Evaluation of the effectiveness of Sulfadoxine-Pyrimethamine (Sp) as antimalarial prophylaxis in pregnant women in selected health facilities in Central Region

Abstract

The use of sulfadoxinepyrimethaine (SP) as an intermittent preventive treatment (IPT) against malaria during pregnancy has become a policy in most sub-Sahara African countries but crucially depends on the efficacy of SP. This study sets out to evaluate the effectiveness of the SP given to the pregnant women in the selected health facilities in the Central region of Ghana to prevent maternal malaria in the pregnant women. A cross-sectional study was carried out to evaluate the effectiveness of SP in clearing malaria parasites in 543 pregnant women recruited from 7 selected health centres in Central Region of Ghana. To determine the quality of SP, high performance liquid chromatography (HPLC) was used to assay the SP in samples of the tablets given to the pregnant women. The tablets were taken through dissolution test. The parasite density of Plasmodium falciparum was determined from the peripheral blood of the pregnant women using microscopy. Haemoglobin levels as well as ABO blood types were determined. The pregnant women did not receive IPT-SP because of either unavailability of the drug or they were not due to take SP were 44.0%. Malaria infection was recorded in 11.2% of pregnant women who had a history of SP consumption. Low haemoglobin level was recorded in 73.5% of the pregnant women. Pregnant women with blood group O had the highest frequency of 55.2% of the population. SP was found to be sub-standard because it failed the dissolution test. IPT-SP is ineffective in preventing malaria infection. Manufacturing practice of SP should be improved as well as in the stocking of SP tablets at the health centres to make it readily available to the pregnant women.