Field evaluation of the intermittent preventive treatment of malaria during pregnancy (IPTp) in Benin: evolution of the coverage rate since its implementation

A retrospective longitudinal study was conducted in eight maternity hospitals in two geographical areas in Benin (in the south and north). The study investigated 2420 women who gave birth from 2005 to 2009. The antenatal cards of those women were randomly selected over 5 years with the aim of analyzing the IPT coverage in the study's maternity hospitals.The rate of IPT-SP coverage evolved from 3.7% in 2005 to 87.8% in 2009 for women who had received at least one dose and from 2.7% to 68.4% from 2005 to 2009 for those who had received complete ITP (two doses). Variability in the results was observed depending on the geographical area (north/south) and the type of area (rural/urban).In total, application of IPT-SP 2-doses has rapidly evolved since 2005, but the objective of 80% IPT coverage has not yet been achieved throughout the country. Moreover, problems of drug shortage recurring in the field (reported by health staff) remain to be resolved.Malaria is an important world public health problem, particularly in Africa [1]. In Benin, in 2008, malaria was the leading cause for medical consultation (39.6% of disorders encountered in consultation), hospitalization (20.1% of the causes of hospitalization), and death (15.7% of the causes of death) [2]. High-risk populations are children under 5 years of age and pregnant women in areas where malaria transmission is high [3]. Malarial infections during pregnancy are reported to cause the death of 200,000 infants every year [4] and 30 million pregnant women are estimated to live in endemic areas [5]. In high-transmission areas, the main consequences of gestational malaria are anemia in the pregnant woman and low birth weight in the newborn, which is associated with an increased risk of morbidity and mortality in the first years of life [6].Aiming to reduce the consequences of gestational malaria, the World Health Organization (WHO) recommends a series of interventions [6-8] including Intermittent Preventive Treatment (IPT) w