Comparison of Intermittent Preventive Treatment with Chemoprophylaxis for the Prevention of Malaria during Pregnancy in Mali

Background. Malaria during pregnancy contributes to maternal anemia and low birth weight. In East Africa, several studies have demonstrated that intermittent preventive treatment (IPT) with sulfadoxine-pyrimethamine (SP) is more efficacious than weekly chloroquine (CQ) chemoprophylaxis in preventing...

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Bibliographic Details
Published in:The Journal of infectious diseases 2005-01, Vol.191 (1), p.109-116
Main Authors: Kayentao, Kassoum, Kodio, Mamoudou, Newman, Robert D., Maiga, Hamma, Doumtabe, Didier, Ongoiba, Aissata, Coulibaly, Drissa, Keita, Abdoul Salam, Maiga, Bouboucar, Mungai, Mary, Parise, Monica E., Doumbo, Ogobara
Format: Article
Language:English
Subjects:
Abortion, Spontaneous
Adolescent
Adult
Anemia
Biological and medical sciences
Birth Weight
Blood
Chemoprevention
Chemoprevention - methods
Chloroquine - administration & dosage
Chloroquine - therapeutic use
Drug Administration Schedule
Drug Combinations
Female
Fundamental and applied biological sciences. Psychology
Hemoglobins
Human protozoal diseases
Humans
Infant
Infant, Newborn
Infections
Infectious diseases
Malaria
Malaria - prevention & control
Mali
Medical sciences
Microbiology
Multivariate Analysis
Parasitemia
Parasites
Parasitic diseases
Placenta Diseases - prevention & control
Pregnancy
Pregnancy Complications, Parasitic - prevention & control
Pregnancy Outcome
Protozoal diseases
Pyrimethamine - administration & dosage
Pyrimethamine - therapeutic use
Sulfadoxine - administration & dosage
Sulfadoxine - therapeutic use
Women
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Summary:Background. Malaria during pregnancy contributes to maternal anemia and low birth weight. In East Africa, several studies have demonstrated that intermittent preventive treatment (IPT) with sulfadoxine-pyrimethamine (SP) is more efficacious than weekly chloroquine (CQ) chemoprophylaxis in preventing these adverse consequences. To our knowledge, there are no published trials evaluating IPT in West Africa. Methods. We undertook a randomized controlled trial of weekly CQ chemoprophylaxis, 2-dose IPT with CQ, and 2-dose IPT with SP; 1163 women were enrolled. Results. In multivariate analyses, when compared with weekly CQ, IPT/SP was associated with a reduction in third-trimester anemia (adjusted odds ratio [AOR], 0.49; P = .001), placental parasitemia (AOR, 0.69; P = .04), and low birth weight (2 doses may be required to prevent placental reinfection prior to delivery.
ISSN:0022-1899
1537-6613
DOI:10.1086/426400