TY - JOUR
T1 - Effect of haematinic supplementation and malaria prevention on maternal anaemia and malaria in western Kenya
AU - Van Eijk, Anna
AU - Ayisi, John G.
AU - Slutsker, Laurence
AU - Ter Kuile, Feiko
AU - Rosen, Daniel H.
AU - Otieno, Juliana A.
AU - Shi, Ya Ping
AU - Kager, Piet A.
AU - Steketee, Richard W.
AU - Nahlen, Bernard L.
PY - 2007/3/1
Y1 - 2007/3/1
N2 - OBJECTIVE To evaluate the effect of routine antenatal haematinic supplementation programmes and intermittent preventive treatment (IPT) with sulphadoxine-pyrimethamine (SP) in Kenya.METHODS Anaemia [haemoglobin (Hb) < 11 g/dl), severe anaemia (Hb < 8 g/dl) and placental malaria were compared among women with known HIV status who delivered at a provincial hospital after study enrolment in the third trimester during three consecutive periods: period 1, no routine intervention (reference); period 2, routine haematinic supplementation (60 mg elementary iron three times/day, folic acid 5 mg once daily) and period 3, haematinics and IPT with SP.RESULTS Among 3108 participants, prevalence of placental malaria, anaemia and severe anaemia postpartum was 16.7%, 53.6% and 12.7%, respectively. Compared with period 1, women in period 2 were less anaemic [adjusted odds ratio (AOR), 95% confidence interval anaemia: 0.56, 0.47-0.67; severe anaemia 0.37, 0.28-0.49] and shared a similar prevalence of placental malaria (AOR 1.07, 0.86-1.32). Women in period 3 were also less anaemic (AOR anaemia: 0.43, 0.35-0.53 and severe anaemia: 0.43, 0.31-0.59), and had less placental malaria (AOR 0.56, 0.42-0.73). The effect of intervention did not differ significantly by HIV status.CONCLUSION The haematinic supplementation programme was associated with significant reductions in anaemia in HIV-seropositive and HIV-seronegative women. The subsequent introduction of IPT was associated with halving of malaria, but no additional haematological benefit over haematinics.
AB - OBJECTIVE To evaluate the effect of routine antenatal haematinic supplementation programmes and intermittent preventive treatment (IPT) with sulphadoxine-pyrimethamine (SP) in Kenya.METHODS Anaemia [haemoglobin (Hb) < 11 g/dl), severe anaemia (Hb < 8 g/dl) and placental malaria were compared among women with known HIV status who delivered at a provincial hospital after study enrolment in the third trimester during three consecutive periods: period 1, no routine intervention (reference); period 2, routine haematinic supplementation (60 mg elementary iron three times/day, folic acid 5 mg once daily) and period 3, haematinics and IPT with SP.RESULTS Among 3108 participants, prevalence of placental malaria, anaemia and severe anaemia postpartum was 16.7%, 53.6% and 12.7%, respectively. Compared with period 1, women in period 2 were less anaemic [adjusted odds ratio (AOR), 95% confidence interval anaemia: 0.56, 0.47-0.67; severe anaemia 0.37, 0.28-0.49] and shared a similar prevalence of placental malaria (AOR 1.07, 0.86-1.32). Women in period 3 were also less anaemic (AOR anaemia: 0.43, 0.35-0.53 and severe anaemia: 0.43, 0.31-0.59), and had less placental malaria (AOR 0.56, 0.42-0.73). The effect of intervention did not differ significantly by HIV status.CONCLUSION The haematinic supplementation programme was associated with significant reductions in anaemia in HIV-seropositive and HIV-seronegative women. The subsequent introduction of IPT was associated with halving of malaria, but no additional haematological benefit over haematinics.
KW - Anaemia
KW - Haematinic supplementation
KW - Kenya
KW - Malaria
KW - Pregnancy
KW - Sulphadoxine- pyrimethamine
U2 - 10.1111/j.1365-3156.2006.01787.x
DO - 10.1111/j.1365-3156.2006.01787.x
M3 - Article
SN - 1360-2276
VL - 12
SP - 342
EP - 352
JO - Tropical Medicine and International Health
JF - Tropical Medicine and International Health
IS - 3
ER -
