Featured Research

from universities, journals, and other organizations

More Effective Treatment For Malaria Control During Pregnancy In Africa Identified

Date:
June 20, 2007
Source:
JAMA and Archives Journals
Summary:
A review of previous studies indicates that two doses of a malaria preventive therapy during pregnancy provides substantial benefit to HIV-negative women in Africa, with more frequent dosing apparently necessary for HIV-positive women, according to a recent article.

A review of previous studies indicates that two doses of a malaria preventive therapy during pregnancy provides substantial benefit to HIV-negative women in Africa, with more frequent dosing apparently necessary for HIV-positive women, according to an article in the June 20 issue of JAMA.

In malaria-endemic regions, the burden of disease is primarily in young children and pregnant women. Women are particularly vulnerable to the adverse effects of malaria during their first and second pregnancies, according to background information in the article. Approximately 50 million women living in malaria-endemic areas become pregnant each year, half in areas of sub-Saharan Africa with stable Plasmodium falciparum (a parasite that causes malaria) transmission.

In these regions, strategies to control malaria during pregnancy rely on case management of malaria illness and anemia, and a variety of preventive measures that consists of insecticide-treated nets (ITNs) and intermittent preventive therapy (IPT) with the malaria drug sulfadoxine-pyrimethamine.

Feiko ter Kuile, M.D., Ph.D., of the Liverpool School of Tropical Medicine, Liverpool, England and colleagues evaluated data to assess whether increasing the frequency of IPT with sulfadoxine-pyrimethamine during pregnancy could provide a temporary respite in areas in Africa with increasing sulfadoxine-pyrimethamine resistance.

The researchers identified four trials that compared 2-dose IPT with sulfadoxine-pyrimethamine to case management or placebo in women during their first or second pregnancy. The IPT reduced the risk of placental malaria by 52 percent, the risk of low birth weight by 29 percent, and the risk of anemia by 10 percent. The effect did not vary by sulfadoxine-pyrimethamine resistance levels (range, 19 percent-26 percent).

Efficacy of IPT with sulfadoxine-pyrimethamine was lower among women using insecticide-treated nets. Three trials compared 2-dose with monthly IPT with sulfadoxine-pyrimethamine during pregnancy. Among HIV-positive women in their first or second pregnancy, monthly IPT resulted in less placental malaria and higher birth weight over the range of sulfadoxine-pyrimethamine resistance tested (8 percent-39 percent). Among HIV-negative women, there was no conclusive additional effect of monthly dosing.

"The deleterious effects of malaria during pregnancy can be substantially reduced by using IPT in pregnant women. Sulfadoxine-pyrimethamine is currently the only single-dose long-acting antimalarial drug that has ideal properties (low cost, documented safety, and ease of use) for use as an IPT during pregnancy. The current appraisal of available data on the efficacy of IPT with sulfadoxine-pyrimethamine as a function of sulfadoxine-pyrimethamine treatment responses in children provides policy makers with a clearer understanding of the value of different IPT regimens with sulfadoxine-pyrimethamine during pregnancy in the context of increasing sulfadoxine-pyrimethamine drug resistance," the authors write.

"Reserving the use of sulfadoxine-pyrimethamine for IPT during pregnancy and for infants may reduce drug pressure and may prolong longevity of this valuable drug. Almost all countries in Africa are taking this course and have either implemented or are in the process of implementing the use of combination therapy for first-line treatment in the population, mostly with artemisinin-based [a type of antimalarial drug] combinations.

This will also limit the options to monitor the degree of sulfadoxine-pyrimethamine resistance in treatment studies in children in vivo, and future studies that aim to determine the effect of sulfadoxine-pyrimethamine resistance on the efficacy of IPT with sulfadoxine-pyrimethamine during pregnancy may need to rely on molecular markers."

Reference: JAMA. 2007;297:2603-2616.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Cite This Page:

JAMA and Archives Journals. "More Effective Treatment For Malaria Control During Pregnancy In Africa Identified." ScienceDaily. ScienceDaily, 20 June 2007. <www.sciencedaily.com/releases/2007/06/070619161824.htm>.
JAMA and Archives Journals. (2007, June 20). More Effective Treatment For Malaria Control During Pregnancy In Africa Identified. ScienceDaily. Retrieved September 20, 2014 from www.sciencedaily.com/releases/2007/06/070619161824.htm
JAMA and Archives Journals. "More Effective Treatment For Malaria Control During Pregnancy In Africa Identified." ScienceDaily. www.sciencedaily.com/releases/2007/06/070619161824.htm (accessed September 20, 2014).

Share This



More Health & Medicine News

Saturday, September 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Sierra Leone's Nationwide Ebola Curfew Underway

Sierra Leone's Nationwide Ebola Curfew Underway

Newsy (Sep. 20, 2014) Sierra Leone is locked down as aid workers and volunteers look for new cases of Ebola. Video provided by Newsy
Powered by NewsLook.com
Changes Found In Brain After One Dose Of Antidepressants

Changes Found In Brain After One Dose Of Antidepressants

Newsy (Sep. 19, 2014) A study suggest antidepressants can kick in much sooner than previously thought. Video provided by Newsy
Powered by NewsLook.com
Could Grief Affect The Immune Systems Of Senior Citizens?

Could Grief Affect The Immune Systems Of Senior Citizens?

Newsy (Sep. 19, 2014) The study found elderly people are much more likely to become susceptible to infection than younger adults going though a similar situation. Video provided by Newsy
Powered by NewsLook.com
Jury Delivers Verdict in Salmonella Trial

Jury Delivers Verdict in Salmonella Trial

AP (Sep. 19, 2014) A federal jury has convicted three people in connection with an outbreak of salmonella poisoning five years ago that sickened hundreds of people and was linked to a number of deaths. (Sept. 19) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins