Evidence map›Paper›PMID 25962439›Full record

Trial reportMalaria journal2015

In vivo efficacy of sulphadoxine-pyrimethamine for the treatment of asymptomatic parasitaemia in pregnant women in Machinga District, Malawi.

Julie Gutman, Dyson Mwandama, Ryan E Wiegand, Joseph Abdallah, Nnaemeka C Iriemenam, Ya Ping Shi, Don P Mathanga, Jacek Skarbinski

Registry-linked trialOpen access · goldAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Malaria journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01120145 (Assessment of the Efficacy and Effectiveness of Sulphadoxine-pyrimethamine for Intermittent Preventive Treatment of Malaria in Pregnancy in Malawi), which is not on this map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.6field-weighted citation impact, top 10% 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.

NCT01120145 completednot on this map

Assessment of the Efficacy and Effectiveness of Sulphadoxine-pyrimethamine for Intermittent Preventive Treatment of Malaria in Pregnancy in Malawi

TypeobservationalSponsorCenters for Disease Control and PreventionRan2010 to 2011Enrolled1,410ConditionsMalaria in Pregnancy
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 13 citations in OpenAlex.

  1. Prevalence of Mutations in theTropical medicine and infectious disease · 2022
    Article
  2. Observational
  3. Article
  4. Article
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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

8 authors at 3 institutions in 3 countries.

Julie GutmanMalaria Branch, Division of Parasitic Diseases & Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA. jgutman@cdc.gov.
Dyson MwandamaMalaria Alert Centre, University of Malawi College of Medicine, Blantyre, Malawi. dmwandama@mac.medcol.mw.
Ryan E WiegandMalaria Branch, Division of Parasitic Diseases & Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA. fwk2@cdc.gov.
Joseph AbdallahRwanda Zambia HIV Research Group, Emory University, Atlanta, GA, USA. joseph.farahat.abdallah@emory.edu.
Nnaemeka C IriemenamMalaria Branch, Division of Parasitic Diseases & Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA. iqd4@cdc.gov.
Ya Ping ShiMalaria Branch, Division of Parasitic Diseases & Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA. yps0@cdc.gov.
Don P MathangaMalaria Alert Centre, University of Malawi College of Medicine, Blantyre, Malawi. dmathang@mac.medcol.mw.
Jacek SkarbinskiMalaria Branch, Division of Parasitic Diseases & Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA. dvo5@cdc.gov.
Centers for Disease Control and Prevention · USUniversity of Malawi · MWEmory University · US

Funding

Strengthening National Capacity in Operations ResearchU01CI000189 · CI · UNIVERSITY OF MALAWI · PI BOWIE, CAMERON · 2004 to 2009
$2.0M
NCPDCID CDC HHS 5 U01 CI000189NCPDCID CDC HHS U01 CI000189
6 · The paper itself

Abstract

backgroundThe effectiveness of sulphadoxine-pyrimethamine (SP) intermittent preventive treatment of malaria in pregnancy (IPTp) might be compromised by high prevalence of resistance-associated Plasmodium falciparum dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) mutations. As a proxy for IPTp-SP effectiveness, the in vivo efficacy of SP to clear parasitaemia and prevent reinfection in asymptomatic parasitaemic pregnant women in an area with high SP resistance prevalence was assessed.

methodsPregnant women 16-26 weeks' gestation with asymptomatic parasitaemia presenting for antenatal care were given IPTp-SP and followed for 42 days. The primary outcome was polymerase chain reaction (PCR) uncorrected 42-day survival rate; the per cent of patients without recrudescence or reinfection by day 42. PCR was used to distinguish recrudescence from reinfection. DNA was sequenced to detect resistance-associated dhfr and dhps mutations.

resultsOf 245 pregnant women included in the intention-to-treat analysis, 93.9% cleared their parasitaemia by day 7. The day 42 PCR-uncorrected survival rate was 58.1% (95% confidence interval (CI) 51.5-65.7) and day 42 PCR-corrected survival was 68.7% (CI 61.4-76.0). Recrudescence was more common among primi- than among multigravid women; recrudescence rate 33.3% (CI 25.1-42.4%) versus 21.4% (CI 15.0-29.0%) (log rank test p-value 0.006). The quintuple mutant was present in nearly all samples (95%), while 2% were sextuple mutants with an additional mutation at dhps A581G.

conclusionsSP efficacy for acute malaria treatment has been compromised by resistance, but SP retains partial activity among pregnant women with asymptomatic parasitaemia, and thus might be useful for IPTp. Nonetheless, research on non-SP IPTp regimens should continue.

trial registrationClinicalTrials.gov NCT01120145 .

Indexed as

Drug ResistanceAdolescentAdultAntimalarialsAsymptomatic InfectionsDihydropteroate SynthaseDrug CombinationsFemaleHumansMalaria, FalciparumMalawiParasitemiaParityPlasmodium falciparumPolymerase Chain ReactionPregnancyAntimalarialsDihydropteroate SynthaseDrug Combinationsfanasil, pyrimethamine drug combinationProtozoan ProteinsPyrimethamineSulfadoxineTetrahydrofolate Dehydrogenase

Identifiers

PMID25962439
PMCPMC4435920
OpenAlexW2117596429

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.