Intermittent preventive treatment and its effect on maternal and neonatal malaria in two health facilities, Rivers State, south-south Nigeria
The use of sulphadoxine pyrimethamine (IPTp-Sp) as a control measure for malaria infection has been found to prevent malaria in pregnancy. However there are still gaps in levels of compliance. This study was carried out to evaluate these gaps in compliance to IPTp-Sp and its effects on placental and neonatal malaria in two health facilities in Rivers State, Nigeria. Three hundred consented participants were administered questionnaires, and blood samples collected from maternal peripheral blood (MPB), placental blood (PLB) and neonatal cord blood (NCB) immediately after delivery. Malaria parasitaemia and anaemia were analysed using standard parasitological and haematological methods of examination. Results showed that 83(27.7%) MPB, 66(22.0%) PLB, and 40(13.3%) NCB were positive to malaria parasitaemia cases. On IPTp-SP usage, 261(87.0%) received SP in different doses while 39(13.0%) did not (p<0.05). Sixty-six (25.3%) of users and 17(43.6%) of non-users tested positive to malaria parasitaemia (p<0.05). Sixty-six infected mothers who received IPTp-SP, 49(74.2%), 15(22.7%) and 2(3.0%) had 1, 2, 3 doses respectively. Maternal anaemia was 12(4.6%) for IPTp-SP users and 12(30.8%) for nonusers while neonatal recorded 4(1.5%) and 5(13.5%) respectively (p<0.05). The birth-weight of the babies weighing <2.5 kg recorded 3(1.2%) for IPTp-SP users and 6(16.2%) for non-users. Knowledge on SP showed that 239(79.7%) had good knowledge while 61(20.3%) had no knowledge and 13(4.3%), 201(67.0%) and 86(28.7%) commenced treatment on first, second and third trimesters respectively. Prevalence based on age showed that 22(15.1%) mothers within the age of 31-40 years, while prevalence based on education showed that mothers who had tertiary education has the least infection 21(18.3%). The use and compliance to IPTp-Sp is observed to reduce the prevalence and complications of malaria among the studied population. However, there are still gaps in compliance and efforts should be intensified towards total compliance which includes enforcing total compliance, availability of drugs and education of the pregnant women.
Keywords: Malaria parasitaemia; preventive treatment; pregnancy.