Clinical malaria among pregnant women on combined insecticide treated nets (ITNs) and intermittent preventive treatment (IPTp) with sulphadoxine-pyrimethamine in Yaounde, Cameroon

Mbu, Robinson Enow; Takang, W; Fouedjio, Hortence Jeanne; Fouelifack, Florent Ymélé; Tumasang, Florence; Tonye, R

doi:10.1186/1472-6874-14-68

Cited by 13 publications

(17 citation statements)

References 34 publications

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“…The strong association between the number of ANC visits and use of prophylactic medication is expected since these medications are most often administered from ANC clinic. There is an obvious clinical benefit to 2 or 3 doses of SP compared to single dose and longer time (>10 weeks) between doses has been associated with suboptimal outcomes [28]. Wealth was associated with access to and use of malaria prophylaxis medications in prior studies but was not seen in this study [21, 29].…”

Section: Discussionmentioning

confidence: 76%

Predictors of the use of interventions to prevent malaria in pregnancy in Cameroon

Dionne-Odom

Westfall

Apinjoh

et al. 2017

Malar J

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BackgroundMalaria in pregnancy is common in sub-Saharan Africa where it contributes to perinatal morbidity and mortality. Use of insecticide-treated bed nets and intermittent preventive therapy with sulfadoxine–pyrimethamine during pregnancy are effective but underutilized interventions to prevent infection. Factors associated with bed net ownership and usage, and use of prophylaxis among recently pregnant women in Cameroon were investigated.MethodsNational data from the 2011 Cameroon Demographic Health Survey was used to identify women with a pregnancy within the previous 5 years. Logistic regression models were created to assess for independent predictors of reported bed net ownership, bed net usage, and the use of malaria prophylaxis medications during pregnancy.ResultsNearly one in two women surveyed had a recent pregnancy (n = 7647). In this group, bed net ownership and usage rates were low (33.7 and 16.9%, respectively); 61.6% used medication for malaria prophylaxis during pregnancy. Bed net ownership and usage were associated with maternal literacy (aOR 1.4 for net usage, 95% CI 1.1–1.8) and the presence of children under age 5 in the home (aOR 2.3 for net usage, 95% CI 1.6–3.3). The use of malaria prophylaxis medication was associated with measures of healthcare access (aOR 17.8, 95% CI 13–24.5 for ≥4 antenatal care visits), higher maternal education (aOR 1.5, 95% CI 1.1–2.1) and maternal literacy (aOR 1.4, 95% CI 1.1–1.7).ConclusionsWomen in Cameroon and their antenatal providers missed many opportunities to prevent malaria in pregnancy. Efforts toward ensuring universal bed net provision, consistent antenatal care and the education of girls are likely to improve birth outcomes attributable to malaria infection.

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Section: Discussionmentioning

confidence: 76%

Predictors of the use of interventions to prevent malaria in pregnancy in Cameroon

Dionne-Odom

Westfall

Apinjoh

et al. 2017

Malar J

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“…Women with increased Ab levels probably became infected with P. falciparum when SP levels declined below effective levels because of a delay in taking SP. A recent study in Cameroon 38 showed that clinical malaria was associated with long spacing between SP doses. In our study, malaria was not always detected in blood smears when Ab levels increased, suggesting that the women rapidly cleared their infections or had submicroscopic infections.…”

Section: Discussionmentioning

confidence: 99%

Influence of Intermittent Preventive Treatment on Antibodies to VAR2CSA in Pregnant Cameroonian Women

Babakhanyan¹,

Tutterrow²,

Bobbili³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Intermittent preventive treatment (IPT) and insecticide-treated bed nets are the standard of care for preventing malaria in pregnant women. Since these preventive measures reduce exposure to malaria, their influence on the antibody (Ab) response to the parasite antigen VAR2CSA was evaluated in pregnant Cameroonian women exposed to holoendemic malaria. Ab levels to full-length VAR2CSA (FV2), variants of the six Duffy binding like (DBL) domains, and proportion of high avidity Ab to FV2 were measured longitudinally in 92 women before and 147 women after IPT. As predicted, reduced exposure interfered with acquisition of Ab in primigravidae, with 71% primigravidae being seronegative to FV2 at delivery. Use of IPT for > 13 weeks by multigravidae resulted in 26% of women being seronegative at delivery and a significant reduction in Ab levels to FV2, DBL5, DBL6, proportion of high avidity Ab to FV2, and number of variants recognized. Thus, in women using IPT important immune responses were not acquired by primigravidae and reduced in a portion of multigravidae, especially women with one to two previous pregnancies. Longitudinal data from individual multigravidae on IPT suggest that lower Ab levels most likely resulted from lack of boosting of the VAR2CSA response and not from a short-lived Ab response.

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“…Longitudinal cohort studies investigating the clinical presentation of malaria parasite infection in pregnant women showed that during routine ANC (scheduled) visits, malaria is less common [ 4 , 9 , 10 ]. However, studies in Mozambique [ 4 ] and Benin [ 5 ] revealed that during unscheduled visits, about 90 % of pregnant women infected with malaria parasite had symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…Symptoms commonly associated with malaria parasitaemia include fever, headache and shivering [ 5 ]. It is possible that in malaria stable transmission areas, the burden of malaria is been underestimated, as most studies have been carried out in women reporting for scheduled visits or at delivery to investigate placental malaria [ 6 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Clinical manifestations of P.falciparum infection may largely depend on the intensity and stability of malaria transmission in the local environment [ 11 ]. Other factors commonly reported to increase risk of malaria among pregnant women include; younger age, primigravidity, second and third trimester of gestation [ 3 , 10 ], level of education [ 10 , 12 ] and rainy season [ 3 ]. Malaria alters haematological parameters with low platelet, WBCs and lymphocyte counts being the most important predictors of malaria infection.…”

Section: Introductionmentioning

confidence: 99%

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Plasmodium falciparum parasitaemia and malaria among pregnant women at first clinic visit in the mount Cameroon Area

et al. 2015

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BackgroundPregnant women in malaria endemic areas are at high risk of P. falciparum infection and its complications. This study investigated the prevalence and risk factors for P. falciparum infection and malaria among pregnant women reporting for first antenatal care (ANC) clinic visit in the mount Cameroon area.MethodsVenous blood samples from consented pregnant women were screened for malaria parasitaemia by light microscopy. Haemoglobin levels, white blood cell (WBC) counts, lymphocyte counts and percentage were determined using an automated haematology analyser. Socio-demographic/economic data, environmental factors and use of malaria control measures were documented. Univariate and multivariate statistical analyses were used.ResultsSixty-eight (22.4 %; N = 303) of the women enrolled were positive for P. falciparum parasitaemia. Malaria parasitaemia was significantly (P < 0.001) associated with febrile illness. The overall prevalence of malaria and asymptomatic infection was 16.0 % (95 % CI = 11-20 %) and 10.5 % (95 % CI = 7.3-15 %) respectively. A greater proportion of the malaria cases (61 %) reported at the clinic during unscheduled days meanwhile women with asymptomatic parasitaemia mostly (92.8 %) seek for ANC during scheduled clinic days. Lower lymphocyte percentage was significantly associated with increase parasite density (r = − 0.34; P = 0.011) and febrile status (MU = 2.46; P = 0.014). While age and gravidity were significant factors associated with P. falciparum infection and/or malaria, the presence of bush and/or standing water around human residence was an independent risk factor of P. falciparum parasitaemia (OR = 3.3: 95 % CI = 1.6 – 7.0; P = 0.002) and malaria ( OR = 5.2: 95 % CI = 2.0 – 14; P = 0.001). Being unmarried was significantly associated with increase risk (OR = 2.6:95 % CI = 1.1 – 6.0; P = 0.032) of P. falciparum parasitaemia. Similarly, single women (938) had a significantly higher (t = 2.70; P = 0.009) geometric mean parasite density (GMPD) compared with married women (338).ConclusionMarital status and human residence in areas with bushes and/or standing water modify risk of P. falciparum infection and malaria. Education on early ANC attendance and environmental sanitation are important public health targets for malaria control in pregnancy in this setting.

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Clinical malaria among pregnant women on combined insecticide treated nets (ITNs) and intermittent preventive treatment (IPTp) with sulphadoxine-pyrimethamine in Yaounde, Cameroon

Cited by 13 publications

References 34 publications

Predictors of the use of interventions to prevent malaria in pregnancy in Cameroon

Predictors of the use of interventions to prevent malaria in pregnancy in Cameroon

Influence of Intermittent Preventive Treatment on Antibodies to VAR2CSA in Pregnant Cameroonian Women

Plasmodium falciparum parasitaemia and malaria among pregnant women at first clinic visit in the mount Cameroon Area

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