Scholarlink

Background <p>Malaria in pregnancy remains a major public health concern in Madagascar, particularly in southern regions with unstable transmission. Intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) is a key prevention strategy, yet its coverage remains poorly documented at the district level. This study aimed to assess IPTp-SP coverage, malaria prevalence, and associated complications among pregnant women in Amboasary-Sud, southern Madagascar.</p> Methods <p>A retrospective descriptive study was conducted using routine antenatal care (ANC) data from two public health facilities in 2021. A total of 1262 pregnant women attending at least one ANC visit were included. Data on sociodemographics, ANC attendance, IPTp-SP uptake, malaria rapid diagnostic test (RDT) results, and maternal–fetal outcomes were extracted and analysed. Logistic regression was used to identify factors associated with adequate IPTp-SP coverage (≥ 3 doses).</p> Results <p>Among ANC attendees, 64.9% (819/1262) received at least one dose of IPTp-SP, but only 49.9% (409/819) completed the recommended three or more doses. Malaria RDTs were performed among symptomatic women (n = 289), with a positivity rate of 21.1% (61/289). The observed proportion of confirmed symptomatic malaria cases among all ANC attendees was 4.8% (61/1262). Maternal (n = 7) and fetal (n = 3) complications were observed exclusively among women who had not received IPTp-SP; however, the small number of events precluded causal interpretation. In multivariable analysis, living within 5&#xa0;km of a health facility (aOR = 1.54, 95% CI 1.14–2.08) and attending four or more ANC visits (aOR = 2.38, 95% CI 1.76–3.21) were independently associated with adequate IPTp-SP coverage.</p> Conclusions <p>IPTp-SP coverage in Amboasary-Sud remains suboptimal despite continuous drug availability. Strengthening ANC attendance and addressing geographical barriers may improve uptake of malaria prevention during pregnancy. Community-based delivery strategies could complement facility-based services in settings with limited access.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Prevalence of malaria during pregnancy and coverage of intermittent preventive treatment with sulfadoxine-pyrimethamine in urban Amboasary-Sud, Southern Madagascar

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月11日

查看全文
  • Norosoa Julie Zafindraibe,
  • Ainamalala Catherine Razafindrakoto,
  • Christiana Belle Zemey,
  • Raphael Rakotozandrindrainy,
  • Andry Rasamindrakotroka,
  • Lala Rasoamialy Soa Razanakolona

摘要

Background

Malaria in pregnancy remains a major public health concern in Madagascar, particularly in southern regions with unstable transmission. Intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) is a key prevention strategy, yet its coverage remains poorly documented at the district level. This study aimed to assess IPTp-SP coverage, malaria prevalence, and associated complications among pregnant women in Amboasary-Sud, southern Madagascar.

Methods

A retrospective descriptive study was conducted using routine antenatal care (ANC) data from two public health facilities in 2021. A total of 1262 pregnant women attending at least one ANC visit were included. Data on sociodemographics, ANC attendance, IPTp-SP uptake, malaria rapid diagnostic test (RDT) results, and maternal–fetal outcomes were extracted and analysed. Logistic regression was used to identify factors associated with adequate IPTp-SP coverage (≥ 3 doses).

Results

Among ANC attendees, 64.9% (819/1262) received at least one dose of IPTp-SP, but only 49.9% (409/819) completed the recommended three or more doses. Malaria RDTs were performed among symptomatic women (n = 289), with a positivity rate of 21.1% (61/289). The observed proportion of confirmed symptomatic malaria cases among all ANC attendees was 4.8% (61/1262). Maternal (n = 7) and fetal (n = 3) complications were observed exclusively among women who had not received IPTp-SP; however, the small number of events precluded causal interpretation. In multivariable analysis, living within 5 km of a health facility (aOR = 1.54, 95% CI 1.14–2.08) and attending four or more ANC visits (aOR = 2.38, 95% CI 1.76–3.21) were independently associated with adequate IPTp-SP coverage.

Conclusions

IPTp-SP coverage in Amboasary-Sud remains suboptimal despite continuous drug availability. Strengthening ANC attendance and addressing geographical barriers may improve uptake of malaria prevention during pregnancy. Community-based delivery strategies could complement facility-based services in settings with limited access.