Evidence map›Paper›PMID 27756308›Full record

Trial reportMalaria journal2016

Malaria burden in a birth cohort of HIV-exposed uninfected Ugandan infants living in a high malaria transmission setting.

Abel Kakuru, Paul Natureeba, Mary K Muhindo, Tamara D Clark, Diane V Havlir, Deborah Cohan, Grant Dorsey, Moses R Kamya, Theodore Ruel

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

Trial report in Malaria journal, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00993031 (Protease Inhibitors to Reduce Malaria Morbidity in HIV-Infected Pregnant Women), which is not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact, top 85% 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.

NCT00993031 phase3completednot on this map

Protease Inhibitors to Reduce Malaria Morbidity in HIV-Infected Pregnant Women

TypeinterventionalSponsorUniversity of California, San FranciscoRan2009 to 2013Enrolled389ConditionsMalaria, HIV InfectionsArmsLopinavir/ritonavir, Efavirenz, Zidovudine, Lamivudine
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Article
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

9 authors at 3 institutions in 2 countries.

Abel KakuruInfectious Diseases Research Collaboration, Kampala, Uganda. abelkakuru@gmail.com.
Paul NatureebaInfectious Diseases Research Collaboration, Kampala, Uganda.
Mary K MuhindoInfectious Diseases Research Collaboration, Kampala, Uganda.
Tamara D ClarkDepartment of Medicine, University of California, San Francisco, USA.
Diane V HavlirDepartment of Medicine, University of California, San Francisco, USA.
Deborah CohanDepartment of Obstetrics and Gynecology, University of California, San Francisco, USA.
Grant DorseyDepartment of Medicine, University of California, San Francisco, USA.
Moses R KamyaDepartment of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
Theodore RuelDepartment of Pediatrics, University of California, San Francisco, USA.
University of California, San Francisco · USInfectious Diseases Research Collaboration · UGMakerere University · UG

Funding

San Francisco Vaccine and Prevention UnitUM1AI069496 · NIAID · PUBLIC HEALTH FOUNDATION ENTERPRISES · PI Susan Buchbinder, Diane V Havlir · 2012 to 2026
$30.5M
The immunologic consequences of prenatal exposure to malariaP01HD059454 · NICHD · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HAVLIR, DIANE V · 2008 to 2017
$22.6M
NIAID NIH HHS UM1 AI069496NICHD NIH HHS P01 HD059454
6 · The paper itself

Abstract

backgroundHIV-exposed, uninfected (HEU) infants suffer high morbidity and mortality in the first year of life compared to HIV-unexposed, uninfected (HUU) infants, but accurate data on the contribution of malaria are limited.

methodsThe incidence of febrile illnesses and malaria were evaluated in a birth cohort of HEU infants. Infants were prescribed daily trimethoprim-sulfamethoxazole (TS) prophylaxis from 6 weeks of age until exclusion of HIV-infection after cessation of breastfeeding. Infants were followed for all illnesses using passive surveillance and routine blood smears were done monthly. Malaria was diagnosed as a positive blood smear plus fever. Placental malaria was determined by histopathology, placental blood smear and PCR. Risk factors for time to first episode of malaria were assessed using a Cox proportional hazards model. Malaria incidence among HEU infants aged 6-12 months was compared to that in other cohorts of HEU and HUU infants from the same region.

resultsAmong 361 HEU infants enrolled, 248 completed 12 months of follow-up resulting in 1562 episodes of febrile illness and 253 episodes of malaria after 305 person-years of follow-up. The incidence of febrile illness was 5.12 episodes per person-year (PPY), ranging from 4.13 episodes PPY in the first 4 months of life to 5.71 episodes PPY between 5 and 12 months of age. The overall malaria incidence was 0.83 episodes per person-year (PPY), increasing from 0.03 episodes PPY in the first 2 months of life to 2.00 episodes PPY between 11 and 12 months of age. There were no episodes of complicated malaria. The prevalence of asymptomatic parasitaemia was 1.2 % (19 of 1568 routine smears positive). Infants born to mothers with parasites detected from placental blood smears were at higher risk of malaria (hazard ratio = 4.51, P < 0.001). HEU infants in this study had a 2.4- to 3.5-fold lower incidence of malaria compared to HUU infants in other cohort studies from the same area.

conclusionThe burden of malaria in this birth cohort of HEU infants living in a high-transmission setting and taking daily TS prophylaxis was relatively low. Alternative etiologies of fever should be considered in HEU-infants taking daily TS prophylaxis who present with fever. Trial Registration NCT00993031, registered 8 October, 2009.

Indexed as

Maternal ExposureAntimalarialsChemopreventionCohort StudiesFemaleHumansIncidenceInfantInfant, NewbornMalariaMaleRisk FactorsTrimethoprim, Sulfamethoxazole Drug CombinationUgandaAntimalarialsTrimethoprim, Sulfamethoxazole Drug CombinationHIV-exposed uninfected infantsMalariaPlacental malaria

Identifiers

PMID27756308
PMCPMC5070200
OpenAlexW2534708778

What OpenQuestion holds

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LicenceCC BY
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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.