Effectiveness of intermitent preventive treatment with sulphadoxinepyrimethamine and insecticide treated nets on the prevention of malaria in pregnancy in non-malarial endemic area
Abstract
Background
Malaria prevention strategies significantly reduced the prevalence of malaria in pregnant
women in several studies done in malaria endemic regions. We assessed the effectiveness
of Intermittent preventive treatment with sulphadoxine-pyrimethamine and Insecticide
treated nets on the prevention of malaria in pregnancy in a non-malaria endemic area.
Objective.
To determine the effectiveness of Intermittent preventive treatment with sulphadoxinepyrimethamine and
Insecticide treated nets on the prevention of malaria in pregnancy in a
non-malaria endemic area.
Study Des2"in.
Comparison pre and post Interventions.
StudY Area.
Kapsabet district hospital-Cental Nandi.
Methodologv.
this was pre and post IPT/ITN Intervention comparison study, where 143 non-randomised
pregnant women were followed through the Antenatal clinic before 28 weeks gestation
until delivery and compared with records of 600 pregnant women who attended ANC and
delivered at the hospital in year 2001 before the interventions were implemented.
Results
The incidence of malaria infection in pregnancy was 21% in the non-intervention group
compared with 8% in the intervention group, (p-value 0.000). The incidence of low birth
weight was 12.S% in the non-intervention group compared with S.6% in the intervention
group (p-value 0.018), this showed a reduction of low birth weight by SO%.
The incidence of Still births was 6% in the non-intervention group and 1.4% in the
intervention group (p-value 0.02S). There were 2 (0.3%) cases of maternal mortality in the
non-intervention group and no mortality in the intervention group which was statistically
not significant but clinically significant.
Conclusion
The use of Intermittent preventive treatment with sulphadoxine-pyrimethamine and
Insecticide Treated Nets is effective in prevention of malaria in pregnancy in non-malaria
endemic region and is associated with reduction of adverse pregnancy outcomes.
Recommendations
Ministry of health and partners to:-
• Maintain and upscale the use of sulphadoxine-pyrimethamine during pregnancy,
• Avail subsidised long lasting insecticide treated bed nets to pregnant women.
• Carry out periodic health promotion and vector control activity education at the
community level. .