Effectiveness of intermitent preventive treatment with sulphadoxinepyrimethamine and insecticide treated nets on the prevention of malaria in pregnancy in non-malarial endemic area

Abstract

Background Malaria prevention strategies significantly reduced the prevalence of malaria in pregnant women in several studies done in malaria endemic regions. We assessed 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. Objective. To determine the effectiveness of Intermittent preventive treatment with sulphadoxinepyrimethamine and Insecticide treated nets on the prevention of malaria in pregnancy in a non-malaria endemic area. Study Des2"in. Comparison pre and post Interventions. StudY Area. Kapsabet district hospital-Cental Nandi. Methodologv. this was pre and post IPT/ITN Intervention comparison study, where 143 non-randomised pregnant women were followed through the Antenatal clinic before 28 weeks gestation until delivery and compared with records of 600 pregnant women who attended ANC and delivered at the hospital in year 2001 before the interventions were implemented. 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.S% in the non-intervention group compared with S.6% in the intervention group (p-value 0.018), this showed a reduction of low birth weight by SO%. The incidence of Still births was 6% in the non-intervention group and 1.4% in the intervention group (p-value 0.02S). There were 2 (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 sulphadoxine-pyrimethamine 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 outcomes. Recommendations Ministry of health and partners to:- • Maintain and upscale the use of sulphadoxine-pyrimethamine during pregnancy, • Avail subsidised long lasting insecticide treated bed nets to pregnant women. • Carry out periodic health promotion and vector control activity education at the community level. .