The Effect of Intermittent Preventive Treatment of Malaria During Pregnancy and Placental Malaria on Infant Risk of Malaria.
Adult
Antimalarials
/ therapeutic use
Artemisinins
/ therapeutic use
Drug Combinations
Female
Humans
Infant
Malaria
/ drug therapy
Malawi
/ epidemiology
Parasitemia
/ prevention & control
Piperazines
/ therapeutic use
Placenta
/ parasitology
Pregnancy
Pregnancy Complications, Parasitic
/ drug therapy
Pyrimethamine
/ therapeutic use
Quinolines
/ therapeutic use
Sulfadoxine
/ therapeutic use
Treatment Outcome
dihydroartemisinin-piperaquine
infants
intermittent preventive treatment
malaria
placental malaria
pregnancy
sulfadoxine-pyrimethamine
Journal
The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675
Informations de publication
Date de publication:
18 01 2022
18 01 2022
Historique:
received:
25
03
2021
accepted:
02
07
2021
pubmed:
4
7
2021
medline:
16
2
2022
entrez:
3
7
2021
Statut:
ppublish
Résumé
Intermittent preventive treatment of malaria during pregnancy (IPTp) with dihydroartemisinin-piperaquine (DP) provides greater protection from placental malaria than sulfadoxine-pyrimethamine (SP). Some studies suggest placental malaria alters risk of malaria infection in infants, but few have quantified the effect of IPTp on infant susceptibility to malaria. Infants born to women enrolled in a randomized clinical trial comparing IPTp-SP and IPTp-DP in Malawi were followed from birth to 24 months to assess effect of IPTp and placental malaria on time to first malaria episode and Plasmodium falciparum incidence. In total, 192 infants born to mothers randomized to IPTp-SP and 195 randomized to IPTp-DP were enrolled. Infants in IPTp exposure groups did not differ significantly regarding incidence of clinical malaria (incidence rate ratio [IRR], 1.03; 95% confidence interval [CI], .58-1.86) or incidence of infection (IRR, 1.18; 95% CI, .92-1.55). Placental malaria exposure was not associated with incidence of clinical malaria (IRR, 1.03; 95% CI, .66-1.59) or infection (IRR, 1.15; 95% CI, .88-1.50). Infant sex, season of birth, and maternal gravidity did not confound results. We did not find evidence that IPTp regimen or placental malaria exposure influenced risk of malaria during infancy in this population. Clinical Trials Registration. NCT03009526.
Sections du résumé
BACKGROUND
Intermittent preventive treatment of malaria during pregnancy (IPTp) with dihydroartemisinin-piperaquine (DP) provides greater protection from placental malaria than sulfadoxine-pyrimethamine (SP). Some studies suggest placental malaria alters risk of malaria infection in infants, but few have quantified the effect of IPTp on infant susceptibility to malaria.
METHODS
Infants born to women enrolled in a randomized clinical trial comparing IPTp-SP and IPTp-DP in Malawi were followed from birth to 24 months to assess effect of IPTp and placental malaria on time to first malaria episode and Plasmodium falciparum incidence.
RESULTS
In total, 192 infants born to mothers randomized to IPTp-SP and 195 randomized to IPTp-DP were enrolled. Infants in IPTp exposure groups did not differ significantly regarding incidence of clinical malaria (incidence rate ratio [IRR], 1.03; 95% confidence interval [CI], .58-1.86) or incidence of infection (IRR, 1.18; 95% CI, .92-1.55). Placental malaria exposure was not associated with incidence of clinical malaria (IRR, 1.03; 95% CI, .66-1.59) or infection (IRR, 1.15; 95% CI, .88-1.50). Infant sex, season of birth, and maternal gravidity did not confound results.
CONCLUSIONS
We did not find evidence that IPTp regimen or placental malaria exposure influenced risk of malaria during infancy in this population. Clinical Trials Registration. NCT03009526.
Identifiants
pubmed: 34216212
pii: 6314274
doi: 10.1093/infdis/jiab351
pmc: PMC8763957
doi:
Substances chimiques
Antimalarials
0
Artemisinins
0
Drug Combinations
0
Piperazines
0
Quinolines
0
fanasil, pyrimethamine drug combination
37338-39-9
artenimol
6A9O50735X
Sulfadoxine
88463U4SM5
piperaquine
A0HV2Q956Y
Pyrimethamine
Z3614QOX8W
Banques de données
ClinicalTrials.gov
['NCT03009526']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
248-256Subventions
Organisme : NIAID NIH HHS
ID : K24 AI114996
Pays : United States
Organisme : NIAID NIH HHS
ID : R21 AI121990
Pays : United States
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
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