Comparison of Intermittent Preventive Treatment with Chemoprophylaxis for the Prevention of Malaria during Pregnancy in Mali

Kayentao, Kassoum; Kodio, Mamoudou; Newman, Robert D.; Maiga, Hamma; Doumtabé, Didier; Ongoïba, Aïssata; Coulibaly, Drissa; Keita, Abdoul S.; Maiga, Bakary; Mungai, Mary; Parise, Monica E.; Doumbo, Ogobara K.

doi:10.1086/426400

Cited by 144 publications

(133 citation statements)

References 27 publications

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“…Our findings confirm the beneficial effects of IPTp in pregnant women in terms of reduction of the prevalence of malaria as well as maternal anemia, which have been shown in other studies. [23][24][25][26] At delivery, however, there was a slight increase in malaria prevalence, although not reaching the level observed in first ANVs. The shorter duration of time intervals between ANV1 and ANV2, compared with ANV2 and delivery, suggests reinfection of the women after the levels of antimalarials have dropped below subtherapeutic concentrations.…”

Section: Discussionmentioning

confidence: 84%

Maternal Anemia in Pregnancy: Assessing the Effect of Routine Preventive Measures in a Malaria-Endemic Area

Ouédraogo¹,

Koura²,

Bodeau-Livinec³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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Abstract. We investigated the effectiveness of routine preventive measures for anemia in Beninese pregnant women during pregnancy. Anemia (hemoglobin 110 g/L) was common: 68.3% at first antenatal visit (ANV1), 64.7% at second antenatal visit (ANV2), and 40.6% at delivery. Parasitic infections and nutritional deficiencies were the most preventable causes. After intermittent preventive treatment (IPTp) and antihelminthic treatments, malaria prevalence decreased from 15.1% (ANV1) to 4.0% (ANV2) and increased again to 9.6% at delivery. Helminth infections dropped from 11.1% (ANV1) to 7.2% (ANV2) and 2.4% at delivery. Malaria was associated with lower mean hemoglobin on ANV1 and delivery, and iron deficiency was associated with lower mean hemoglobin on ANV1 and ANV2. IPTp and antihelminthic treatments were efficacious to clear parasitic infections and improve hematologic status, whereas the effectiveness of daily iron and folic acid supplements to correct iron and folate deficiencies and decrease anemia was less marked, possibly because of lack of compliance.

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Section: Discussionmentioning

confidence: 84%

Maternal Anemia in Pregnancy: Assessing the Effect of Routine Preventive Measures in a Malaria-Endemic Area

Ouédraogo¹,

Koura²,

Bodeau-Livinec³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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“…This study sought to provide evidence of the efficacy of the later regimen in the treatment of uncomplicated malaria as the partner drug is used in intermittent preventive treatment in pregnant women (IPTp) and seasonal malaria chemoprevention (SMC) in children in Africa. [23][24][25][26] We evaluated efficacy of the combinations AL and AS+SP in children aged 6 months and older and adults living in a malaria-endemic area in Mali. We showed that AS+SP is as efficacious as the first-line treatment ACT with a high cure rate.…”

Section: Discussionmentioning

confidence: 99%

“…[27][28][29][30][31][32] SP is recommended in IPTp and has been used in other interventions such as SMC in Africa. [23][24][25][26] There is a concern about the rapid emergence of SP resistance. One limitation of this study is the lack of genotyping data on molecular markers of SP resistance before and after treatment.…”

Section: Discussionmentioning

confidence: 99%

In Vivo Efficacy and Parasite Clearance of Artesunate + Sulfadoxine–Pyrimethamine Versus Artemether–Lumefantrine in Mali

Niaré¹,

Dara²,

Sagara³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Although artemisinin resistance has yet to be reported in Africa, surveillance of the efficacy of artemisininbased combination therapies (ACTs) is warranted. Here, the efficacy of artesunate + sulfadoxine-pyrimethamine (AS+SP) and artemether-lumefantrine (AL) was evaluated in Mali. Randomized open-label comparative in vivo assay of AS+SP versus AL were carried out using the 28-day follow-up World Health Organization protocol. Patients with uncomplicated falciparum malaria and at least 6 months of age were recruited between October 2010 and January 2014. A subset of these patients was selected to measure Plasmodium falciparum clearance time. Polymerase chain reactioncorrected adequate clinical and parasitological responses were 100% for AS+SP and 98.2% for AL with no significant difference (P = 0.06). The reinfection rates were comparable (P = 0.63) with 8.0% for AS+SP and 12.6% for AL. Individuals under 8 years were more susceptible to treatment failure (relative risk = 1.9; 95% confidence interval = 1.2, 3.3). Median parasite clearance half-life was 1.7 hours (interquartile range [IQR] = 1.3-2.2) for AS+SP and 1.9 hours (IQR = 1.5-2.5) for AL with no statistically significant difference (P = 0.24). Efficacy of AS+SP and AL was high. This study provides baseline information on parasite clearance half-lives after ACT treatment, particularly AS+SP, in Mali.

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“…Approximately two-fifths and three-fifths of healthcare providers still prescribe chloroquine and pyrimethamine respectively despite overwhelming evidence against such practice due to increasing resistance to these drugs, and reducing efficacy of chloroquine (CQ) chemoprophylaxis 15 and weekly pyrimethamine 16,17 . The possible reasons for this would include easy availability, affordability.…”

Section: Discussionmentioning

confidence: 99%

Perception and Practice of Malaria Prophylaxis in Pregnancy among Health Care Providers in Ibadan

Onyeaso

Fawole²

2007

African Journal of Reproductive Health

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The study assessed knowledge and practice of health care providers on current concepts on malaria prophylaxis in pregnancy. 497 randomly selected respondents at the three levels of care in two local governments in Ibadan, South western Nigeria were interviewed using a self-administered questionnaire. Respondents were selected from 45 health facilities: 48 (9.7%) community health extension workers (CHEWS), 139 (28.9%) auxiliary nurses, 220 (44.3%) formally trained nurses and 90 (18.1%) medical doctors. Only 57 (11.5%) respondents were knowledgeable about current WHO strategies for malaria prevention in pregnancy. Three hundred and eighty six respondents (77.7%) were aware of intermittent preventive treatment (IPT). Awareness about IPT was highest among CHEWS (95.8%). Pyrimethamine was prescribed mainly by healthcare providers in the secondary (60.6%) and primary (60.3%) levels of care (X 2 = 11.54, p < 0.01). Chloroquine was prescribed by 42.5% of respondents. Sulfadoxine-pyrimethamine was significantly more commonly prescribed by primary health care providers than in other levels of care (X 2 = 15.07, p < 0.01). Prescription for insecticide treated nets was high. Respondents' practice of anti-malarial chemoprophylaxis was influenced by the cadre of the health care provider and level of practice. There are several knowledge gaps on current malaria prevention strategies in pregnancy among healthcare providers. Multiple strategies are required to improve health care workers' knowledge and practice of malaria prevention during pregnancy. RÉSUMÉPerception et pratique de la prophylaxie du paludisme pendant la grossesse chez les dispensateurs des soins de santé à Ibadan L'étude a évalué la connaissance et la pratique chez les dispensateurs de soins de santé à l'égard de concepts courants à l'égard de la prophylaxie du paludisme pendant la grossesse. Nous avons selectionné au hasard 497 répondants à tous les trois niveaux de soin dans deux administrations locales à Ibadan au sud-ouest du Nigéria qui ont été interviewés à l'aide d'un questionnaire auto-administré. Les répondants ont été selectionnés aupres des 45 établissements de santé: 48(9,7%) parmi le personnel des services de santé extra-hospitalier (PSSEH) 139(28,9%) infirmières auxillaires, 220(44,3%) infirmières formellement formées et 90(18,1%) médecins. Seuls 57(11,5%) des répondants connaissaient les stratégies courantes de l'OMS pour la prévention du paludisme pendant la grossesse. Trois cent quatre-vingt-six répondants (77,7%) étaient au courant du traitement préventif intermittent (TPI). La conscience du TPI était la plus élevée parmi les PSSEH (95,8%). Les dispensateurs de soins de santé ont surtout prescrit pyriméthamine au niveau secondaire (60, 6%) et au niveau primaire (60,3%) de soin (X 2 = 11, 54, p < 0, 01). Chloroquine a été prescrite par 42,5% des répondants. Sulfadoxinepyriméthamine a été, de manière signifactive, la plus communément prescrite par les dispensateurs des services de soins primaries qu'à d'autres niveaux de soin (X 2 = 15, ...

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Comparison of Intermittent Preventive Treatment with Chemoprophylaxis for the Prevention of Malaria during Pregnancy in Mali

Cited by 144 publications

References 27 publications

Maternal Anemia in Pregnancy: Assessing the Effect of Routine Preventive Measures in a Malaria-Endemic Area

Maternal Anemia in Pregnancy: Assessing the Effect of Routine Preventive Measures in a Malaria-Endemic Area

In Vivo Efficacy and Parasite Clearance of Artesunate + Sulfadoxine–Pyrimethamine Versus Artemether–Lumefantrine in Mali

Perception and Practice of Malaria Prophylaxis in Pregnancy among Health Care Providers in Ibadan

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