32%) and three doses: 11/57 (22%). The mean Hb level (10.4 ± 1.69 g/dl) for the SP group (all doses combined) was significantly higher than that (9.9 ± 1.64 g/dl) in the no SP group (p = 0.002). Further, there was a significant association between IPTp using SP and haemoglobin level (p = 0.01) with a dose-response relationship. SP usage had no significant adverse effects on the pregnant women. Effective implementation of IPTp using SP is an evidence-based measure for control of malaria-related anaemia in pregnancy.

Key words: Malaria, intermittent preventive treatment, pregnant women, sulphadoxine-pyrimethamine.