Intermittent preventive treatment with sulfadoxine-pyrimethamine for malaria effects on plasma levels of ions (Na+, K+ and Cl-) in pregnant women of Libreville

[Speaker] Serge Thierry Omouessi:1
[Co-author] Joseph Richard Oparadji:2, Marilyne Dabo Igozo:1, Justine Mouecoucou:1, Marielle Karine Bouyou Akotet:2
1:Physiology, Faculty of Medicine, University of Health Sciences (USS), Gabon, 2:Department of Parasitology, USS, Gabon

With 212 millions of malaria cases and 429 thousands death around the world, malaria remains the first endemic parasitemia. Most of malaria cases are counting in Sub-Saharan Africa. Under 5 years old childs and pregnant women are the most vulnerable populations.
In pregnant women, malaria is regarded like a serious illness which touch about 125 millions of those per year. The usage of Intermittent Preventive Treatment with Sulfadoxine-pyrymethamine (IPT-SP) is recommended by The World Health Organization (WHO) to prevent malaria in this aimed population.
To evaluate the effects of IPT-SP treatment against malaria during the pregnancy, plasma levels of ions (Na+, K+; Cl-) were measured on samples (n=484) coming from pregnant women (n=313) and non-pregnant (n=171) of Libreville city (Gabon).
The data shown that infected pregnant women (IPW: Na+=165.7 mmol/l; K+=0.49 mmol/l) and non-infected pregnant women (NIPW: Na+=181 mmol/l; K+=1.94 mmol/l), overall were hypernatremic and hypokalaemic; whereas non-infected women (NIW: Na+=151.8 mmol/l; K+=3.51 mmol/l) displayed a normal kalaemia and hypernatremia. Pregnancy did not influence chloremia.
Following the gestational age, the NIPW and IPW showed a significant increase of average natremia on the 2nd quarter than the 3rd quarter of pregnancy (NIPW: 189.5 mmol/l vs 176 mmol/l, *p<0.05); (IPW: 197 mmol/l vs 159.6 mmol/l, **p<0.01), respectively. The average kalaemia was also enhanced on 2nd quarter than the 3rd quarter in both groups (NIPW: 2.59 mmol/l vs 1.54 mmol/l, **p<0.01); (IPW: 2.3 mmol/l vs 0.89 mmol/l, **p<0.01).
Put on the IPT-SP treatment, treated pregnant women were not significantly different compared to non-treated pregnant women, concerning the average natremia, kalaemia and chloremia. In contrast, malaria induced more decrease of hypernatremia in non-treated IPW (Na+=152.8 mmol/l) than treated NIPW (Na+=180.68 mmol/l) and IPW (Na+=161.9 mmol/l), **p<0.01. The drop of hypokalaemia was also more pronounced in non-treated IPW (K+=0.45 mmol/l) than treated NIPW (K+=1.98 mmol/l) and IPW (K+=0.89 mmol/l) ***p<0.001.
These results revealed that IPT-SP treatment brakes the drop of hypernatremia and hypokalaemia; suggesting a beneficial protective effect of this treatment in pregnant women, to struggle against hyponatremia and hypokalaemia related to malaria.

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