Intermittent Treatment for the Prevention of Malaria during Pregnancy in Benin: A Randomized, Open‐Label Equivalence Trial Comparing Sulfadoxine‐Pyrimethamine with Mefloquine

Abstract

MQ proved to be highly efficacious--both clinically and parasitologically--for use as IPTp. However, its low tolerability might impair its effectiveness and requires further investigations.

Prevention of Malaria during Pregnancy: Assessing the Effect of the Distribution of IPTp Through the National Policy in Benin

“…In the clinical trial, HIV screening was routinely undertaken by the national program during the trial, but the HIV status of women was only determined for 50% of women. 9 HIV-positive women were excluded from the analysis. Generally, the prevalence of HIV is low (2%) in this area.…”

“…Because the efficacy of IPTp with MQ and SP were very close at the end of the clinical trial, both arms were kept pooled for the present analysis. 9 When nonparametric methods were required, a Fisher exact test or Kruskall-Wallis test was applied.…”

Mefloquine Versus Sulfadoxine–Pyrimethamine for Intermittent Preventive Treatment in Pregnancy: A Joint Analysis on Efficacy and Tolerability

“…In two recent clinical trials, MQ-IPTp has proven to be equivalent to SP-IPTp in preventing LBW. 6,7 It was also found to be more efficacious than SP-IPTp in preventing maternal anemia, symptomatic malaria, and placental, and peripheral malaria infections at delivery both in human immunodeficiency virus (HIV)-negative and HIV-positive women. [6][7][8][9] However, owing to its moderate tolerability, the Malaria Policy Advisory Committee to the WHO, which met in September 2013, proposed that MQ at the 15 mg/kg dose regimen should not be recommended for IPTp.…”

“…6,7 It was also found to be more efficacious than SP-IPTp in preventing maternal anemia, symptomatic malaria, and placental, and peripheral malaria infections at delivery both in human immunodeficiency virus (HIV)-negative and HIV-positive women. [6][7][8][9] However, owing to its moderate tolerability, the Malaria Policy Advisory Committee to the WHO, which met in September 2013, proposed that MQ at the 15 mg/kg dose regimen should not be recommended for IPTp. 10 In the current debate regarding the relevance of MQ for IPTp, we reanalyzed data from the first Beninese trial with an original statistical approach already used to assess treatments in rheumatology, 6 which made it possible to perform a global comparison of SP and MQ for IPTp taking into account both the preventive and adverse effects of the treatments simultaneously.…”

Maternal Anemia in Benin: Prevalence, Risk Factors, and Association with Low Birth Weight

“…The trial's study design and maternal characteristics have been described elsewhere. 11 Women of all gravidities presenting with no history of a neurologic or psychiatric disorder, and who had not either previously used SP or mefloquine or reported having adverse reactions to medications containing sulfa were eligible to participate. Among the recruited women, 44.1% had already had at least one ANC before inclusion in the trial.…”