Evaluation of the use of sulfadoxine-pyrimethamine (SP) intermittent treatment (IPT) to prevent malaria during pregnancy in Ndola, Zambia.
Thesis (MFamMed)--Stellenbosch University, 2009.
ENGLISH SUMMARY : Background: Malaria in pregnancy is associated with many negative outcomes on the pregnant woman, the fetus and the neonate. Intermittent Preventive Treatment during pregnancy (IPTp) using Sulfadoxine-Pyrimethamine (SP) is one of the main strategies used to prevent malaria in this vulnerable group in conjunction with use of Insecticide Treated mosquito Nets (ITN) and Indoor Residual Spray (IRS). The aim of this study was to evaluate the effectiveness of these strategies on the prevalence of the disease in pregnant women, five years after their implementation in Zambia. If possible to make recommendations on how prevention can be improved. Methods: A questionnaire on socio-demographic information, history of malaria during the current pregnancy (any anti-malaria treatment) and malaria prevention strategy used (ITN and repellent use) was administered to 450 consecutive patients. Information was collected from the antenatal cards on the last menstrual period, date at which each dose of IPTp was taken, gravidity, and Human Immuno-deficiency Virus (HIV) status. A blood slide to assess parasitaemia was collected from each woman when they attended the labour ward. Results: 2.4% of participants had a positive parasitemia. All the participants took at least one dose of SP/IPTp with 87.6% completing the stipulated three doses. The mean gestational age for each dose were 22.1 (SD 4.6), 29.1 (SD 4.4) and 34.4 (SD 3.9) weeks for the first, second and third doses respectively. The Insecticide Treated Nets (ITN) ownership percentage was 79.5% and the ITN regular utilization rate 74.1%. Conclusion: We found that the prevalence of malaria in pregnancy in Ndola is remarkably low due to the implementation of different preventives strategies under the Roll Back Malaria (RBM) initiative. A considerable proportion of pregnant women received the three recommended doses, though the timing of delivery of each dose needs to be improved. The study also showed that the ownership rate of ITNs was high, but that the utilization rate still needs to be increased. Ministry of Health should continue supporting and encouraging the implementation of these strategies as they are certainly impacting positively on the reduction of malaria burden on the pregnant women.
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