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5.4 Intermittent Preventive Treatment in Pregnancy

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Malaria parasites can easily accumulate and multiply in the placenta leading to placenta malaria infections, resulting to complications such as maternal anaemia, low birth weight, premature delivery, congenital infection and/or perinatal death.

Note: IPTp is an administration of antimalarial in full therapeutic doses at predetermined intervals during pregnancy to individuals with no signs/symptoms of malaria. The aim is to prevent above mentioned complications with adverse effects to both mother and fetus3

The medicine of choice for IPT

A: Sulphadoxine/Pyrimethamine (SP). Give SP tablet strength 500 mg Sulphadoxine, 25 mg Pyrimethamine. Dosage:

  • The dose is 3 tablets once
  • A minimum of 3 doses of Sulphadoxine/Pyrimethamine (SP) in entire pregnancy period
  • The first IPTp-SP dose should be administered from 14 weeks of pregnancy onwards
  • Each SP dose should be given at least 4 weeks apart
  • The last dose of IPTp with SP can be administered up to the time of delivery, without safety concerns
Note: 
SP should not be administered to women receiving cotrimoxazole prophylaxis or pregnant women who are taking folic acid at a daily dose equal or above 5 mg, as counteracts its efficacy
SP can be administered safely with combined ferrous sulphate 200 mg + folic acid 0.25 mg (FeFo)
If malaria is diagnosed to a scheduled pregnant woman for IPT with SP; SP should not be given, instead a full treatment with antimalarial should be given
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