Bernard Tornyigah
University of Ghana, Legon
Title: Assessment and impact of the new IPTp implementation strategy on maternal, fetal and neonatal outcome in Ghana
Biography
Biography: Bernard Tornyigah
Abstract
On the back of wide spread sulphadoxine pyrimethamine resistance across Africa and its implication to malaria prevention among pregnant women and also the dose dependent beneficial effect of SP against malaria in pregnancy, WHO reviewed their guidelines to a monthly SP administration. Ghana adopted this amendment and the new policy is currently being implemented. To assess the implication of the new IPTp strategy to maternal and neonatal outcomes, 1,000 pregnant women visiting health facilities from a peri-uban (Kpone-on-sea) and urban (Maamobi) setting in the Greater Accra Region, for their first antenatal care (ANC) and another 1,000 for delivery were recruited. Plasma levels of antimalarial drugs including SP and artemisinin derivatives were measured using an HPLC/MS/MS method. Parasitemia was also determined using microscopy and real-time PCR. Of the 1,000 women recruited from the first ANC visit, the mean ± SD gestational age was 17±7 weeks at Kpone-on-sea and 18±7weeks at Maamobi. At Kpone-on-sea, 40.9% of participants at ANC were PCR positive compared to 39% from Maamobi. Also, 4.2% of participants at delivery were PCR positive compared to 23.6% from Maamobi. At delivery, 96% of the women reported at least one SP uptake in Kpone-on-sea while 78% did in Maamobi. This corroborates with the high percentage of participants in Maamobi parasiticides compared to Kpone. This might be due to the fact that pregnant women are not given SP or any other antimalarial to prevent malaria. Also, high level of SP was measured in the cord blood, strongly suggesting placental barrier corsage. This observed phenomenon suggests that although IPTp is beneficial, its administration close to delivery could have negative impact on the new born. The detailed analysis and data will be discussed at the congress.