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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
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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