Evidence map›Paper›PMID 22441649›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2012

Antenatal receipt of sulfadoxine-pyrimethamine does not exacerbate pregnancy-associated malaria despite the expansion of drug-resistant Plasmodium falciparum: clinical outcomes from the QuEERPAM study.

Steve M Taylor, Alejandro L Antonia, Ebbie Chaluluka, Victor Mwapasa, Gaoqian Feng, Malcolm E Molyneux, Feiko O ter Kuile, Steven R Meshnick, Stephen J Rogerson

Open 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, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 1 pooled it
7.2field-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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.

  1. Pooled it
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  7. Investigating the dynamics ofOpen research Europe · 2025
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  14. Reply to Harrington et al.The Journal of infectious diseases · 2016
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 6 countries.

Steve M TaylorDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, 27599, USA. taylo115@email.unc.edu
Alejandro L Antonia
Ebbie Chaluluka
Victor Mwapasa
Gaoqian Feng
Malcolm E Molyneux
Feiko O ter Kuile
Steven R Meshnick
Stephen J Rogerson
Royal Dental Hospital of Melbourne · AUUniversity of North Carolina at Chapel Hill · USDepartment of Health · ZALiverpool School of Tropical Medicine · GBMalawi-Liverpool-Wellcome Trust Clinical Research Programme · MWUniversity of Amsterdam · NLUniversity of Liverpool · GB

Funding

MALARIA AND HIV IN PREGNANT WOMEN IN MALAWIR01AI049084 · NIAID · UNIVERSITY OF NORTH CAROLINA CHAPEL HILL · PI MESHNICK, STEVEN RICHARD · 2001 to 2005
$1.5M
TRAINING MED SCHOOL FACULTY TO TACKLE MALARIA IN MALAWID43TW000908 · FIC · MICHIGAN STATE UNIVERSITY · PI TAYLOR, TERRIE ELLEN · 1997 to 2002
$430k
FIC NIH HHS 5 D43TW00908FIC NIH HHS D43 TW000908NIAID NIH HHS AI 49084NIAID NIH HHS R01 AI049084Wellcome Trust
6 · The paper itself

Abstract

backgroundAntenatal intermittent preventive therapy with 2 doses of sulfadoxine-pyrimethamine (IPTp-SP) is the mainstay of efforts in sub-Saharan Africa to prevent pregnancy-associated malaria (PAM). Recent studies report that drug resistance may cause IPTp-SP to exacerbate PAM morbidity, raising fears that current policies will cause harm as resistance spreads.

methodsWe conducted a serial, cross-sectional analysis of the relationships between IPTp-SP receipt, SP-resistant Plasmodium falciparum, and PAM morbidity in delivering women during a period of 9 years at a single site in Malawi. PAM morbidity was assessed by parasite densities, placental histology, and birth outcomes.

resultsThe prevalence of parasites with highly SP-resistant haplotypes increased from 17% to 100% (P < .001), and the proportion of women receiving full IPTp (≥2 doses) increased from 25% to 82% (P < .001). Women who received full IPTp with SP had lower peripheral (P = .018) and placental (P < .001) parasite densities than women who received suboptimal IPTp (<2 doses). This effect was not significantly modified by the presence of highly SP-resistant haplotypes. After adjustment for covariates, the receipt of SP in the presence of SP-resistant P. falciparum did not exacerbate any parasitologic, histologic, or clinical measures of PAM morbidity.

conclusionsIn this longitudinal study of malaria at delivery, the receipt of SP as IPTp did not potentiate PAM morbidity despite the increasing prevalence and fixation of SP-resistant P. falciparum haplotypes. Even when there is substantial resistance, SP may be used in modified IPTp regimens as a component of comprehensive antenatal care.

Indexed as

AdolescentAdultAntibiotic ProphylaxisAntimalarialsCross-Sectional StudiesDrug CombinationsDrug ResistanceFemaleHaplotypesHemoglobinsHumansMalaria, FalciparumParasitemiaPlasmodium falciparumPregnancyPregnancy Complications, ParasiticAntimalarialsDrug Combinationsfanasil, pyrimethamine drug combinationHemoglobinsPyrimethamineSulfadoxine

Identifiers

PMID22441649
PMCPMC3520448
OpenAlexW2172273208

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.