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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
A randomized placebo-controlled trial of intermittent preventive treatment in pregnant women in the context of insecticide treated nets delivered through the antenatal clinic
PLoS ONE, Volume 3, No. 4, Article e1934, Year 2008
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Description
Background: Current recommendations to prevent malaria in African pregnant women rely on insecticide treated nets (TTNS) and intermittent preventive treatment (IPTp). However, there is no information on the safety and efficacy of their combined use. Methods: 1030 pregnant Mozambican women of all gravidities received a long-lasting ITN during antenatal clinic (ANC) visits and, irrespective of HIV status, were enrolled in a randomise, double blind, placebo-controlled trial, to assess the safety and efficacy of 2-dose sulphadoxine-pyrimenthamine (SP). The main outcome was the reduction in low birth weight. Findings: Two-dose SP was safe and well tolerated, but was not associated with reductions in anaemia prevalence at delivery (RR, 0.92 [95% CI, 0.79 1.08]), low birth weight (RR, 0.99 [95% CI, 0.70-1.39]), or overall placental infection (p=0.964). However, the SP group showed a 40% reduction (95% CI, 7.40-61.20]; p-0.020) in the incidence of clinical malaria during pregnancy, and reductions in the prevalence of peripheral parasitaemia (7.10% vs 15.15%) (p<0.001), and of actively infected placentas (7.04% vs 13.60%) (p=0.002). There was a reduction in severe anaemia at delivery of borderline statistical significance (p=0.055). These effects were not modified by gravidity or HIV status. Reported ITN's use was more than 90% in both groups. Conclusions: Two-dose SP was associated with a reduction in some indicators, but these were not translated to significant improvement in other maternal or birth outcomes. The use of ITNs during pregnancy may reduce the need to administer IPTp. ITNs should be part of the ANC package in sub-Sahara Africa. © 2008 Menendez et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC2277457/bin/pone.0001934.s001.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC2277457/bin/pone.0001934.s002.doc
Authors & Co-Authors
Menéndez, Clara
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Bardají, Azucena
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Sigaúque, Betuel
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Mozambique, Maputo
Ministry of Health Mozambique
Romagosa, Cleofé
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Sanz, Sergi M.
Spain, Barcelona
Instituto de Salud Global de Barcelona
Serra-Casas, Elisa
Spain, Barcelona
Instituto de Salud Global de Barcelona
MacEte, Eusébio V.
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Mozambique, Maputo
Instituto Nacional de Saude Maputo
Berenguera, A.
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
David, Catarina
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Maputo
Instituto Nacional de Saude Maputo
Dobaño, Carlota
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Naniche, Denise
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mayor, A. G.
Spain, Barcelona
Instituto de Salud Global de Barcelona
Ordi, J.
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mandomando, Inácio M.
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Mozambique, Maputo
Instituto Nacional de Saude Maputo
Aponte, John Jairo
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Mabunda, Samuel Jose Alves
Mozambique, Maputo
Instituto Nacional de Saude Maputo
Alonso, Pedro Luís
Spain, Barcelona
Instituto de Salud Global de Barcelona
Mozambique, Manhica
Centro de Investigação em Saúde de Manhiça Cism
Statistics
Citations: 169
Authors: 17
Affiliations: 4
Identifiers
Doi:
10.1371/journal.pone.0001934
e-ISSN:
19326203
Research Areas
Disability
Health System And Policy
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Cohort Study
Participants Gender
Female