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Efecto de la suplementación hematínica y la prevención de la malaria sobre la anemia materna y la malaria en Kenia Occidental
Author(s) -
Van Eijk Anna M.,
Ayisi John G.,
Slutsker Laurence,
Ter Kuile Feiko O.,
Rosen Daniel H.,
Otieno Juliana A.,
Shi YaPing,
Kager Piet A.,
Steketee Richard W.,
Nahlen Bernard L.
Publication year - 2007
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2006.01787.x
Subject(s) - malaria , medicine , odds ratio , pregnancy , obstetrics , anemia , malaria prophylaxis , pediatrics , immunology , biology , genetics
Summary 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.