ArticleEClinicalMedicine2025
Dihydroartemisinin-piperaquine versus sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria in pregnancy: a systematic review and individual participant data meta-analysis.
Article in EClinicalMedicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Efficacy of dihydroartemisinin-piperaquine to prevent malaria and complication-related malaria during pregnancy compared to sulfadoxine-pyrimethamine: a systematic review, meta-analysis, and meta-regression.Epidemiology and infection · 2026Pooled it
- The impact of sulfadoxine-pyrimethamine resistance on the effectiveness of intermittent preventive treatment for the prevention of malaria in pregnancy in Africa: an updated systematic review and meta-analysis.The Lancet. Infectious diseases · 2025Pooled it
- Impact of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine on sexually transmitted and reproductive tract infections: results from a randomized trial in Uganda.International journal of epidemiology · 2026Trial
- Trial
- Clinical malaria recurrence and associated factors in infancy following IPTp-DP versus IPTp-SP in Busia, Uganda; a secondary analysis using the Conditional Frailty model.Malaria journal · 2026Article
- Beyond malaria prevention: sulfadoxine-pyrimethamine treatment in pregnancy selectively remodels the maternal gut microbiome to increase gestational weight gain and improve birthweight.medRxiv : the preprint server for health sciences · 2026Article
- Effect mechanisms of different malaria chemoprevention regimens in pregnancy on infant growth outcomes: causal mediation analysis of a randomized controlled trial.medRxiv : the preprint server for health sciences · 2026Article
- Impact of intermittent preventive treatment for malaria in pregnancy with sulfadoxine-pyrimethamine, dihydroartemisinin-piperaquine, and their combination on infant outcomes: A randomized controlled trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Beyond malaria: can intermittent preventive treatment with sulphadoxine-pyrimethamine reduce the number of small vulnerable newborns globally?The Lancet. Global health · 2026Review
- Association between adequacy of antenatal care and uptake of intermittent preventive treatment of malaria in pregnancy among women in Ghana.Malaria journal · 2025Article
- RecurrentmedRxiv : the preprint server for health sciences · 2025Article
- A need for new tools for prevention of malaria in pregnancy.PLoS medicine · 2025Article
- Article
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26 authors.
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Abstract
Background: High-grade Methods: We conducted two-stage, individual participant data meta-analyses of randomised trials comparing IPTp with dihydroartemisinin-piperaquine to sulfadoxine-pyrimethamine on maternal, birth, and infant outcomes. We searched the WHO International Clinical Trials Registry Platform, ClinicalTrials.Gov, PubMed, and the Malaria in Pregnancy Consortium Library, on July 30, 2020 (updated on September 24, 2024), without restrictions by publication date, peer-review status, or language. Eligible trials enrolled HIV-uninfected pregnant women, followed participants to delivery, included participants with no prior IPTp use during the current pregnancy, and were conducted in areas with high-level parasite resistance to sulfadoxine-pyrimethamine (i.e., PfDHPS 540E ≥ 90% and/or 581G>0%). Only singleton pregnancies were analysed. The primary endpoint was a composite measure of any adverse pregnancy outcome defined as fetal or neonatal loss, small-for-gestational age, low birthweight, or preterm birth. Summary estimates were generated using a random-effects model. Gravidity subgroup analyses were performed. Causal mediation analyses were used to investigate the maternal mechanisms underlying the effect of IPTp regimens on birth outcomes. The meta-analysis is registered in PROSPERO (CRD42020196127). Findings: Of 85 screened records, six trials (one multi-country trial) from Kenya, Malawi, Uganda and Tanzania contributed data on 6646 pregnancies. Compared to sulfadoxine-pyrimethamine, dihydroarteminsinin-piperaquine was associated with a 69% [95% CI: 45%-82%] lower incidence of clinical malaria during pregnancy, a 62% [37%-77%] lower risk of placental parasitaemia, and a 17% [0%-31%] lower incidence of moderate maternal anaemia. In contrast, sulfadoxine-pyrimethamine was associated with higher mean maternal weight gain (34 g/week [17-51]). There were no statistically significant differences in the composite adverse pregnancy outcome (RR = 1.05 [0.92-1.19]; Interpretation: In areas with high Funding: This work was supported by the Bill and Melinda Gates Foundation and Eunice Kennedy Shriver National Institute of Child Health and Human Development.
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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.