Training Manual for Preventive Malaria - Ministry of Health

• IPT with SP when delivered as part of antenatal care significantly reduces the
prevalence of maternal anaemia and placental parasitemia and the incidence of low birth
weight.
Studies in Kenya and Malawi have shown that IPT with SP has a beneficial impact on
maternal and infant health
• Although there are concerns that sulfa drugs may be associated with kernicterus when
given to premature neonates, this problem has not been noted in studies of IPT where
Sulfadoxine Pyrimethamine (SP) has been administered to the mother.
• Studies examining the risk to the foetus from uterine exposure to SP
have generally not found any increased risk in spontaneous abortions or congenital
defects. One retrospective study of antifolate drugs given before and during pregnancy
did find that there was an increased risk of birth defects when such drugs were taken
during the first trimester, but not during the second or third trimester.
DOSAGE
Sulphadoxine – Pyrimethamine (SP) or Fansidar should be given as single adult dose (3 tablets)
at regularly scheduled antenatal care visits during the second and third trimesters.
Up to a maximum of 3 doses is recommended by the Ministry of Health.
1 st . Dose: Given after quickening or after (16 weeks)
2 nd . Dose: At least one month after the first dose.
3 rd . Dose: At least one month after the second dose.
ADMINISTRATION
Sulphadoxine-pyrimethamine should be given at the ANC clinic or at where there is
supervision of a midwife/health worker through a Directly Observed Treatment (DOT)
Method.
Step 1
° When a pregnant woman comes to the clinic before quickening, inform her to come back
for her next regularly scheduled ANC visit.
° Screen the pregnant woman for history of allergy to Sulpha drugs and record in maternal
health record book.
° If quickening has occurred, ask the pregnant woman whether she has received treatment
with SP in the past one month. If she has, ask her to return one month after the last SP dose.
Proceed to step 2.
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