Intermittent sulphadoxine-pyrimethamine to prevent severe anaemia secondary to malaria in pregnancy: a randomised placebo-controlled trial

Shulman, Caroline; Dorman, E. B.; Cutts, Felicity; Kawuondo, Ken; Bulmer, JN; Peshu, Norbert; Marsh, Kevin

doi:10.1016/s0140-6736(98)07318-8

Cited by 339 publications

(256 citation statements)

References 27 publications

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“…Our findings support the call for urgent implementation of antimalarial strategies in the antenatal period which are already known to be effective but are still not in widespread use in many of the malaria endemic areas of subSaharan Africa 8,32 . …”

Section: Uterine Artery Doppler and Malaria Dorman Et Alsupporting

confidence: 82%

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Impaired uteroplacental blood flow in pregnancies complicated by falciparum malaria

Dorman

Shulman

Kingdom

et al. 2002

Ultrasound in Obstet & Gyne

120

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Section: Uterine Artery Doppler and Malaria Dorman Et Alsupporting

confidence: 82%

“…Malaria is an important cause of maternal and perinatal morbidity and mortality. In areas of endemic, stable transmission, malaria is the main cause of severe maternal anemia (Hb < 7 g /dL) in primigravidae [6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

Impaired uteroplacental blood flow in pregnancies complicated by falciparum malaria

Dorman

Shulman

Kingdom

et al. 2002

Ultrasound in Obstet & Gyne

120

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“…18 As a tool for preventing anemia in pregnancy, ITNs were found to be ineffective in a high transmission area of Kenya, but did reduce anemia in an area of low transmission on the Thailand/Burma (Myanmar) border. 19,20 Intermittent preventive treatment for the prevention of malaria and anemia in pregnancy has been found to be effective in high transmission areas in Africa, 21 but there are no data on its effectiveness in low transmission areas and during epidemics. Weekly chemoprophylaxis has been found to be effective for prevention of malaria in pregnancy in a low transmission area in Thailand, 22 and studies on its effectiveness in a low transmission area of Madagascar are ongoing.…”

Section: (Worrall E 2001 An Economic Evaluation Of Malaria Early Wamentioning

confidence: 99%

The Burden of Malaria Epidemics and Cost-Effectiveness of Interventions in Epidemic Situations in Africa

Worrall¹,

Rietveld²,

Delacollette³

2004

The American Journal of Tropical Medicine and Hygiene

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Abstract. Attempts to quantify the epidemiologic and economic burden of malaria have so far neglected to specifically address the burden of epidemic malaria. Moreover, the data on the effectiveness and cost-effectiveness of interventions in epidemics is extremely limited. Answering such key questions in an epidemic prone context is more challenging than doing so in endemic areas. Using the limited data available, we estimate that in Africa, there are more than 12 million malaria episodes and 155,000−310,000 malaria deaths per year attributable to epidemics if control options are not implemented or well timed, which is equivalent to some 4% of estimated annual malaria cases worldwide and 12−25% of estimated annual worldwide malaria deaths, including up to 50% of the estimated annual worldwide malaria mortality in persons > 15 years of age. The possible economic impact of malaria epidemics is described and the limited evidence on the effectiveness and cost-effectiveness of interventions in areas of low or seasonal transmission is reviewed.

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“…The World Health Organization recommends that women living in sub-Saharan Africa receive at least two doses of intermittent preventive treatment (IPTp) with sulfadoxinepyrimethamine (SP) to prevent malaria and improve pregnancy outcomes (1)(2)(3)(4)(5) and this advice is widely followed. However, the rapid spread of SP-resistant parasites might undermine the efficacy of SP-IPTp, although it still confers benefits in areas with low to moderate levels of drug resistance (6).…”

mentioning

confidence: 99%

Competitive facilitation of drug-resistant Plasmodium falciparum malaria parasites in pregnant women who receive preventive treatment

Harrington

Mutabingwa

Muehlenbachs

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

189

244

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Intermittent preventive treatment in pregnancy (IPTp) is used to prevent Plasmodium falciparum malaria. However, parasites resistant to the IPTp drug sulfadoxine-pyrimethamine (SP) have emerged worldwide, and infections with mixed resistant and susceptible parasites are exacerbated by pyrimethamine in mice. In a prospective delivery cohort in Muheza, Tanzania, we examined the effects of SP IPTp on parasite resistance alleles, parasite diversity, level of parasitemia, and inflammation in the placenta. IPTp use was associated with an increased fraction of parasites carrying the resistance allele at DHPS codon 581, an increase in the level of parasitemia, and more intense placental inflammation. The lowest mean level of parasite diversity and highest mean level of parasitemia occurred in women after recent IPTp use. These findings support a model of parasite release and facilitation, whereby the most highly resistant parasites out-compete less fit parasite populations and overgrow under drug pressure. Use of partially effective anti-malarial agents for IPTp may exacerbate malaria infections in the setting of widespread drug resistance.evolution of drug resistance ͉ intermittent preventive treatment in pregnancy ͉ malaria drug resistance ͉ pregnancy malaria M alaria during pregnancy causes both maternal and fetal morbidity and mortality, including the deaths of an estimated 100,000 infants each year because of malaria-related low birth weight. The World Health Organization recommends that women living in sub-Saharan Africa receive at least two doses of intermittent preventive treatment (IPTp) with sulfadoxinepyrimethamine (SP) to prevent malaria and improve pregnancy outcomes (1-5) and this advice is widely followed. However, the rapid spread of SP-resistant parasites might undermine the efficacy of SP-IPTp, although it still confers benefits in areas with low to moderate levels of drug resistance (6). The effect of SP IPTp in areas where resistant parasites are more widespread has not been studied.Pyrimethamine and sulfadoxine target the parasite proteins DHFR and DHPS, respectively, and increasing resistance is conferred by ordered accumulating point mutations, of which DHPS codon 581 is one of the final to occur (7). The mutation at DHPS codon 581 has been associated with high-level in vitro resistance (8), as well as treatment failure in children (9, 10). Single-dose treatment of children with SP has been associated with an increase in parasite resistance alleles (11, 12), but little work has been done to examine the relationship between IPTp and selection for drug resistance alleles. One recent study observed an increased prevalence of placental infections harboring the DHFR triple mutant in women who had received pyrimethamine prophylaxis during pregnancy, as compared with women who had not (13). In contrast, IPTp use was not related to increased prevalence of resistance alleles at the same study site (14). Modeling studies have proposed that IPTp is less likely to contribute to accumulating drug resistance as...

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Intermittent sulphadoxine-pyrimethamine to prevent severe anaemia secondary to malaria in pregnancy: a randomised placebo-controlled trial

Cited by 339 publications

References 27 publications

Impaired uteroplacental blood flow in pregnancies complicated by falciparum malaria

Impaired uteroplacental blood flow in pregnancies complicated by falciparum malaria

The Burden of Malaria Epidemics and Cost-Effectiveness of Interventions in Epidemic Situations in Africa

Competitive facilitation of drug-resistant Plasmodium falciparum malaria parasites in pregnant women who receive preventive treatment

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