Evidence map›Paper›PMID 21765070›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2011

Intermittent treatment to prevent pregnancy malaria does not confer benefit in an area of widespread drug resistance.

Whitney E Harrington, Theonest K Mutabingwa, Edward Kabyemela, Michal Fried, Patrick E Duffy

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04783051 (Comparison of IST Using Ultra-sensitive Malaria Rapid Diagnostic Test and Pyronaridine - Artesunate - PYRAMAX®) to Standard IPT Sulfadoxine-pyrimethamine to Prevent Malaria in Pregnant Women Living in Endemic Areas), which is not on this map. Cited by 97 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
97citing papers in PubMed, 6 pooled it
15.1field-weighted citation impact, top 1% 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.

NCT04783051 phase3completednot on this mapstarted 2021, after this paper: background citation

Comparison of IST Using Ultra-sensitive Malaria Rapid Diagnostic Test and Pyronaridine - Artesunate - PYRAMAX®) to Standard IPT Sulfadoxine-pyrimethamine to Prevent Malaria in Pregnant Women Living in Endemic Areas

TypeinterventionalSponsorUniversity of KinshasaRan2021 to 2022Enrolled250ConditionsMalaria in PregnancyArmsSulfadoxine pyrimethamine, Pyramax
3 · Its place in the literature

Who cites it

97 citing papers in PubMed, 6 syntheses or guidelines pooled it, 153 citations in OpenAlex.

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  13. The Performance of a Rapid Diagnostic Test in Detecting Malaria Infection in Pregnant Women and the Impact of Missed Infections.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016
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  20. Prevalence ofPathogens (Basel, Switzerland) · 2026
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37 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 2 countries.

Whitney E HarringtonMalaria Program, Seattle Biomedical Research Institute, Seattle, Washington, USA.
Theonest K Mutabingwa
Edward Kabyemela
Michal Fried
Patrick E Duffy
Center for Infectious Disease Research · USNational Institute for Medical Research · TZNational Institute of Allergy and Infectious Diseases · USUniversity of Washington · US

Funding

Malaria Pathogenesis in young children and vaccine discoveryZIAAI001134 · NIAID · NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES · PI DUFFY, PATRICK · 2010 to 2025
$11.3M
Pathogenesis of falciparum malaria in infancyR01AI052059 · NIAID · SEATTLE BIOMEDICAL RESEARCH INSTITUTE · PI DUFFY, PATRICK E · 2001 to 2004
$2.7M
Pregnancy Malaria: Pathogenesis and ImmunityZIAAI001178 · NIAID · NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES · PI DUFFY, PATRICK · 2012 to 2015
$2.1M
Malaria at the Mother-child InterfaceD43TW005509 · FIC · SEATTLE BIOMEDICAL RESEARCH INSTITUTE · PI KUBLIN, JAMES G. · 2002 to 2013
$1.6M
Inflammation, Anemia and Respiratory Distress in Mothers and Infants with MalariaF30HL096298 · NHLBI · UNIVERSITY OF WASHINGTON · PI HARRINGTON, WHITNEY ELIZABETH · 2009 to 2011
$116k
FIC NIH HHS D43 TW005509NHLBI NIH HHS 1F30HL096298NHLBI NIH HHS F30 HL096298NIAID NIH HHS R01 AI052059NIAID NIH HHS R01AI52059
6 · The paper itself

Abstract

backgroundMillions of African women receive sulfadoxine-pyrimethamine (SP) as intermittent preventive treatment during pregnancy (IPTp) to avoid poor outcomes that result from malaria. However, parasites resistant to SP are widespread in parts of Africa, and IPTp may perversely exacerbate placental infections that contain SP-resistant parasites.

methodsThe study used a cross-sectional design. We determined IPTp use in a delivery cohort of 880 pregnant women in Muheza, Tanzania, by report and by plasma sulfa measurements, and we examined its effects on maternal and fetal delivery outcomes.

resultsIn the overall cohort, IPTp was not associated with decreased odds of placental malaria or with increased mean maternal hemoglobin or mean birth weight. Unexpectedly, IPTp was associated with decreased cord hemoglobin level and increased risk of fetal anemia, which may be related to in utero SP exposure.

conclusionsIPTp does not improve overall pregnancy outcomes in Muheza, Tanzania, where SP-resistant parasites predominate and may increase the odds of fetal anemia. As parasite resistance increases in a community, the overall effect of IPTp may transition from net benefit to neutral or net harm.

Indexed as

Drug ResistanceAdultAntimalarialsChemopreventionCross-Sectional StudiesDrug CombinationsFemaleHumansInfantInfant, NewbornMalariaMalePlasmodiumPregnancyPregnancy Complications, InfectiousPyrimethamineAntimalarialsDrug Combinationsfanasil, pyrimethamine drug combinationPyrimethamineSulfadoxine

Identifiers

PMID21765070
PMCPMC3202321
OpenAlexW2141917084

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.