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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Intermittent treatment to prevent pregnancy malaria does not confer benefit in an area of widespread drug resistance
Clinical Infectious Diseases, Volume 53, No. 3, Year 2011
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Description
Background. Millions of African women receive sulfadoxine-pyrimethamine (SP) as intermittent preventive treatment during pregnancy (IPTp) to avoid poor outcomes that result from malaria. However, parasites resistant to SP are widespread in parts of Africa, and IPTp may perversely exacerbate placental infections that contain SP-resistant parasites. Methods. The study used a cross-sectional design. We determined IPTp use in a delivery cohort of 880 pregnant women in Muheza, Tanzania, by report and by plasma sulfa measurements, and we examined its effects on maternal and fetal delivery outcomes. Results. In the overall cohort, IPTp was not associated with decreased odds of placental malaria or with increased mean maternal hemoglobin or mean birth weight. Unexpectedly, IPTp was associated with decreased cord hemoglobin level and increased risk of fetal anemia, which may be related to in utero SP exposure. Conclusions. IPTp does not improve overall pregnancy outcomes in Muheza, Tanzania, where SP-resistant parasites predominate and may increase the odds of fetal anemia. As parasite resistance increases in a community, the overall effect of IPTp may transition from net benefit to neutral or net harm. © 2011 The Author Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Harrington, Whitney E.
United States, Seattle
Seattle Biomedical Research Institute
United States, Seattle
University of Washington
Mutabingwa, Theonest K.
United States, Seattle
Seattle Biomedical Research Institute
Tanzania, Tanga
National Institute for Medical Research Tanga
Kabyemela, Edward R.
United States, Seattle
Seattle Biomedical Research Institute
Fried, Michal W.
United States, Seattle
Seattle Biomedical Research Institute
United States, Seattle
University of Washington
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Duffy, Patrick Emmet
United States, Seattle
Seattle Biomedical Research Institute
United States, Seattle
University of Washington
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Statistics
Citations: 154
Authors: 5
Affiliations: 4
Identifiers
Doi:
10.1093/cid/cir376
ISSN:
10584838
e-ISSN:
15376591
Research Areas
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Tanzania
Participants Gender
Female