Additional Screening and Treatment of Malaria During Pregnancy Provides Further Protection Against Malaria and Nonmalarial Fevers During the First Year of Life

• Published in: The Journal of infectious diseases 2018-05, Vol.217 (12), p.1967-1976
• Main Authors: Natama, Hamtandi Magloire, Rovira-Vallbona, Eduard, Sorgho, Hermann, Somé, M Athanase, Traoré-Coulibaly, Maminata, Scott, Susana, Zango, Serge Henri, Sawadogo, Ousséni, Zongo, Sibiri Claude, Valéa, Innocent, Mens, Petra F, Schallig, Henk D F H, Kestens, Luc, Tinto, Halidou, Rosanas-Urgell, Anna
• Format: Article
• Language: English
• Subjects: Adult; Antimalarials - therapeutic use; Burkina Faso; Cohort Studies; Drug Combinations; Female; Humans; Incidence; Infant; Malaria, Falciparum - diagnosis; Malaria, Falciparum - drug therapy; Male; Mass Screening - methods; Plasmodium falciparum - drug effects; Pregnancy; Pregnancy Complications, Parasitic - diagnosis; Pregnancy Complications, Parasitic - drug therapy; Pyrimethamine - therapeutic use; Sulfadoxine - therapeutic use
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jiy140

Although consensus exists that malaria in pregnancy (MiP) increases the risk of malaria in infancy, and eventually nonmalarial fevers (NMFs), there is a lack of conclusive evidence of benefits of MiP preventive strategies in infants. In Burkina Faso, a birth cohort study was nested to a clinical trial assessing the effectiveness of a community-based scheduled screening and treatment of malaria in combination with intermittent preventive treatment with sulfadoxine-pyrimethamine (CSST/IPTp-SP) to prevent placental malaria. Clinical episodes and asymptomatic infections were monitored over 1 year of follow-up to compare the effect of CSST/IPTp-SP and standard IPTp-SP on malaria and NMFs. Infants born during low-transmission season from mothers receiving CSST/IPTp-SP had a 26% decreased risk of experiencing a first clinical episode (hazard ratio, 0.74 [95% confidence interval, .55-0.99]; P = .047). CSST/IPTp-SP interacted with birth season and gravidity to reduce the incidence of NMFs. No significant effects of CSST/IPTp-SP on the incidence of clinical episodes, parasite density, and Plasmodium falciparum infections were observed. Our findings indicate that CSST/IPTp-SP strategy may provide additional protection against both malaria and NMFs in infants during the first year of life, and suggest that malaria control interventions during pregnancy could have long-term benefits in infants.