Evidence map›Paper›PMID 39418986›Full record

Trial reportEBioMedicine2024

Intermittent preventive treatment for malaria in pregnancy and infant growth: a mediation analysis of a randomised trial.

Yanwei Tong, Kalani Ratnasiri, Suhi Hanif, Anna T Nguyen, Michelle E Roh, Grant Dorsey, Abel Kakuru, Prasanna Jagannathan, Jade Benjamin-Chung

2 registry-linked trialsAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in EBioMedicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are 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
–field-weighted citation impact
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.

NCT02793622 phase3completednot on this map

Prevention of Malaria in HIV-uninfected Pregnant Women and Infants

TypeinterventionalSponsorUniversity of California, San FranciscoRan2016 to 2018Enrolled782ConditionsMalariaArmsMonthly Sulfadoxine-Pyrimethamine (SP) During Pregnancy, Monthly Dihydroartemisinin-Piperaquine (DP) During Pregnancy
NCT04978272 phase3active not recruitingnot on this map

Enhancing Immunity to Malaria in Young Children With Effective Chemoprevention

TypeinterventionalSponsorGrant Dorsey, M.D, Ph.D.Ran2022 to 2027Enrolled924ConditionsMalariaArmsDihydroartemisinin-piperaquine (DP), DP Placebo
3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Article
  4. Article
  5. Review
  6. Article
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  8. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Yanwei TongDepartment of Statistics, Stanford University, Stanford, United States.
Kalani RatnasiriDepartment of Epidemiology and Population Health, Stanford University, Stanford, United States; Department of Microbiology and Immunology, Stanford University, Stanford, United States.
Suhi HanifDepartment of Epidemiology and Population Health, Stanford University, Stanford, United States.
Anna T NguyenDepartment of Epidemiology and Population Health, Stanford University, Stanford, United States.
Michelle E RohInstitute for Global Health Sciences, University of California San Francisco, San Francisco, United States; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, United States.
Grant DorseyDepartment of Medicine, Division of HIV, ID, and Global Medicine, University of California San Francisco, San Francisco, United States.
Abel KakuruInfectious Diseases Research Collaboration, Kampala, Uganda.
Prasanna JagannathanDepartment of Medicine, Stanford University, Stanford, United States.
Jade Benjamin-ChungDepartment of Epidemiology and Population Health, Stanford University, Stanford, United States; Chan Zuckerberg Biohub, San Francisco, United States. Electronic address: jadebc@stanford.edu.

Funding

The immunologic consequences of prenatal exposure to malariaP01HD059454 · NICHD · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HAVLIR, DIANE V · 2008 to 2017
$22.6M
Enhancing immunity to malaria in young children with effective chemopreventionU01AI155325 · NIAID · STANFORD UNIVERSITY · PI JAGANNATHAN, PRASANNA · 2021 to 2025
$6.3M
Stanford BSSR Pre-Doctoral Training Program at the Intersection of Data Sciences with Behavioral, Social, and Population Health ResearchT32HL151323 · NHLBI · STANFORD UNIVERSITY · PI Michelle Christina Odden, David H Rehkopf · 2020 to 2026
$1.6M
Measuring spillover effects of reactive, focal malaria elimination interventionsK01AI141616 · NIAID · UNIVERSITY OF CALIFORNIA BERKELEY · PI BENJAMIN-CHUNG, JADE · 2019 to 2022
$601k
Examining the mechanisms and optimization of malaria chemoprevention strategies to improve birth outcomes in AfricaK99HD111572 · NICHD · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI ROH, MICHELLE · 2023 to 2024
$246k
Evaluating the causal effects of anti-malarial chemoprevention in pregnancy and childhood on growth outcomesF31AI179107 · NIAID · STANFORD UNIVERSITY · PI Anna Thuy Nhu Nguyen · 2024 to 2026
$142k
NHLBI NIH HHS T32 HL151323NIAID NIH HHS F31 AI179107NIAID NIH HHS K01 AI141616NIAID NIH HHS U01 AI155325NICHD NIH HHS K99 HD111572NICHD NIH HHS P01 HD059454
6 · The paper itself

Abstract

backgroundIntermittent preventive treatment for malaria in pregnancy (IPTp) can improve birth outcomes, but whether it confers benefits to postnatal growth is unclear. We investigated the effect of IPTp on infant growth in Uganda and its pathways of effects using causal mediation analyses.

methodsWe analysed data from 633 infants born to mothers enrolled in a randomised trial of monthly IPTp with dihydroartemisinin-piperaquine (DP) vs. sulfadoxine-pyrimethamine (SP) (NCT02793622). Weight and length were measured from 0 to 12 months of age. Using generalised linear models, we estimated effects of DP vs. SP on gravidity-stratified mean length-for-age (LAZ) and weight-for-length Z-scores (WLZ). We investigated mediation by placental malaria, gestational weight change, maternal anaemia, maternal inflammation-related proteins, preterm birth, birth length, and birth weight. Mediation models adjusted for infant sex, gravidity, gestational age at enrolment, maternal age, maternal parasitaemia at enrolment, education, and wealth.

findingsSP increased mean LAZ by 0.18-0.28 Z from birth through age 4 months compared to DP, while DP increased mean WLZ by 0.11-0.28 Z from 2 to 8 months compared to SP among infants of multigravidae; at these ages, confidence intervals for mean differences excluded 0. We did not observe differences among primigravida. Mediators of SP included birth weight, birth length, maternal stem cell factor, and DNER. Mediators of DP included placental malaria and birth length, maternal IL-18, CDCP1, and CD6 at delivery.

interpretationIn high malaria transmission settings, this exploratory study suggests different IPTp regimens may influence infant growth among multigravidae, potentially through distinct pathways, in the exclusive breastfeeding period, when few other interventions are available.

fundingStanford Center for Innovation in Global Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bill & Melinda Gates Foundation.

Indexed as

AntimalarialsMalariaPregnancy Complications, ParasiticAdultArtemisininsDrug CombinationsFemaleHumansInfantInfant, NewbornMalePiperazinesPregnancyPyrimethamineQuinolinesSulfadoxineAntimalarialsArtemisininsartenimolDrug Combinationsfanasil, pyrimethamine drug combinationpiperaquinePiperazinesPyrimethamineQuinolinesSulfadoxineChild growthIntermittent preventive treatmentMalariaMediation

Identifiers

PMID39418986
PMCPMC11530852

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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.