Prevention of Malaria during Pregnancy: Assessing the Effect of the Distribution of IPTp Through the National Policy in Benin

Port, Agnès Le; Cottrell, Gilles; Dechavanne, Célia; Briand, Valérie; Bouraïma, Aziz; Guerra, José; Choudat, Isabelle; Massougbodji, Achille; Fayomi, Benjamin; Migot-Nabias, Florence; Garcia, André; Cot, Michel

doi:10.4269/ajtmh.2011.10-0319

Cited by 23 publications

(22 citation statements)

References 19 publications

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“…The results are consistent with efficacy results reported from several sub- Saharan African countries17,18,26–28 in regard to the prevalence of LBW and severe anemia in the controlled IPTp group.…”

Section: Discussionsupporting

confidence: 91%

Comparative efficacy of uncontrolled and controlled intermittent preventive treatment during pregnancy (IPTp) with combined use of LLTNs in high resistance area to sulfadoxine-pyrimethamine in Côte d’Ivoire

Offianan¹,

Pénali²,

Coulibaly³

et al. 2012

IDR

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IntroductionIn recent years, intermittent preventive treatment for pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) has become policy in much of sub-Saharan Africa. But resistance to SP has been spreading across sub-Saharan Africa and thus the effectiveness of IPTp-SP has been questioned. The present study therefore sought to assess the incidence of placental malaria, low birth weight, and anemia of two IPTp-SP approaches (directly observed treatment scheme versus no directly observed treatment) in Anonkoua-Kouté and Samo, Côte d’Ivoire where the reported prevalence of dfr single mutant 108 was 62% and 52.2%, respectively.MethodsThe study was a longitudinal design involving pregnant women and was conducted in Anonkoua-Kouté, a suburban area, and Samo, a rural area, from January 2008 through March 2009. Women of a pregnancy less than 28 weeks duration were randomized to receive SP (1.5 g/0.075 g SP) in a single intake twice and were followed up monthly until delivery. Doses were administered under supervision in the controlled IPTp group, while SP was given free to women in the uncontrolled IPTp group with a recommendation to take it at home. The primary end point was the proportion of low birth weight infants (body weight < 2500 g) and the secondary end point was the rate of severe anemia and placental malaria detected at delivery.ResultsA total of 420 pregnant women were enrolled (212 and 208, respectively, in the controlled and uncontrolled groups). Delivery outcome was available for 378 women. In the modified intention-to-treat analysis, low birth weight infants were born from 15.5% of women of the uncontrolled IPTp group and from 11.9% of women in the controlled IPTp group (P = 0.31). The per-protocol population analysis showed consistent results. The proportion of women with placental malaria infection, moderate anemia (hemoglobin < 11 g/dL), and severe anemia (hemoglobin < 8 g/dL) at delivery were similar between the two groups (P > 0.05).ConclusionThe study showed that the two approaches were equivalent, suggesting that unsupervised IPTp-SP free of charge should be used in areas where implementation of the directly observed treatment scheme suffers from many constraints.

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Section: Discussionsupporting

confidence: 91%

Comparative efficacy of uncontrolled and controlled intermittent preventive treatment during pregnancy (IPTp) with combined use of LLTNs in high resistance area to sulfadoxine-pyrimethamine in Côte d’Ivoire

Offianan¹,

Pénali²,

Coulibaly³

et al. 2012

IDR

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“…IPTp has been shown to be effective in reducing maternal and infant mortality that are related to malaria for the most at risk group for malaria [10][11][12][13]. No cost effectiveness analysis has been done for the IPTp.…”

Section: Introductionmentioning

confidence: 99%

Cost Effectiveness Analysis of Optimal Malaria Control Strategies in Kenya

2016

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Malaria remains a leading cause of mortality and morbidity among the children under five and pregnant women in sub-Saharan Africa, but it is preventable and controllable provided current recommended interventions are properly implemented. Better utilization of malaria intervention strategies will ensure the gain for the value for money and producing health improvements in the most cost effective way. The purpose of the value for money drive is to develop a better understanding (and better articulation) of costs and results so that more informed, evidence-based choices could be made. Cost effectiveness analysis is carried out to inform decision makers on how to determine where to allocate resources for malaria interventions. This study carries out cost effective analysis of one or all possible combinations of the optimal malaria control strategies (Insecticide Treated Bednets-ITNs, Treatment, Indoor Residual Spray-IRS and Intermittent Preventive Treatment for Pregnant Women-IPTp) for the four different transmission settings in order to assess the extent to which the intervention strategies are beneficial and cost effective. For the four different transmission settings in Kenya the optimal solution for the 15 strategies and their associated effectiveness are computed. Cost-effective analysis using Incremental Cost Effectiveness Ratio (ICER) was done after ranking the strategies in order of the increasing effectiveness (total infections averted). The findings shows that for the endemic regions the combination of ITNs, IRS, and IPTp was the most cost-effective of all the combined strategies developed in this study for malaria disease control and prevention; for the epidemic prone areas is the combination of the treatment and IRS; for seasonal areas is the use of ITNs plus treatment; and for the low risk areas is the use of treatment only. Malaria transmission in Kenya can be minimized through tailor-made intervention strategies for malaria control which produces health improvements in the most cost effective way for different epidemiological zones. This offers the good value for money for the public health programs and can guide in the allocation of malaria control resources for the post-2015 malaria eradication strategies and the achievement of the Sustainable Development Goals.

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“…SP is still recommended in combination with artesunate or chloroquine as a second-line therapy for uncomplicated P. falciparum and P. vivax malaria (7,17,19). SP is also still widely used in Africa for the intermittent preventive treatment (IPT) of malaria in infants (6), children (3), and pregnant women (8). SP resistance has been well characterized at the molecular level.…”

mentioning

confidence: 99%

The F423Y Mutation in the pfmdr2 Gene and Mutations N51I, C59R, and S108N in the pfdhfr Gene Are Independently Associated with Pyrimethamine Resistance in Plasmodium falciparum Isolates

Briolant

Bogreau

Gil

et al. 2012

Antimicrob Agents Chemother

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Prevention of Malaria during Pregnancy: Assessing the Effect of the Distribution of IPTp Through the National Policy in Benin

Cited by 23 publications

References 19 publications

Comparative efficacy of uncontrolled and controlled intermittent preventive treatment during pregnancy (IPTp) with combined use of LLTNs in high resistance area to sulfadoxine-pyrimethamine in Côte d’Ivoire

Comparative efficacy of uncontrolled and controlled intermittent preventive treatment during pregnancy (IPTp) with combined use of LLTNs in high resistance area to sulfadoxine-pyrimethamine in Côte d’Ivoire

Cost Effectiveness Analysis of Optimal Malaria Control Strategies in Kenya

The F423Y Mutation in the pfmdr2 Gene and Mutations N51I, C59R, and S108N in the pfdhfr Gene Are Independently Associated with Pyrimethamine Resistance in Plasmodium falciparum Isolates

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Prevention of Malaria during Pregnancy: Assessing the Effect of the Distribution of IPTp Through the National Policy in Benin

Cited by 23 publications

References 19 publications

Comparative efficacy of uncontrolled and controlled intermittent preventive treatment during pregnancy (IPTp) with combined use of LLTNs in high resistance area to sulfadoxine-pyrimethamine in C&ocirc;te d&rsquo;Ivoire

Comparative efficacy of uncontrolled and controlled intermittent preventive treatment during pregnancy (IPTp) with combined use of LLTNs in high resistance area to sulfadoxine-pyrimethamine in C&ocirc;te d&rsquo;Ivoire

Cost Effectiveness Analysis of Optimal Malaria Control Strategies in Kenya

The F423Y Mutation in the pfmdr2 Gene and Mutations N51I, C59R, and S108N in the pfdhfr Gene Are Independently Associated with Pyrimethamine Resistance in Plasmodium falciparum Isolates

Contact Info

Product

Resources

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Comparative efficacy of uncontrolled and controlled intermittent preventive treatment during pregnancy (IPTp) with combined use of LLTNs in high resistance area to sulfadoxine-pyrimethamine in Côte d’Ivoire

Comparative efficacy of uncontrolled and controlled intermittent preventive treatment during pregnancy (IPTp) with combined use of LLTNs in high resistance area to sulfadoxine-pyrimethamine in Côte d’Ivoire