Sustained clinical benefit of malaria chemoprevention with sulfadoxine-pyrimethamine (SP) in pregnant women in a region with high SP resistance markers.
| Autor: | Matambisso G; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Moçambique., Brokhattingen N; ISGlobal, Barcelona Institute for Global Health, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain., Maculuve S; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Moçambique., Cístero P; ISGlobal, Barcelona Institute for Global Health, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain., Mbeve H; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Moçambique., Escoda A; ISGlobal, Barcelona Institute for Global Health, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain., Bambo G; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Moçambique., Cuna B; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Moçambique., Melembe C; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Moçambique., Ndimande N; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Moçambique., Tetteh KKA; Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK., Drakeley C; Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK., Gamain B; Sorbonne Université, INSERM, CNRS, Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris, Paris, France., Chitnis C; Malaria Parasite Biology and Vaccines, Department of Parasites & Insect Vectors, Institut Pasteur, Paris, France., Chauhan V; Malaria Group, International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, India., Quintó L; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Moçambique; ISGlobal, Barcelona Institute for Global Health, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain., Macete E; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Moçambique; National Directare of Health, Ministry of Health, Maputo, Mozambique., Mayor A; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Moçambique; ISGlobal, Barcelona Institute for Global Health, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Physiologic Sciences, Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique. Electronic address: alfredo.mayor@isglobal.org. |
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| Jazyk: | angličtina |
| Zdroj: | The Journal of infection [J Infect] 2024 May; Vol. 88 (5), pp. 106144. Date of Electronic Publication: 2024 Apr 02. |
| DOI: | 10.1016/j.jinf.2024.106144 |
| Abstrakt: | Objective: The effectiveness of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is threatened by increasing SP-resistance in Africa. We assessed the level of SP-resistance markers, and the clinical and parasitological effectiveness of IPTp-SP in southern Mozambique. Methods: P. falciparum infection, antimalarial antibodies and dhfr/dhps SP-resistance mutants were detected by quantitative polymerase chain reaction (qPCR), suspension array technology and targeted deep sequencing, respectively, among 4016 HIV-negative women in Maputo province (2016-2019). Univariate and multivariate regression models were used to assess the association between taking the recommended three or more IPTp-SP doses (IPTp3+) and parasitological and clinical outcomes. Results: 84.3% (3385/4016) women received three or more IPTp-SP doses. The prevalence of quintuple mutants at first antenatal care (ANC) visit was 94.2%. IPTp3+ was associated with a higher clearance rate of qPCR-detected infections from first ANC visit to delivery (adjusted odds ratio [aOR]=5.9, 95% CI: 1.5-33.3; p = 0.012), lower seroprevalence at delivery of antibodies against the pregnancy-specific antigen VAR2CSA Conclusion: A sustained parasitological effect of IPTp-SP contributes to the clinical effectiveness of IPTp3+ in areas with high prevalence of SP-resistance markers. Competing Interests: Declaration of Competing Interest All authors reported no conflicts of interest. (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.) |
| Databáze: | MEDLINE |
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