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Individual efficacy of intermittent preventive treatment with sulfadoxine-pyrimethamine in primi- and secundigravidae in rural Burkina Faso: impact on parasitaemia, anaemia and birth weight

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dc.contributor.author Gies, S. en
dc.contributor.author Coulibaly, S. O. en
dc.contributor.author Ouattara, F. T. en
dc.contributor.author D'Alessandro, U. en
dc.date.accessioned 2009-02-20T11:12:27Z
dc.date.available 2009-02-20T11:12:27Z
dc.date.issued 2009
dc.identifier.issn 1360-2276
dc.identifier.doi http://dx.doi.org/10.1111/j.1365-3156.2008.02215.x
dc.identifier.other ITG-P1B en
dc.identifier.other ITG-PLA en
dc.identifier.other PARAS en
dc.identifier.other U-MALAR en
dc.identifier.other JIF en
dc.identifier.other DOI en
dc.identifier.other FTB en
dc.identifier.other ABSTRACT en
dc.identifier.other UPD10 en
dc.identifier.uri http://hdl.handle.net/10390/2528
dc.description The definitive version is available at www3.interscience.wiley.com
dc.description.abstract Summary Objective To assess the efficacy at individual level of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) in primi- and secundigravidae in rural Burkina Faso. Methods Data of 1441 women enrolled in a health centre randomized trial and delivering a live-singleton between September 2004 and October 2006 were analysed at individual level. Prevalence of peripheral and placental parasitaemia, anaemia (PCV <33%), low-birth weight (<2500 g; LBW), mean packed cell volume (PCV) and birth weight were compared in relation to the number of directly observed SP doses. Results Two or more doses of SP significantly reduced the risk of placental parasitaemia [adjusted odds ratio (AOR) = 0.04, 95%CI = 0.003-0.60, P = 0.023] and anaemia at delivery (AOR = 0.31, 95%CI = 0.18-0.52, P < 0.001). IPTp was associated with reduced risk of LBW in primigravidae (AOR = 0.11, 95%CI = 0.07-0.17, P < 0.001) but not secundigravidae (AOR = 0.70, 95%CI = 0.26-1.91, P = 0.452). For each increment in number of SP doses mean PCV increased by 1.0% (95%CI = 0.4-1.7, P = 0.005) at 32 weeks gestation, by 1.2% (95%CI = 0.2-2.2, P = 0.025) at delivery and mean birth weight by 220 g (95%CI = 134-306 P < 0.001) in primigravidae and by 102 g (95%CI = 55-148, P = 0.001) in secundigravidae. Conclusion The risk of malaria infection was significantly reduced by IPTp with SP in primi- and secundigravidae in rural Burkina Faso. The impact on clinical outcomes is lower and mainly limited to primigravidae for LBW. Incomplete uptake of IPTp-SP and limited effect in low risk groups together may substantially dilute the measurable impact of effective interventions. This needs to be taken into account when evaluating interventions at community level. en
dc.language English en
dc.publisher Blackwell Publishing
dc.subject Protozoal diseases en
dc.subject Malaria en
dc.subject Pregnancy en
dc.subject Drug therapy en
dc.subject Intermittent treatment en
dc.subject Sulfadoxine-pyrimethamine en
dc.subject Treatment outcomes en
dc.subject Parasitemia en
dc.subject Anemia en
dc.subject Birth weight en
dc.subject Burkina Faso en
dc.subject Africa, West en
dc.title Individual efficacy of intermittent preventive treatment with sulfadoxine-pyrimethamine in primi- and secundigravidae in rural Burkina Faso: impact on parasitaemia, anaemia and birth weight en
dc.type Article en
dc.citation.issue 2 en
dc.citation.jtitle Tropical Medicine and International Health en
dc.citation.volume 14 en
dc.citation.pages 174-182 en
dc.publisher.place Oxford
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/19171009
dc.citation.jabbreviation Trop Med Int Health en


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