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Correlating Lignin Positivity with Self-Reported Administration of Sulfadoxine-Pyrimethamine (SRA-Sp) among Pregnant Women

Adebayo, D. A.; Adedeji, W. A.; Alarape-Raji, A.; Balogun, S. T.; Adaramola, B. A.; Fehintola, F. A.

2025-08-02 public and global health
10.1101/2025.08.01.25332604 medRxiv
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BackgroundThis study explores the relationship between lignin positivity and self-reported sulfadoxine-pyrimethamine (SP) administration in pregnant women residing in malaria-endemic regions of Yemetu, Ibadan. Sulfadoxine-pyrimethamine, a commonly used malaria prevention drug during pregnancy, has shown varying levels of efficacy based on individual adherence to treatment regimens. Lignin positivity, a potential biomarker associated with oxidative stress, was assessed as a correlate of therapeutic response to SP and its potential role in monitoring adherence. Materials and MethodsThe study employed a longitudinal design involving 355 pregnant women attending Adeoyo Maternity Teaching Hospital, Yemetu, Ibadan, aged 18-45, who had received SP for malaria prophylaxis. Self-reported data on SP administration were collected through a researchers self-structured questionnaire, while lignin positivity was determined through biochemical lignin tests on the urine of the pregnant women conducted at three intervals (Day 0, Day 7, and Day 28). ResultsThe results demonstrated a significant increase in lignin positivity over the 28-day period (Day 0 to Day 7 (p > 0.000) at 91.3% increase, and 7 to Day 28 (p > 0.007) with 93.5% rate of lignin positivity rise), with the highest positivity observed at Day 28. This trend was statistically significant, indicating a strong correlation between SP administration and increased lignin test results. ConclusionThere existed strong evidence supporting a statistically significant correlation between lignin positivity and the self-reported administration of sulfadoxine-pyrimethamine (SP) among pregnant women attending Adeoyo Maternity Teaching Hospital, Yemetu, Ibadan. This implies that lignin positivity is a useful potential biomarker for ascertaining SP adherence in pregnant women. These results highlight the effectiveness of sulfadoxine-pyrimethamine in malaria prevention and suggest that lignin positivity could serve as a valuable tool for assessing adherence to malaria chemoprophylaxis among pregnant women.

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