In-vivo parasitological response to sulfadoxine-pyrimethamine in pregnant women in southern Malawi.

BACKGROUND: Malaria in pregnancy is a significant cause of maternal and infant morbidity and mortality. Malawi adopted intermittent preventive treatment with sulfadoxinepyrimethamine (SP) for the control of malaria in pregnancy in 1993. However there is little information on the in-vivo SP efficacy in pregnant women. This study was conducted to determine: prevalence of malaria and anaemia at the first antenatal visit and rate of parasitological failure to SP in pregnancy. METHODS: A cross-sectional followed by a prospective cohort study was conducted in women attending antenatal care clinic at Montfort Hospital in Lower Shire Valley from June 2004 to February 2005. Women were screened for malaria and anaemia at the first antenatal visit. After taking SP under direct observation, women with malaria parasitaemia were followed up to day 14 to determine parasitological response. RESULTS: Of 961 women screened, 9% had malaria, 77% had anaemia (HB<11.0g/dl), 24% had moderate anaemia (HB 7.0-8.9g/dl) and 6% had severe anaemia (HB<7.0g/dl). Malaria was significantly more frequent in primigravidae, the second trimester and in the post- rainy season (all p <0.05). Moderate anaemia (Hb < 9.0g/dl) was significantly more common in adolescents and primigravidae (both p <0.05). In the14-day follow up study, loss to follow up was 13%. Of the 74 women who completed the follow up, 89% cleared malaria parasites successfully and 11% had parasitological failure. Parasitological failures were all of the R1 type except for one with R2 failure. CONCLUSION: Anaemia prevalence was high at first antenatal visit in this population. Rate of parasitological failure to SP in pregnancy increased from 5% in 1996 to 11% in 2004.

In-Vivo Parasitological Response to sulfadoxine-pyrimethamine in Pregnant Women in Southern Malawi

Background : Malaria in pregnancy is a significant cause of maternal and infant morbidity and mortality. Malawi adopted intermittent preventive treatment with sulfadoxinepyrimethamine (SP) for the control of malaria in pregnancy in 1993. However there is little information on the in-vivo SP efficacy in pregnant women. This study was conducted to determine: prevalence of malaria and anaemia at the first antenatal visit and rate of parasitological failure to SP in pregnancy. Methods: A cross-sectional followed by a prospective cohort study was conducted in women attending antenatal care clinic at Montfort Hospital in Lower Shire Valley from June 2004 to February 2005. Women were screened for malaria and anaemia at the first antenatal visit. After taking SP under direct observation; women with malaria parasitaemia were followed up to day 14 to determine parasitological response.Results: Of 961 women screened; 9 had malaria; 77 had anaemia (HB11.0g/dl); 24 had moderate anaemia (HB 7.0-8.9g/dl) and 6 had severe anaemia (HB7.0g/dl). Malaria was significantly more frequent in primigravidae; the second trimester and in the post- rainy season (all p 0.05). Moderate anaemia (Hb 9.0g/dl) was significantly more common in adolescents and primigravidae (both p 0.05). In the14-day follow up study; loss to follow up was 13. Of the 74 women who completed the follow up; 89 cleared malaria parasites successfully and 11 had parasitological failure. Parasitological failures were all of the R1 type except for one with R2 failure

We won't repeat the mistakes of the past.

PIP: The Planned Parenthood Association of Ghana and the country's Ministry of Health have seized on an innovative new method for promoting immunization coverage -- a baby contest. The event seeks to promote the benefits of good health habits, a sound environment, and immunization on a child's development. The contest is designed to determine whether the mother has understood the educational lessons concerning family planning and family health given at the immunization centers and welfare clinics. The prize for winning the contest consists of 3 plastic basins, bars of bath soap, and a white shirt. In order to take part in the baby contest, a mother has to demonstrate the following: that she took 2 doses of tetanus vaccine during pregnancy; that she is able to administer first aid and oral rehydration therapy; that she has a certain level of knowledge concerning family planning methods, environmental sanitation, and personal hygiene; and that she is able to prepare Weanimix, a local weaning food for children. The 1st baby contest was held in December 1989 in the 9 communities that form the Integrated Family Planning, Nutrition and Parasite Control Project (IP) area. This 1st competition succeeded in getting 513 mothers to complete their immunization schedules prior to the event. Because the initial contests took place in remote villages, they received little media coverage, which affected attendance. But as more contests were held and more people became involved, the media picked up the story, further increasing participation. Organizers indicate that the number of people taking part in the contests, as well as the number of children being immunized, has increased steadily every month.^ieng