Hounkonnou C. P. A., Tuikue Ndam Nicaise, Fievet Nadine, Accrombessi M., Yovo E., Mama A., Sossou D., Vianou B., Massougbodji A., Briand Valérie, Cot Michel, Cottrell Gilles. (2021). Suboptimal intermittent preventive treatment in pregnancy (IPTp) is associated with an increased risk of submicroscopic Plasmodium falciparum infection in pregnant women : a prospective cohort study in Benin. Clinical Infectious Diseases, 73 (11), E3759-E3767 [9 p.]. ISSN 1058-4838.
Titre du document
Suboptimal intermittent preventive treatment in pregnancy (IPTp) is associated with an increased risk of submicroscopic Plasmodium falciparum infection in pregnant women : a prospective cohort study in Benin
Année de publication
2021
Auteurs
Hounkonnou C. P. A., Tuikue Ndam Nicaise, Fievet Nadine, Accrombessi M., Yovo E., Mama A., Sossou D., Vianou B., Massougbodji A., Briand Valérie, Cot Michel, Cottrell Gilles
Source
Clinical Infectious Diseases, 2021,
73 (11), E3759-E3767 [9 p.] ISSN 1058-4838
Background. Harmful maternal and neonatal health outcomes result from malaria in pregnancy, the prevention of which primarily relies on intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP). The World Health Organization recommends IPTp-SP in sub-Saharan Africa, but implementation is highly heterogeneous and often suboptimal in terms of the number of doses and their timing. In this study, we assessed the impact of this heterogeneity on malaria in pregnancy, mainly with respect to submicroscopic Plasmodium falciparum infections. Methods. We used data from 273 Beninese women followed throughout pregnancy. Screening for P. falciparum infections, using both microscopy-based and polymerase chain reaction (PCR)-based methods, was performed monthly, and information on IPTp-SP doses was collected. Gestational age was estimated by repeated ultrasound scans. Using a negative binomial model, we investigated the effect of IPTp-SP doses and timing after 17 weeks of gestation on the number of P. falciparum infections, focusing on submicroscopic infections detectable only by PCR. Results. At least 2 IPTp-SP doses were taken by 77.3% of the women. The median gestational age at the first IPTp-SP dose was 22 weeks. A late first IPTp-SP dose (>21.2 weeks) was marginally associated with an increased number of P. falciparum infections (adjusted incidence rate ratio [aIRR] = 1.3; P = .098). The number of IPTp-SP doses was not associated with the number of submicroscopic infections (aIRR = 1.2, P = .543). Conclusions. A late first IPTp-SP dose failed to provide optimal protection against P. falciparum, especially submicroscopic infections. This highlights the need for a new antimalarial drug for IPTp that could be taken early in pregnancy.
Plan de classement
Santé : généralités [050]
;
Entomologie médicale / Parasitologie / Virologie [052]
Description Géographique
BENIN
Localisation
Fonds IRD [F B010083900]
Identifiant IRD
fdi:010083900
