التفاصيل البيبلوغرافية
| العنوان: |
Monthly Sulfadoxine-Pyrimethamine During Pregnancy Prevents Febrile Respiratory Illnesses: A Secondary Analysis of a Malaria Chemoprevention Trial in Uganda |
| المؤلفون: |
Lee, Jordan John, Kakuru, Abel, Jacobson, Karen B, Kamya, Moses R, Kajubi, Richard, Ranjit, Anju, Gaw, Stephanie L, Parsonnet, Julie, Benjamin-Chung, Jade, Dorsey, Grant, Jagannathan, Prasanna, Roh, Michelle E |
| المساهمون: |
Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Allergy and Infectious Diseases, March of Dimes Foundation, Bill and Melinda Gates Foundation, Burroughs Wellcome Fund, ASTMH |
| المصدر: |
Open Forum Infectious Diseases ; volume 11, issue 4 ; ISSN 2328-8957 |
| بيانات النشر: |
Oxford University Press (OUP) |
| سنة النشر: |
2024 |
| مصطلحات موضوعية: |
Infectious Diseases, Oncology |
| الوصف: |
Background Trials evaluating antimalarials for intermittent preventive treatment in pregnancy (IPTp) have shown that dihydroartemisinin-piperaquine (DP) is a more efficacious antimalarial than sulfadoxine-pyrimethamine (SP); however, SP is associated with higher birthweight, suggesting that SP demonstrates “nonmalarial” effects. Chemoprevention of nonmalarial febrile illnesses (NMFIs) was explored as a possible mechanism. Methods In this secondary analysis, we leveraged data from 654 pregnant Ugandan women without HIV infection who participated in a randomized controlled trial comparing monthly IPTp-SP with IPTp-DP. Women were enrolled between 12 and 20 gestational weeks and followed through delivery. NMFIs were measured by active and passive surveillance and defined by the absence of malaria parasitemia. We quantified associations among IPTp regimens, incident NMFIs, antibiotic prescriptions, and birthweight. Results Mean “birthweight for gestational age” Z scores were 0.189 points (95% CI, .045–.333) higher in women randomized to IPTp-SP vs IPTp-DP. Women randomized to IPTp-SP had fewer incident NMFIs (incidence rate ratio, 0.74; 95% CI, .58–.95), mainly respiratory NMFIs (incidence rate ratio, 0.69; 95% CI, .48–1.00), vs IPTp-DP. Counterintuitively, respiratory NMFI incidence was positively correlated with birthweight in multigravidae. In total 75% of respiratory NMFIs were treated with antibiotics. Although overall antibiotic prescriptions were similar between arms, for each antibiotic prescribed, “birthweight for gestational age” Z scores increased by 0.038 points (95% CI, .001–.074). Conclusions Monthly IPTp-SP was associated with reduced respiratory NMFI incidence, revealing a potential nonmalarial mechanism of SP and supporting current World Health Organization recommendations for IPTp-SP, even in areas with high-grade SP resistance. While maternal respiratory NMFIs are known risk factors of lower birthweight, most women in our study were presumptively treated with antibiotics, masking the ... |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1093/ofid/ofae143 |
| DOI: |
10.1093/ofid/ofae143/56965216/ofae143.pdf |
| DOI: |
10.1093/ofid/ofae143/57165217/ofae143.pdf |
| الإتاحة: |
https://doi.org/10.1093/ofid/ofae143Test |
| حقوق: |
https://creativecommons.org/licenses/by/4.0Test/ |
| رقم الانضمام: |
edsbas.F2D1A983 |
| قاعدة البيانات: |
BASE |
