The authors declare that they have no competing interests.
IV participated in study coordination and data cleaning, performed the data analysis and drafted the manuscript. HT participated in the design, study coordination and corrected the manuscript. MKD, HS and JPG corrected the manuscript. LH participated in data cleaning and corrected the manuscript. RTG and KP participated in the design of the study. UDA participated in the design, helped in data analysis and corrected the manuscript. All authors read and approved the final manuscript.
A prospective study aiming at assessing the effect of adding a third dose sulphadoxine-pyrimethamine (SP) to the standard two-dose intermittent preventive treatment for pregnant women was carried out in Hounde, Burkina Faso, between March 2006 and July 2008. Pregnant women were identified as earlier as possible during pregnancy through a network of home visitors, referred to the health facilities for inclusion and followed up until delivery.
Study participants were enrolled at antenatal care (ANC) visits and randomized to receive either two or three doses of SP at the appropriate time. Women were visited daily and a blood slide was collected when there was fever (body temperature > 37.5°C) or history of fever. Women were encouraged to attend ANC and deliver in the health centre, where the new-born was examined and weighed. The timing and frequency of malaria infection was analysed in relation to the risk of low birth weight, maternal anaemia and perinatal mortality.
Data on birth weight and haemoglobin were available for 1,034 women. The incidence of malaria infections was significantly lower in women having received three instead of two doses of SP. Occurrence of first malaria infection during the first or second trimester was associated with a higher risk of low birth weight: incidence rate ratios of 3.56 (p < 0.001) and 1.72 (p = 0.034), respectively. After adjusting for possible confounding factors, the risk remained significantly higher for the infection in the first trimester of pregnancy (adjusted incidence rate ratio = 2.07, p = 0.002). The risk of maternal anaemia and perinatal mortality was not associated with the timing of first malaria infection.
Malaria infection during first trimester of pregnancy is associated to a higher risk of low birth weight. Women should be encouraged to use long-lasting insecticidal nets before and throughout their pregnancy.
van Geertruyden JP, Thomas F, Erhart A, d'Alessandro U: The contribution of malaria in pregnancy to perinatal mortality. Am J Trop Med Hyg. 2004, 71: 35-40. PubMed
WHO/AFRO: A strategic framework for malaria prevention and control during pregnancy in the African Region. 2004, Word Health Organisation Regional Office for Africa. Brazzaville
Ministere de la Santé/Programme National de Lutte contre le Paludisme: Directives Nationales pour la prise en charge du paludisme au Burkina Faso. 2006
Gies S, Coulibaly SO, Ouattara FT, d'Alessandro U: Individual efficacy of intermittent preventive treatment with sulfadoxine-pyrimethamine in primi- and secundigravidae in rural Burkina Faso: impact on parasitaemia, anaemia and birth weight. Trop Med Int Health. 2009, 14: 174-182. 10.1111/j.1365-3156.2008.02215.x. CrossRefPubMed
Sirima SB, Cotte AH, Konate A, Moran AC, Asamoa K, Bougouma EC, Diarra A, Ouedraogo A, Parise ME, Newman RD: Malaria prevention during pregnancy: assessing the disease burden one year after implementing a program of intermittent preventive treatment in Koupela District, Burkina Faso. Am J Trop Med Hyg. 2006, 75: 205-211. PubMed
Tiono AB, Ouedraogo A, Bougouma EC, Diarra A, Konate AT, Nebie I, Sirima SB: Placental malaria and low birth weight in pregnant women living in a rural area of Burkina Faso following the use of three preventive treatment regimens. Malar J. 2009, 8: 224-10.1186/1475-2875-8-224. PubMedCentralCrossRefPubMed
Cottrell G, Mary JY, Barro D, Cot M: The importance of the period of malarial infection during pregnancy on birth weight in tropical Africa. Am J Trop Med Hyg. 2007, 76: 849-854. PubMed
Cot M, Abel L, Roisin A, Barro D, Yada A, Carnevale P, Feingold J: Risk factors of malaria infection during pregnancy in Burkina Faso: suggestion of a genetic influence. Am J Trop Med Hyg. 1993, 48: 358-364. PubMed
Huynh BT, Fievet N, Gbaguidi G, Dechavanne S, Borgella S, Guezo-Mevo B, Massougbodji A, Ndam NT, Deloron P, Cot M: Influence of the timing of malaria infection during pregnancy on birth weight and on maternal anemia in Benin. Am J Trop Med Hyg. 2011, 85: 214-220. 10.4269/ajtmh.2011.11-0103. PubMedCentralCrossRefPubMed
Coulibaly SO, Gies S, d'Alessandro U: Malaria burden among pregnant women living in the rural district of Boromo, Burkina Faso. Am J Trop Med Hyg. 2007, 77: 56-60. PubMed
Valea I, Tinto H, Drabo MK, Huybregts L, Henry MC, Roberfroid D, Guiguemde RT, Kolsteren P, d'Alessandro U: Intermittent preventive treatment of malaria with sulphadoxine-pyrimethamine during pregnancy in Burkina Faso: effect of adding a third dose to the standard two-dose regimen on low birth weight, anaemia and pregnancy outcomes. Malaria Journal. 2010, 9: 324- PubMedCentralPubMed
Piola P, Nabasumba C, Turyakira E, Dhorda M, Lindegardh N, Nyehangane D, Snounou G, Ashley EA, McGready R, Nosten F, Guerin PJ: Efficacy and safety of artemether-lumefantrine compared with quinine in pregnant women with uncomplicated Plasmodium falciparum malaria: an open-label, randomised, non-inferiority trial. Lancet Infect Dis. 2010, 10: 762-769. 10.1016/S1473-3099(10)70202-4. CrossRefPubMed
Rogerson SJ, Mwapasa V, Meshnick SR: Malaria in pregnancy: linking immunity and pathogenesis to prevention. Am J Trop Med Hyg. 2007, 77: 14-22. PubMed
Bourgoing R: Bednets for malaria. Reports from the field -- Africa. Glob Impacts. 1997, 14-15.
- An analysis of timing and frequency of malaria infection during pregnancy in relation to the risk of low birth weight, anaemia and perinatal mortality in Burkina Faso
Maxime K Drabo
Robert T Guiguemde
Jean Pierre van Geertruyden
the FSP/MISAME study Group
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II