Comparative Study of Total Antioxidant Capacity (TAC) Levels of Pregnant Women on Intermittent Preventive Treatment with Sulphadoxine Pyrimethamine and their Controls in Malaria Endeminicity

Abstract

Background: The issue of malaria prevention in endemic areas during antenatal periods needs continuous emphasis so as to achieve its desired goals. Its roles in reducing the problems of malaria in pregnancy has been proven. The problems of anaemia in pregnancy, preterm labours, small for gestational age babies have been greatly reduced by adequate practice of Intermittent Preventive Treatment with Sulphadoxine Pyrimethamine (IPT-SP). It is also advocated that optimal levels of antioxidants like Total Antioxidant status (TAC/TAS) is necessary to assist pregnant women enjoy uneventful pregnancies as well as avert other problems associated with pregnancy. Such problems may include preterm births, neonatal anaemias, intrauterine growth retardations (IUGR), increased admissions into special care baby units and even neonatal deaths. Objectives: We have comparatively studied the plasma Total Antioxidant Capacity / Status levels in parturients who received intermittent preventive treatment with sulphadoxine pyrimethamine (IPT-SP), and their controls during current confinements. Method: This study was carried out at the Federal Medical Centre (FMC), Owerri Nigeria. Owerri, the capital of Imo state Nigeria and has a typical malaria endemic setting as seen in most parts of Sub-Saharan Africa. Ethical clearance and subsequent certification were obtained from the ethics committee of FMC Owerri enabling the commencement of the longitudinal recruitment of participants. This was after an adequate counseling and informed consent involving both groups. As a laboratory based, cross-sectional descriptive study, it involved 296 participants who clearly satisfied the inclusion criteria for either the study or control groups as allotted longitudinal. Participants were followed up after recruitment through their entire antenatal course till delivery to enable collection of blood samples for the estimation of Total Antioxidant Status/Capacity which was done using the Ferric Reducing Ability of Plasma, FRAP; by (Benzie and Strain, 1996). The methodology principle is based on the fact that at low pH, antioxidant power causes the reduction of ferric tripyridyl triazine (Fe III TPTZ) complex to ferrous form (which has an intense blue colour) that can be monitored by measuring the change in absorption at 593nm. FRAP values are obtained by comparing the absorbance change at 593 nm in mixture (test), with those containing ferrous ion in known concentration (Standard). Data analysis: The data obtained was analysis using the computer Software Package for Social Science (SPSS) version 20.0 (SPSS, Inc, 2007, Chicago) while the descriptive statistics (mean, standard deviation, range, percentages etc) were determined for continuous variables. P-value less than (<0.05) at 95% confidence interval was considered statistically significant. Result: The mean serum level of total antioxidant status (TAS) in the study group was 846.55 umol/l while the minimum and maximum serum Total antioxidant status were 706 and 991 umol/l respectively. For their controls, the mean serum level of Total antioxidant status was 833.70 umol/l. However, the minimum and maximum serum Total antioxidant statuses were 291 and 1065 umol/l respectively. The difference was not statistically significant (p= 0.167) with odds ratio 1.00 (CI of 95% 0.997-1.006).