BACKGROUND Growing concerns about the waning efficacy of IPTp-SP warrants continuous monitoring and evaluation. This study determined coverage of IPTp-SP and compared the effectiveness of the 3-dose to 2-dose regimen on placental malaria (PM) infection and low birth weight (LBW) in the Mount Cameroon area. METHODS Consenting pregnant women were enrolled consecutively through a cross-sectional survey at delivery at four antenatal clinics, two each from semi-rural and semi-urban settings from November 2016 to December 2017. Reported IPTp-SP use, demographic and antenatal clinic (ANC) data of the mothers and neonate birth weights were documented. Maternal haemoglobin concentration was measured using a haemoglobinometer and PM infection diagnosed by placental blood microscopy. Logistic regression analysis was used to model study outcomes. RESULTS Among the 465 parturient women enrolled, 47.0% (203), 34.7% (150), 18.3% (79) and 7.1% (33) reported uptake of ≥ 3, 2.1 dose(s) and no SP, respectively. Uptake of ≥ 3 doses varied significantly (p < 0.001) according to type of medical facility, timing of ANC initiation and number of ANC visits. The prevalence of PM was 18.5% where uptake of ≥ 3 SP doses (AOR = 2.36: 95% CI  1.41-4.87), primiparity (AOR = 2.13: 95% CI  1.19-3.81), semi-rural setting (AOR = 1.85: 95% CI  1.12-3.04) increased odds of infection. Also, three or more dosing was associated (p < 0.001) with increased PM density notably among women from semi-urban areas. Compared with third trimester, ANC initiation in the second trimester (AOR: 0.39: 95% CI  0.20-0.74) lower odds of infection. The prevalence of LBW infants was 7.3% and were generally those of anaemic (AOR: 4.6: 95% CI  1.03-20.57) and semi-rural (AOR: 5.29: 95% CI  1.73-16.15) women. Although ≥ 3 (AOR: 0.31: 95% CI  0.11-0.87) and 2 (AOR: 0.32: 95% CI  0.11-0.93) doses of SP was associated with lower odds of LBW, ≥ 3 doses were not associated with additional increase in birth weight nor maternal haemoglobin levels when compared with 2 doses. CONCLUSION In the Mount Cameroon area, reported uptake of IPTp with ≥ 3 SP doses did not provide observable prophylactic benefits. SP resistance efficacy studies are necessary.

中文翻译：

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在喀麦隆西南部喀麦隆地区，使用磺胺多辛-乙胺嘧啶（IPTp-SP）进行的孕妇间歇性预防性治疗的覆盖率和有效性。

背景技术对IPTp-SP的递减效力的日益增长的关注保证了连续的监测和评估。这项研究确定了IPTp-SP的覆盖率，并比较了喀麦隆山地区3剂量对2剂量方案对胎盘疟疾（PM）感染和低出生体重（LBW）的有效性。方法从2016年11月至2017年12月，在四个产前诊所分娩时通过横断面调查连续纳入同意的孕妇，其中两个分别在半农村和半城市环境中进行。报道了IPTp-SP的使用，人口统计学和产前诊所）记录了母亲和新生儿出生体重的数据。使用血红蛋白仪测量母体血红蛋白浓度，并通过胎盘血液显微镜检查诊断为PM感染。使用逻辑回归分析对研究结果进行建模。结果在465名产妇中，分别报道接受≥3、2.1和无SP的摄取率为47.0％（203），34.7％（150），18.3％（79）和7.1％（33）。≥3剂的摄入量根据医疗机构的类型，ANC启动的时间和ANC的就诊次数而有显着差异（p <0.001）。PM的患病率为18.5％，其中摄取≥3 SP剂量（AOR = 2.36：95％CI 1.41-4.87），初产（AOR = 2.13：95％CI 1.19-3.81），半农村环境（AOR = 1.85： 95％CI 1.12-3.04）增加了感染几率。此外，在半城市地区的女性中，三剂或更多剂量与PM浓度增加相关（p <0.001）。与孕晚期相比，孕中期开始ANC（AOR：0.39：95％CI 0.20-0.74）降低了感染几率。LBW婴儿的患病率为7.3％，通常为贫血（AOR：4.6：95％CI 1.03-20.57）和半农村地区（AOR：5.29：95％CI 1.73-16.15）。尽管≥3（AOR：0.31：95％CI 0.11-0.87）和2（AOR：0.32：95％CI 0.11-0.93）剂量的SP与较低的LBW相关，但≥3剂量与LBW的增加无关与2剂相比，出生体重或母体血红蛋白水平都没有。结论在喀麦隆山地区，据报道摄取≥3 SP剂量的IPTp并不能提供明显的预防益处。SP抗药性研究是必要的。与2剂相比，≥3剂与出生体重的额外增加或母亲血红蛋白水平无关。结论在喀麦隆山地区，据报道摄取≥3 SP剂量的IPTp并不能提供明显的预防益处。SP抗药性研究是必要的。与2剂相比，≥3剂与出生体重的额外增加或母亲血红蛋白水平无关。结论在喀麦隆山地区，据报道摄取≥3 SP剂量的IPTp并不能提供明显的预防益处。SP抗药性研究是必要的。