ArticleMalaria journal2015
Lack of effect of intermittent preventive treatment for malaria in pregnancy and intense drug resistance in western Uganda.
Article in Malaria journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 3 of them syntheses that pooled it.
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Who cites it
50 citing papers in PubMed, 3 syntheses or guidelines pooled it, 91 citations in OpenAlex.
- Prevalence, predictors and adverse perinatal outcomes of placental malaria in sub-Saharan Africa: a systematic review and meta-analysis.Archives of public health = Archives belges de sante publique · 2025Pooled it
- Placental malaria: a systematic review and meta-analysis of global burden, risk factors, and maternal and foetal outcomes.Journal of global health · 2025Pooled it
- Mapping sulphadoxine-pyrimethamine-resistant Plasmodium falciparum malaria in infected humans and in parasite populations in Africa.Scientific reports · 2017Pooled it
- Efficacy of artemether-lumefantrine and dihydroartemisinin-piperaquine and prevalence of molecular markers of anti-malarial drug resistance in children in Togo in 2021.Malaria journal · 2024Trial
- First-in-human clinical trial to assess the safety, tolerability and pharmacokinetics of P218, a novel candidate for malaria chemoprotection.British journal of clinical pharmacology · 2020Trial
- The prevalence and antifolate drug resistance profiles of Plasmodium falciparum in study participants randomized to discontinue or continue cotrimoxazole prophylaxis.PLoS neglected tropical diseases · 2019Trial
- Evaluation of Malaria Screening during Pregnancy with Rapid Diagnostic Tests Performed by Community Health Workers in Burkina Faso.The American journal of tropical medicine and hygiene · 2017Trial
- Pharmacokinetics of Sulfadoxine and Pyrimethamine for Intermittent Preventive Treatment of Malaria During Pregnancy and After Delivery.CPT: pharmacometrics & systems pharmacology · 2017Trial
- Multiple local PfDHFR I164L haplotype expansions drive Plasmodium falciparum antifolate resistance in Uganda.Nature communications · 2026Article
- Prevalence of placental Plasmodium falciparum malaria and associated factors among pregnant women in health facilities in Eastern Uganda.Malaria journal · 2026Article
- Molecular surveillance of Plasmodium falciparum resistance to sulfadoxine-pyrimethamine among pregnant women attending antenatal clinics in Bobo-Dioulasso, Burkina Faso.Parasite (Paris, France) · 2026Article
- Geographical Heterogeneity in Antimalarial Resistance Markers Revealed by Genomic Surveillance in Angola, 2023.medRxiv : the preprint server for health sciences · 2025Article
- Video-based education messaging to enhance optimal uptake of malaria preventive therapy in pregnant women: a mixed methods study involving pregnant women and midwives in Uganda.Malaria journal · 2024Article
- Prevalence and factors associated with placental malaria in Lira District, Northern Uganda: a cross-sectional study.Malaria journal · 2024Article
- Adherence to sulfadoxine-pyrimethamine five-dose policy among pregnant women in an urban slum in Ghana: a mixed-methods study.Malaria journal · 2024Article
- Expansion of artemisinin partial resistance mutations and lack of histidine rich protein-2 and -3 deletions in Plasmodium falciparum infections from Rukara, Rwanda.Malaria journal · 2024Article
- Attitudes and perceptions towards developing a health educational video to enhance optimal uptake of malaria preventive therapy among pregnant women in Uganda: a qualitative study involving pregnant women, health workers, and Ministry of health officials.BMC health services research · 2024Article
- Therapeutic efficacy of artesunate-amodiaquine and artemether-lumefantrine for the treatment of uncomplicated falciparum malaria in Chad: clinical and genetic surveillance.Malaria journal · 2023Article
- Targeted and whole-genome sequencing reveal a north-south divide in P. falciparum drug resistance markers and genetic structure in Mozambique.Communications biology · 2023Article
- Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIntermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is widely implemented in sub-Saharan Africa for the prevention of malaria in pregnancy and adverse birth outcomes. However, in areas of intense SP resistance, the efficacy of IPTp may be compromised.
methodsA cross-sectional study among 915 delivering women (728 analysable live singleton deliveries) was conducted in Fort Portal, western Uganda, to assess associations of reported IPTp use, Plasmodium falciparum infection, maternal anaemia, low birth weight, and preterm delivery, and to estimate the degree of SP resistance as reflected by pfdhfr/pfdhps mutations.
resultsPlasmodium falciparum infection was detected by PCR in 8.9 % and by microscopy of placental blood samples in 4.0 %. Infection was significantly associated with stillbirth, early neonatal death, anaemia, low birth weight, and pre-term delivery. Eighty percent of the women had taken at least one dose of IPTp, and more than half had taken two doses. As compared to women without chemoprophylaxis against malaria, IPTp had no significant influence on the presence of P. falciparum infection (13.8 vs. 9.6 %, P = 0.31). Nor was it associated with reductions in anaemia, low birth weight or preterm delivery. P. falciparum with intense SP resistance (pfdhfr/pfdhps quintuple or sextuple mutations) were observed in 93 % (pfdhps 581G, 36 %), and the additional high resistance allele pfhdr 164L in 36 %.
conclusionsIn Fort Portal, Uganda, reported use of IPTp with SP does not provide an observable benefit. The molecular markers of P. falciparum indicate high grade SP resistance reaching the threshold set by WHO for the discontinuation of IPTp with SP. Alternative approaches for the prevention of malaria in pregnancy are urgently needed.
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