Malaria in pregnancy is a major cause of maternal, foetal and infant morbidity and mortality in sub-Saharan Africa. Although frequently asymptomatic, consequences of Plasmodium falciparum infection in pregnancy comprise maternal anaemia, abortion, stillbirth, intrauterine growth retardation, low birth weight (LBW), preterm delivery, and up to 200,000 attributable infant deaths per year. Primiparae are particularly vulnerable as immune mechanisms preventing placental sequestration of pregnancy-specific parasite strains are weak or absent. Intermittent preventive treatment in pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) has been adopted as policy by many countries in sub-Saharan Africa. However, data on the post-implementation effectiveness of this measure are scarce. Clinical and parasitological parameters were assessed among women delivering at a district hospital in rural southern Ghana in the year 2000 when pyrimethamine chemoprophylaxis was recommended (n = 839) and in 2006 (n = 226), approximately one year after the implementation of IPTp-SP. Examinations were performed in an identical manner in 2000 and 2006 including the detection of placental Plasmodium falciparum infection by microscopy, histidine-rich protein 2, and PCR.
Lena Hommerich, Christa von Oertzen, George Bedu-Addo et al; 2007, 6:144 doi:10.1186/1475-2875-6-144