Evidence map›Paper›PMID 21454456›Full record

Trial reportBMJ (Clinical research ed.)2011

Protective efficacy of co-trimoxazole prophylaxis against malaria in HIV exposed children in rural Uganda: a randomised clinical trial.

Taylor G Sandison, Jaco Homsy, Emmanuel Arinaitwe, Humphrey Wanzira, Abel Kakuru, Victor Bigira, Julius Kalamya, Neil Vora, James Kublin, Moses R Kamya and 2 more

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00527800 (Interactions Between HIV and Malaria in African Children), which is not on this map. Cited by 50 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 5 pooled it
6.0field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00527800 phase3completednot on this map

Interactions Between HIV and Malaria in African Children

TypeinterventionalSponsorUniversity of California, San FranciscoRan2007 to 2013Enrolled351ConditionsMalaria, HIV InfectionsArmsDihydroartemisinin-piperaquine, Artemether-lumefantrine, Trimethoprim-sulfamethoxazole
3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 5 syntheses or guidelines pooled it, 77 citations in OpenAlex.

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  11. Artemisinin-based combination therapies are efficacious and safe for treatment of uncomplicated malaria in HIV-infected Ugandan children.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2014
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 7 institutions in 2 countries.

Taylor G SandisonDepartment of Medicine, University of Washington, UW/FHCRC Clinical Research, Box 358080, Seattle, WA 98195-8080, USA. tgsand@u.washington.edu
Jaco Homsy
Emmanuel Arinaitwe
Humphrey Wanzira
Abel Kakuru
Victor Bigira
Julius Kalamya
Neil Vora
James Kublin
Moses R Kamya
Grant Dorsey
Jordan W Tappero
Infectious Diseases Research Collaboration · UGUniversity of California, San Francisco · USCenters for Disease Control and Prevention · USCenters for Disease Control and Prevention · UGFred Hutch Cancer Center · USMakerere University · UGUniversity of Washington · US

Funding

Rebound Malaria Following Trimethoprim-Sulfamethoxazole Prophylaxis in ChildrenK23AI082553 · NIAID · UNIVERSITY OF WASHINGTON · PI SANDISON, TAYLOR · 2009 to 2010
$171k
NIAID NIH HHS K23-AI082553
6 · The paper itself

Abstract

objectiveTo evaluate the protective efficacy of co-trimoxazole prophylaxis against malaria in HIV exposed children (uninfected children born to HIV infected mothers) in Africa.

designNon-blinded randomised control trial

settingTororo district, rural Uganda, an area of high malaria transmission intensity

participants203 breastfeeding HIV exposed infants enrolled between 6 weeks and 9 months of age

interventionCo-trimoxazole prophylaxis from enrollment until cessation of breast feeding and confirmation of negative HIV status. All children who remained HIV uninfected (n = 185) were then randomised to stop co-trimoxazole prophylaxis immediately or continue co-trimoxazole until 2 years old.

main outcome measureIncidence of malaria, calculated as the number of antimalarial treatments per person year.

resultsThe incidence of malaria and prevalence of genotypic mutations associated with antifolate resistance were high throughout the study. Among the 98 infants randomised to continue co-trimoxazole, 299 malaria cases occurred in 92.28 person years (incidence 3.24 cases/person year). Among the 87 infants randomised to stop co-trimoxazole, 400 malaria cases occurred in 71.81 person years (5.57 cases/person year). Co-trimoxazole prophylaxis yielded a 39% reduction in malaria incidence, after adjustment for age at randomisation (incidence rate ratio 0.61 (95% CI 0.46 to 0.81), P = 0.001). There were no significant differences in the incidence of complicated malaria, diarrhoea, pneumonia, hospitalisations, or deaths between the two treatment arms.

conclusionsCo-trimoxazole prophylaxis was moderately protective against malaria in HIV exposed infants when continued beyond the period of HIV exposure despite the high prevalence of Plasmodium genotypes associated with antifolate resistance. Trial registration Clinical Trials NCT00527800.

Indexed as

HIV InfectionsPregnancy Complications, InfectiousAntimalarialsBreast FeedingDiarrhea, InfantileFemaleHIV SeronegativityHumansIncidenceInfantMalariaPregnancyRespiratory Tract InfectionsRural HealthTreatment OutcomeTrimethoprim, Sulfamethoxazole Drug CombinationAntimalarialsTrimethoprim, Sulfamethoxazole Drug Combination

Identifiers

PMID21454456
PMCPMC3068910
OpenAlexW1993749542

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.