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. 2024 Sep 4;12(9):203.
doi: 10.3390/diseases12090203.

Uptake and Effectiveness of Intermittent Preventive Treatment with Sulfadoxine-Pyrimethamine during Pregnancy in Africa: A Scoping Review

Gifty Osei Berchie  1 , Patience Fakornam Doe  2 , Theodora Dedo Azu  1 , Joyce Agyeiwaa  1 , Gifty Owusu  1 , Christian Makafui Boso  3 , Naomi Kyeremaa Yeboa  1 , Dorcas Frempomaa Agyare  3 , Irene Korkoi Aboh  1 , Bernard Nabe  3 , Godson Obeng Ofori  3 , Benjamin Anumel  4 , Justice Enock Kagbo  3 , Amidu Alhassan  3 , Frank Odonkor Offei  3 , Rita Opoku-Danso  3 , Susanna Aba Abraham  2 , Mustapha Amoadu  5 , John Elvis Hagan Jr  6   7
Affiliations

Uptake and Effectiveness of Intermittent Preventive Treatment with Sulfadoxine-Pyrimethamine during Pregnancy in Africa: A Scoping Review

Gifty Osei Berchie et al. Diseases. .

Abstract

Malaria poses a significant threat to pregnant women in sub-Saharan Africa, necessitating effective interventions like the intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP). However, challenges persist in the uptake and effectiveness of this intervention. This scoping review aims to explore IPTp-SP uptake in African countries, identify influencing factors, and assess its effectiveness in preventing malaria and adverse outcomes in pregnancy. This scoping review follows Arksey and O'Malley's framework, employing the PRISMA-ScR guidelines for reporting. Searches were conducted in PubMed, Embase, Scopus, JSTOR, Web of Science, Google Scholar, and ProQuest, focusing on studies post-2000 published in the English language. The search produced 15,153 records, of which 104 full-text records were eligible and 101 papers were included in this review. The findings suggest varying IPTp-SP uptake rates, spanning from 5.3% to 98.9%, with their effectiveness supported by longitudinal studies, randomised controlled-trials (RCTs), cross-sectional surveys, and mixed-method studies. IPTp-SP demonstrates efficacy in reducing malaria during pregnancy, placental parasitaemia, and anaemia episodes, alongside improved birth outcomes. Common adverse effects of IPTp-SP include prematurity and low birth weight. Facilitators of IPTp-SP uptake include education and ANC attendance, while commonly reported barriers included inadequate knowledge and healthcare system challenges. The findings also suggest adverse effects such as prematurity, low birth weight, and maternal and perinatal mortality associated with IPTp-SP uptake. It is vital to strengthen antenatal care services by integrating comprehensive counselling on IPTp-SP and address healthcare system challenges. Community engagement, women's empowerment, and context-specific interventions are necessary for promoting IPTp-SP uptake and improving maternal and neonatal health outcomes in Africa.

Keywords: Africa; IPTp-SP; effectiveness; pregnancy; scoping review; uptake.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
PRISMA flow chart of the search results and screening process.
Figure 2
Figure 2
Countries where included studies were conducted.
Figure 3
Figure 3
Designs used in the included studies.
Figure 4
Figure 4
Sample size of included studies according to designs.
See this image and copyright information in PMC

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