Abstract
Background: Malaria prevention strategies have significantly reduced the prevalence of malaria in pregnant women in several studies done in malaria endemic regions. Objective: To determine the effectiveness of Intermittent preventive treatment with sulphadoxine-pyrimethamine and Insecticide treated nets on the prevention of malaria in pregnancy in a non-malaria endemic area. Design: Comparative study. Setting: Kapsabet District Hospital in Nandi County. Subjects: One hundred and fourty three non-randomised pregnant women were followed through the Antenatal clinic before 28 weeks gestation until delivery and compared with records of 600 pregnant women ( non-intervention arm), who attended ANC and delivered at the hospital. Results: The incidence of malaria infection in pregnancy was 21% in the non-intervention group compared with 8% in the intervention group, (p-value 0.000). The incidence of low birth weight was 12.5% in the non-intervention group compared with 5.6% in the intervention group (p-value 0.018); with a reduction of low birth weight by 50% in the intervention group. The incidence of Still births was 6% in the non-intervention group and 1.4% in the intervention group (p-value 0.025). There were two (0.3%) cases of maternal mortality in the non-intervention group and no mortality in the intervention group which was statistically not significant but clinically significant. Conclusion: The use of intermittent preventive treatment with sulphadoxinepyrimethamine and Insecticide Treated Nets is effective in prevention of malaria in pregnancy in non-malaria endemic region and is associated with reduction of adverse pregnancy outcome. There is therefore a need of up scaling the use of sulphadoxinepyrimethamine during pregnancy, and availing subsidised long lasting insecticide treated bed nets to pregnant women countrywide.
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