Coverage and effectiveness of intermittent preventive treatment of malaria with Sulfadoxine-Pyrimethamine during pregnancy in six sentinels sites of Cte dIvoire

Abstract

Intermittent preventive treatment of malaria during pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is recommended to prevent maternal and neonatal adverse outcomes. This study aimed to assess IPTp-SP coverage in mothers delivering in six health facilities and factors associated with placental malaria and low birth weight. A multicenter, cross-sectional survey was conducted in Cote d’Ivoire from March to October 2017. Regression logistics were used to study factors associated with placental malaria, IPTp-SP uptake, and LBW (<2.500 grams). Out of all the enrolled participants (n=1236), 632 (51.1) received three or more doses of SP while 288 (23.3%), 221 (17.9%) and 95 (7.7%) received two respectively, one and none dose of SP. Uptake of ≥ 3 doses varied significantly (p < 0.001) according to study site, number of ANC visits and profession. Regression analysis identified primigravidae, single dose IPTp-SP, or no IPTp-Sp as factors associated with placental malaria. IPTp-SP coverage observed in this study was low compared to WHO recommendation and contrasted with the high antenatal care (ANC) visits. There is a need for further research to understand the barriers and enablers of uptake in each context in order to improve uptake of adequate IPTp-SP regimen. Key words: Coverage, Effectiveness, Malaria, Pregnancy, IPTp-SP, Cote d’Ivoire.