Sulfadoxine-Pyrimethamine Dosing and Malaria Parasitemia Among Pregnant Women at Lira Regional Referral Hospital, Northern Uganda: A Cross-Sectional Study

Abstract Background : Malaria in pregnancy poses severe adverse effects to both the mother and fetus and the newborn. There is limited literature on the effectiveness of sulfadoxine/pyrimethamine as a malaria preventive measure across Africa and Uganda in particular. Our study assessed sulfadoxine/pyrimethamine dosing and malaria parasitemia among pregnant women at Lira regional referral hospital, northern Uganda. Method : A cross-sectional study that involved 326 pregnant women was conducted at Lira Regional Referral. SP dosages were extracted from antenatal cards, maternal venous blood was collected for assessment of parasitemia, and plasma levels of sulfadoxine were assessed. High-performance liquid chromatography with ultraviolet detection was used to quantify sulfadoxine, whereas microscopy was used to detect malaria parasites. The primary outcome was malaria parasitemia. Data was analysed using STATA version 17. SP dosages and parasitemia were reported as a pie chart and table, respectively. Chi-square was used to determine the relationship between the plasma levels of SP and malaria parasitemia levels. Univariate and multivariate logistic analyses were conducted to determine the correlation between factors and parasitemia levels. Results : In this study SP optimal dosage use was at 70% (228/326) pregnant women attending Lira regional referral hospital, northern Uganda. The mean plasma level of sulfadoxine was 12.76 ± 1.55 μg/mL. Parasitemia level was 7.67%. No significant relationship between optimal SP dosage and malaria parasitemia levels (x 2 = 0.0718, p=0.789). There was no statistically significant relationship between all factors and malaria parasitemia at multivariate analysis. Conclusion and Recommendation : This study has found that most participants took optimal SP dosage. An optimal SP dosage was not associated with increased malaria parasitemia, and similarly, plasma levels of SP had no statistically significant relationship with parasitemia.