Intermittent preventive treatment comparing two versus three doses of sulphadoxine pyrimethamine (IPTp-SP) in the prevention of anaemia in pregnancy in Ghana: A cross-sectional study

Abstract

In 2012 the World Health Organisation (WHO) revised the policy on Intermittent Preventive Treatment with Sulphadoxine Pyrimethamine (IPTp-SP) to at least three doses for improved protection against malaria parasitaemia and its associated effects such as anaemia during pregnancy. We assessed the different SP dosage regimen available under the new policy to determine the dose at which women obtained optimal protection against anaemia during pregnancy. A cross-sectional study was conducted among pregnant women who attended antenatal clinic at four different health facilities in Ghana. The register at the facilities served as a sampling frame and simple random sampling was used to select all the study respondents; they were enrolled consecutively as they kept reporting to the facility to receive antenatal care to obtain the required sample size. The haemoglobin level was checked using the Cyanmethemoglobin method. Multivariable logistic regression was performed to generate odds ratios, confidence intervals and p-values. The overall prevalence of anaemia among the pregnant women was 62.6%. Pregnant women who had taken 3 or more doses of IPTp-SP had anaemia prevalence of 54.1% compared to 66.6% of those who had taken one or two doses IPTp-SP. In the multivariable logistic model, primary (aOR 0.61; p = 0.03) and tertiary education (aOR 0.40; p = <0.001) decreased the odds of anaemia in pregnancy. Further, pregnant women who were anaemic at the time of enrollment (aOR 3.32; p = <0.001) to the Antenatal Care clinic and had malaria infection at late gestation (aOR 2.36; p = <0.001) had higher odds of anaemia in pregnancy. Anaemia in pregnancy remains high in the Northern region of Ghana. More than half of the pregnant women were anaemic despite the use of IPTp-SP. Maternal formal education reduced the burden of anaemia in pregnancy. The high prevalence of anaemia in pregnancy amid IPTp-SP use in Northern Ghana needs urgent attention to avert negative maternal and neonatal health outcomes.

Intermittent preventive treatment in pregnancy with sulfadoxine–pyrimethamine and parasite resistance: cross-sectional surveys from antenatal care visit and delivery in rural Ghana

“…It’s still plausible that the effect of SP treatment on other non-malarial infections (especially sexually transmitted infections) indirectly contributes to this observed beneficial effect on birth weight. Also, an association was not found between uptake of ≥ 3 SP doses and anaemia confirming the finding of Agyeman et al [ 29 ]: IPTp-SP alone doesn’t protect pregnant women from anaemia, because anaemia in pregnancy is multifactorial and involves other factors such as nutrition.…”

Effect of and Interventions in Prevention and Management of Maternal Anemia in the Advent of COVID-19

“…A sensitivity analysis was thus performed to explore the impact of excluding or including studies in the meta-analysis based on sample size, methodological quality, and variance. After removing four studies (n=1,788 pregnant women) [21]–[23], [25] with wider 95% C.I (confidence intervals), a total of 4,341 pregnant women were left for analysis in the remaining studies[19], [20], [24], [26]–[29]. Figure 3 shows a shift to (random effects model RR 0.61, 95% CI 0.43, 0.87; P = 0.…”

Risk factors for anaemia among pregnant women: A cross-sectional study in Upper East Region, Ghana

“…SP drugs are known for their efficacy in preventing and treating malaria during pregnancy, which serves as a significant risk factor for anaemia (33,36). So, a pregnant woman who religiously adheres to SP intake and other malaria preventive measures tends to protect against malaria and anaemia (20,36). Facilities without SP drugs may be an indirect contributor to anaemia in pregnancy, hence further studies should consider health facilities' impact on anaemia by assessing the SP stock level.…”