1. Additional Screening and Treatment of Malaria during Pregnancy Provides Further Protection Against Malaria and Nonmalarial Fevers during the First Year of Life
- Author
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Hermann Sorgho, Serge Henri Zango, Ousséni Sawadogo, Susana Scott, Luc Kestens, Petra F. Mens, Henk D. F. H. Schallig, M. Athanase Somé, Halidou Tinto, Innocent Valea, Sibiri Claude Zongo, Hamtandi Magloire Natama, Maminata Traoré-Coulibaly, Eduard Rovira-Vallbona, Anna Rosanas-Urgell, AII - Infectious diseases, Infectious diseases, and Medical Microbiology and Infection Prevention
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,030231 tropical medicine ,Plasmodium falciparum ,Psychological intervention ,Asymptomatic ,Cohort Studies ,03 medical and health sciences ,Antimalarials ,0302 clinical medicine ,Pregnancy ,Burkina Faso ,Sulfadoxine ,parasitic diseases ,Immunology and Allergy ,Medicine ,Humans ,Mass Screening ,030212 general & internal medicine ,Malaria, Falciparum ,Biology ,biology ,business.industry ,Incidence (epidemiology) ,Incidence ,Hazard ratio ,Infant ,medicine.disease ,biology.organism_classification ,3. Good health ,Clinical trial ,Drug Combinations ,Infectious Diseases ,Pyrimethamine ,Pregnancy Complications, Parasitic ,Female ,Human medicine ,medicine.symptom ,business ,Malaria - Abstract
Background. Although consensus exists that malaria in pregnancy (MiP) increases the risk of malaria in infancy, and eventually nonmalarial fevers (NMFs), there is a lack of conclusive evidence of benefits of MiP preventive strategies in infants. Methods. In Burkina Faso, a birth cohort study was nested to a clinical trial assessing the effectiveness of a community-based scheduled screening and treatment of malaria in combination with intermittent preventive treatment with sulfadoxine-pyrimethamine (CSST/IPTp-SP) to prevent placental malaria. Clinical episodes and asymptomatic infections were monitored over 1 year of follow-up to compare the effect of CSST/IPTp-SP and standard IPTp-SP on malaria and NMFs. Results. Infants born during low-transmission season from mothers receiving CSST/IPTp-SP had a 26% decreased risk of experiencing a first clinical episode (hazard ratio, 0.74 [95% confidence interval, 0.55-0.99]; P = .047). CSST/IPTp-SP interacted with birth season and gravidity to reduce the incidence of NMFs. No significant effects of CSST/IPTp-SP on the incidence of clinical episodes, parasite density, and Plasmodium falciparum infections were observed. Conclusions. Our findings indicate that CSST/IPTp-SP strategy may provide additional protection against both malaria and NMFs in infants during the first year of life, and suggest that malaria control interventions during pregnancy could have long-term benefits in infants.
- Published
- 2018