Two-dose versus monthly intermittent preventive treatment of malaria with sulfadoxine-pyrimethamine in HIV-seropositive pregnant Zambian women
| Autor: | Lwambwa Mubikayi, Davidson H. Hamer, Christopher J. Gill, Victor Chalwe, Modest Mulenga, Lawrence Mwananyanda, Victor Mwanakasale, D Mukwamataba, William B. MacLeod, D. Champo, Roma Chilengi, Donald M. Thea, Chikuli Kabika Mulele |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
medicine.medical_specialty Sulfadoxine medicine.medical_treatment Placenta Population Zambia Parasitemia Drug Administration Schedule Antimalarials Hemoglobins Double-Blind Method Pregnancy Risk Factors parasitic diseases HIV Seropositivity Odds Ratio Immunology and Allergy Medicine Birth Weight Humans Malaria Falciparum Pregnancy Complications Infectious education Antibacterial agent education.field_of_study AIDS-Related Opportunistic Infections business.industry Obstetrics Incidence Pregnancy Outcome Anemia medicine.disease Fetal Blood Sulfadoxine/pyrimethamine Regimen Low birth weight Drug Combinations Infectious Diseases Pyrimethamine Treatment Outcome Immunology Female medicine.symptom business Malaria medicine.drug |
| Zdroj: | The Journal of infectious diseases. 196(11) |
| ISSN: | 0022-1899 |
| Popis: | Intermittent preventive treatment of malaria during pregnancy (IPTp) reduces placental infection, maternal anemia, and low birth weight (LBW). However, the optimal dosing regimen in settings in which human immunodeficiency virus (HIV) is highly prevalent among pregnant women remains controversial.We conducted a randomized, double-blind, placebo-controlled study of IPTp comparing the standard 2-dose sulfadoxine-pyrimethamine (SP) regimen with monthly IPTp among a cohort of HIV-positive pregnant Zambian women. Primary outcomes included placental malaria (by smear and histology) and maternal peripheral parasitemia at delivery.There were no differences between monthly IPTp (n=224) and standard IPTp (n=232) in placental malaria by histopathology (26% vs. 29%; relative risk [RR], 0.90 [95% confidence interval {CI}, 0.64-1.26]) or placental parasitemia (2% vs. 4%; RR, 0.55 [95% CI, 0.17-1.79]). There also were no differences in maternal anemia, stillbirths, preterm delivery, LBW, or all-cause mortality of infants at 6 weeks.In an area of mesoendemicity in Zambia, monthly SP IPTp was not more efficacious than the standard 2-dose regimen for the prevention of placental malaria or adverse birth outcomes. IPTp policy recommendations need to take into account local malaria transmission patterns and the prevalence of HIV.ClinicalTrials.gov identifier: NCT00270530. |
| Databáze: | OpenAIRE |
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