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Malaria Research and Treatment
Volume 2016 (2016), Article ID 1839795, 7 pages
http://dx.doi.org/10.1155/2016/1839795
Research Article

Burden of Placental Malaria among Pregnant Women Who Use or Do Not Use Intermittent Preventive Treatment at Mulago Hospital, Kampala

1Department of Pharmacology and Therapeutics, School of Biomedical Sciences, Makerere University College of Health Sciences, P.O. Box 7072, Upper Mulago Hill Road, Kampala, Uganda
2Department of Pharmacology and Therapeutics, Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda
3Department of Pathology, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7062, Kampala, Uganda
4Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
5Department of Obstetrics and Gynaecology, School of Medicine, College of Health Sciences, Mulago Hospital Complex, P.O. Box 7062, Kampala, Uganda

Received 27 September 2016; Accepted 16 November 2016

Academic Editor: Polrat Wilairatana

Copyright © 2016 Charles Okot Odongo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Intermittent preventive treatment of malaria in pregnancy with sulphadoxine-pyrimethamine (SP-IPTp) is widely used to reduce the incidence of adverse pregnancy outcomes. As a monitor for continued effectiveness of this intervention amidst SP resistance, we aimed to assess malaria burden among pregnant women who use or do not use SP-IPTp. In a descriptive cohort study at Mulago Hospital, Kampala, 87 women who received two supervised doses of SP-IPTp were followed up until delivery. Controls were pregnant women presenting in early labour without history of SP-IPTp. Histopathological investigation for placental malaria (PM) was performed using the Bulmer classification criterion. Thirty-eight of the 87 women returned for delivery and 33 placentas were successfully collected and processed along with 33 placentas from SP nonusers. Overall, 12% (4/33) of the users had evidence of PM compared to 48% (16/33) of nonusers. Among nonusers, 17/33, 8/33, 2/33, and 6/33 had no placental infection, active infection, active-chronic infection, and past-chronic infection, respectively. Among users, respective proportions were 29/33, 2/33, 0/33, and 2/33. No difference in birth weights was apparent between the two groups, probably due to a higher proportion of infections occurring later in pregnancy. Histological evidence here suggests that SP continues to offer substantial benefit as IPTp.