Field utilization patterns of insecticide-treated net and intermittent preventive treatment with sulphadoxine-pyrimethamine in a resource poor endemic area: Patterns′ associations with adverse mother or birth outcomes

Abstract

Objective: (i) Highlight ield realities on proportions of parturient mothers who use during pregnancy intermittent preventive treatment-sulfadoxine-pyrimethamin (IPT-SP) without insecticide-treated net (ITN), IPT-SP in combination with ITN or ITN without IPT-SP; (ii) investigate associations existing between these preventive approaches with low prevalence of peripheral parasitemia, placental malaria, low birth weight (LBW) and anemia. Materials and Methods: Proportions of parturient mothers who utilize any of these approaches during pregnancy were estimated as well as associated rates of peripheral parasitemia, placental malaria, anemia and LBW; associations were investigated by comparing each group with participants who never utilized IPT-SP or ITN during pregnancy. Results and Conclusions: Of the 705 participants, 121 (17.2%) never used IPT-SP or ITN during pregnancy; 83 (11.8%) utilized ITN without IPT-SP and 501 (71.0%) utilized IPT-SP of those, 97% used IPT-SP1 and 3% used IPT-SP2/SP3. 275 (39%) used IPT-SP without ITN and 226 (32%) used IPT-SP in combination with ITN. While signi icant associations were found between: (i) Combined utilization of IPT-SP with ITN and low prevalence of peripheral parasitemia, placental malaria and LBW, (ii) utilization of IPT-SP without ITN and low prevalence of LBW and (iii) utilization of ITN without IPT-SP and low prevalence of placental malaria, no associations were seen between any of these approaches and low prevalence of anemia. Neither IPT nor ITN alone reduced as much adverse outcomes as when used together in combination, suggesting that in areas of moderate or high transmission of malaria, combined utilization of IPT-SP1/SP2 with ITN was the most effective approach for malaria prevention in pregnancy.