OBJECTIVE: To assess the effect of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) on birth weight in sites with varying degrees of drug resistance. METHODS: Birth weight data from three regions in Democratic Republic of Congo with varying degrees of sulfadoxine-pyrimethamine (SP) resistance (1.6% in Mikalayi, 21.7% in Kisangani and 60.6% in Rutshuru) were analysed retrospectively by means of a logistic model that included the number of SP doses taken by the mother and other potentials confounding factors. RESULTS: The IPTp-SP reduced the risk of low birth weight (LBW) in Kisangani (adjusted OR, 0.15; IC95%, 0.05-0.46) and in Mikalayi (adjusted OR, 0.12; IC95%, 0.01-0.89). In both sites, the average birth weight was higher for mothers having received two rather than one or no SP doses (P < 0.001). In Rutshuru, IPTp-SP had an effect in primigravidae but not in multigravidae. However, after adjustment for other LBW risk factors, there was no difference in the proportion of LBW (adjusted OR 0.92; IC95%, 0.37-2.25) between women having taken at least 2 SP doses and those with only one dose or none. CONCLUSION: IPT-SP remains an effective strategy in Kisangani and Mikalayi where the therapeutic failure to SP in children with clinical malaria was 21.7% and 1.6%, respectively, while IPTp-SP effect seems lower in Rutshuru where the therapeutic failure to SP was 60.6%. The threshold value of SP resistance at which IPTp-SP fails to have a significant impact on birth weight and LBW is unknown. Considering that no alternative is currently available, additional studies on the efficacy of IPTp-SP in the areas of high SP resistance such as Rutshuru are needed so that the threshold at which this intervention fails to provide any benefit is determined with some precision.
OBJECTIVE: To assess the effect of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) on birth weight in sites with varying degrees of drug resistance. METHODS: Birth weight data from three regions in Democratic Republic of Congo with varying degrees of sulfadoxine-pyrimethamine (SP) resistance (1.6% in Mikalayi, 21.7% in Kisangani and 60.6% in Rutshuru) were analysed retrospectively by means of a logistic model that included the number of SP doses taken by the mother and other potentials confounding factors. RESULTS: The IPTp-SP reduced the risk of low birth weight (LBW) in Kisangani (adjusted OR, 0.15; IC95%, 0.05-0.46) and in Mikalayi (adjusted OR, 0.12; IC95%, 0.01-0.89). In both sites, the average birth weight was higher for mothers having received two rather than one or no SP doses (P < 0.001). In Rutshuru, IPTp-SP had an effect in primigravidae but not in multigravidae. However, after adjustment for other LBW risk factors, there was no difference in the proportion of LBW (adjusted OR 0.92; IC95%, 0.37-2.25) between women having taken at least 2 SP doses and those with only one dose or none. CONCLUSION:IPT-SP remains an effective strategy in Kisangani and Mikalayi where the therapeutic failure to SP in children with clinical malaria was 21.7% and 1.6%, respectively, while IPTp-SP effect seems lower in Rutshuru where the therapeutic failure to SP was 60.6%. The threshold value of SP resistance at which IPTp-SP fails to have a significant impact on birth weight and LBW is unknown. Considering that no alternative is currently available, additional studies on the efficacy of IPTp-SP in the areas of high SP resistance such as Rutshuru are needed so that the threshold at which this intervention fails to provide any benefit is determined with some precision.
Authors: John E Williams; Matthew Cairns; Fanta Njie; Stephen Laryea Quaye; Timothy Awine; Abraham Oduro; Harry Tagbor; Kalifa Bojang; Pascal Magnussen; Feiko O Ter Kuile; Arouna Woukeu; Paul Milligan; Daniel Chandramohan; Brian Greenwood Journal: Clin Infect Dis Date: 2015-12-31 Impact factor: 9.079
Authors: Harry Tagbor; Matthew Cairns; Kalifa Bojang; Sheick Oumar Coulibaly; Kassoum Kayentao; John Williams; Ismaela Abubakar; Francis Akor; Khalifa Mohammed; Richard Bationo; Edgar Dabira; Alamissa Soulama; Moussa Djimdé; Etienne Guirou; Timothy Awine; Stephen Quaye; Fanta Njie; Jaume Ordi; Ogobara Doumbo; Abraham Hodgson; Abraham Oduro; Steven Meshnick; Steve Taylor; Pascal Magnussen; Feiko ter Kuile; Arouna Woukeu; Paul Milligan; Daniel Chandramohan; Brian Greenwood Journal: PLoS One Date: 2015-08-10 Impact factor: 3.240
Authors: Junior R Matangila; Patrick Mitashi; Raquel A Inocêncio da Luz; Pascal T Lutumba; Jean-Pierre Van Geertruyden Journal: Malar J Date: 2015-11-14 Impact factor: 2.979
Authors: Junior R Matangila; Jean Lufuluabo; Axel L Ibalanky; Raquel A Inocêncio da Luz; Pascal Lutumba; Jean-Pierre Van Geertruyden Journal: Malar J Date: 2014-04-02 Impact factor: 2.979