Abstract:
Malaria in pregnancy still remains a huge public health problem in most parts of
Africa and Asia-Pacific. The use of Sulphadoxine-Pyrimethamine as intermittent
preventive treatment for malaria in pregnancy (SP -IPTp) in endemic regions of
the world has reduced the burden of malaria in pregnancy and minimized the
consequences of malaria to both mother and the foetus. However, there have been
reports of wide-spread mutations, especially in eastern and some parts of southern
Africa, in the dhfr and dhps genes, which confer to the Plasmodium parasite,
resistance to pyrimethamine and sulphadoxine respectively. This, coupled with
the general preponderance of substandard anti-malaria drugs on the African
market, threatens the success of SP-IPTp. The aim of this study was to evaluate
the effectiveness of sulphadoxine and pyrimethamine as IPTp in three selected
health facilities in Sekondi-Takoradi metropolis of the western region of Ghana.
SP was found to be efficacious in clearing parasitaemia amongst parasitaemic yet
asymptomatic pregnant women in the face of high prevalence (71.4%) of dhfi"
triple mutations Nl08, 151 and R59. The quintuple mutation, known to confirm
high-grade resistance to the parasites was found in only two (2) isolates in nonpregnant
attendants at the general outpatient department. There was no
association between number of SP doses taken, the use of insecticide treated nets
(ITNs) and maternal anaemia. Higher doses of SP, ITN usage, but not parity,
reduced the risk of both placental parasitaemia and low birth weight. The SP
tablets in used were found to be of good quality having a USP of 95.3% and
92.8% and dissolution of95.2% and 83.03% for sulphadoxine and pyrimethamine
respectively. This study therefore found the SP tablets in use as IPTp to be of
good quality and effective in the face of high prevalence of dhfr triple mutations.
