Sulfadoxine-pyrimethamine-based intermittent preventive treatment, bed net use, and antenatal care during pregnancy: demographic trends and impact on the health of newborns in the Kassena Nankana District, northeastern Ghana

Am J Trop Med Hyg. 2010 Jul;83(1):79-89. doi: 10.4269/ajtmh.2010.10-0066.

Abstract

Demographics and health practices of 2,232 pregnant women in rural northeastern Ghana and characteristics of their 2,279 newborns were analyzed to determine benefits associated with intermittent preventive treatment (IPTp), antenatal care, and/or bed net use during pregnancy. More than half reported bed net use, 90% reported at least two antenatal care visits, and > 82% took at least one IPTp dose of sulfadoxine-pyrimethamine. Most used a bed net and IPTp (45%) or IPTp alone (38%). Low birth weight (< 2,500 grams) characterized 18.3% of the newborns and was significantly associated with female sex, Nankam ethnicity, first-born status, and multiple births. Among newborns of primigravidae, IPTp was associated with a significantly greater birth weight, significantly fewer low birth weight newborns, improved hemoglobin levels, and less anemia. Babies of multigravidae derived no benefit to birth weight or hemoglobin level from single or multiple doses of sulfadoxine-pyrimethamine during pregnancy. No differences or benefits were seen when a bed net was the only protective factor.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Anemia / chemically induced*
  • Antimalarials / adverse effects*
  • Antimalarials / therapeutic use
  • Drug Administration Schedule
  • Drug Combinations
  • Drug Therapy, Combination / adverse effects
  • Female
  • Ghana / epidemiology
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Infant
  • Infant, Low Birth Weight / immunology
  • Infant, Low Birth Weight / physiology*
  • Infant, Newborn
  • Insecticides / adverse effects*
  • Insecticides / therapeutic use
  • Placenta Diseases / parasitology
  • Pregnancy
  • Pregnancy Complications, Parasitic / chemically induced*
  • Pregnancy Complications, Parasitic / parasitology
  • Pregnancy Complications, Parasitic / physiopathology
  • Pyrimethamine / adverse effects*
  • Pyrimethamine / therapeutic use
  • Rural Population
  • Sulfadoxine / adverse effects*
  • Sulfadoxine / therapeutic use

Substances

  • Antimalarials
  • Drug Combinations
  • Insecticides
  • fanasil, pyrimethamine drug combination
  • Sulfadoxine
  • Pyrimethamine