دورية أكاديمية
Overall, anti-malarial, and non-malarial effect of intermittent preventive treatment during pregnancy with sulfadoxine-pyrimethamine on birthweight: a mediation analysis.
| العنوان: | Overall, anti-malarial, and non-malarial effect of intermittent preventive treatment during pregnancy with sulfadoxine-pyrimethamine on birthweight: a mediation analysis. |
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| المؤلفون: | Roh ME; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA; Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, CA, USA. Electronic address: michelle.roh@ucsf.edu., Kuile FOT; Liverpool School of Tropical Medicine, Liverpool, UK., Rerolle F; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA; Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, CA, USA., Glymour MM; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA., Shiboski S; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA., Gosling R; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA; Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, CA, USA., Gutman J; Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA., Kakuru A; Infectious Diseases Research Collaboration, Kampala, Uganda., Desai M; Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA., Kajubi R; Infectious Diseases Research Collaboration, Kampala, Uganda., L'Ianziva A; Centers for Disease Control and Prevention, Kisumu, Kenya., Kamya MR; School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda., Dorsey G; Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, CA, USA., Chico RM; Department of Disease Control, Faculty of Infectious and Tropical Disease, London School of Hygiene & Tropical Medicine, London, UK. |
| المصدر: | The Lancet. Global health [Lancet Glob Health] 2020 Jul; Vol. 8 (7), pp. e942-e953. |
| نوع المنشور: | Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Ltd Country of Publication: England NLM ID: 101613665 Publication Model: Print Cited Medium: Internet ISSN: 2214-109X (Electronic) Linking ISSN: 2214109X NLM ISO Abbreviation: Lancet Glob Health Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [England] : Elsevier Ltd. 2013- |
| مواضيع طبية MeSH: | Birth Weight*, Antimalarials/*therapeutic use , Malaria/*prevention & control , Pregnancy Complications, Parasitic/*prevention & control , Pyrimethamine/*therapeutic use , Sulfadoxine/*therapeutic use, Adult ; Drug Combinations ; Female ; Humans ; Infant, Newborn ; Kenya ; Pregnancy ; Uganda ; Young Adult |
| مستخلص: | Background: Trials of intermittent preventive treatment (IPTp) of malaria in pregnant women that compared dihydroartemisinin-piperaquine with the standard of care, sulfadoxine-pyrimethamine, showed dihydroartemisinin-piperaquine was superior at preventing malaria infection, but not at improving birthweight. We aimed to assess whether sulfadoxine-pyrimethamine shows greater non-malarial benefits for birth outcomes than does dihydroartemisinin-piperaquine, and whether dihydroartemisinin-piperaquine shows greater antimalarial benefits for birth outcomes than does sulfadoxine-pyrimethamine. Methods: We defined treatment as random assignment to sulfadoxine-pyrimethamine or dihydroartemisinin-piperaquine before pooling individual participant-level data from 1617 HIV-uninfected pregnant women in Kenya (one trial; n=806) and Uganda (two trials; n=811). We quantified the relative effect of treatment on birthweight (primary outcome) attributed to preventing placental malaria infection (mediator). We estimated antimalarial (indirect) and non-malarial (direct) effects of IPTp on birth outcomes using causal mediation analyses, accounting for confounders. We used two-stage individual participant data meta-analyses to calculate pooled-effect sizes. Findings: Overall, birthweight was higher among neonates of women randomly assigned to sulfadoxine-pyrimethamine compared with women assigned to dihydroartemisinin-piperaquine (mean difference 69 g, 95% CI 26 to 112), despite placental malaria infection being lower in the dihydroartemisinin-piperaquine group (relative risk [RR] 0·64, 95% CI 0·39 to 1·04). Mediation analyses showed sulfadoxine-pyrimethamine conferred a greater non-malarial effect than did dihydroartemisinin-piperaquine (mean difference 87 g, 95% CI 43 to 131), whereas dihydroartemisinin-piperaquine conferred a slightly larger antimalarial effect than did sulfadoxine-pyrimethamine (8 g, -9 to 26), although more frequent dosing increased the antimalarial effect (31 g, 3 to 60). Interpretation: IPTp with sulfadoxine-pyrimethamine appears to have potent non-malarial effects on birthweight. Further research is needed to evaluate monthly dihydroartemisinin-piperaquine with sulfadoxine-pyrimethamine (or another compound with non-malarial effects) to achieve greater protection against malarial and non-malarial causes of low birthweight. Funding: Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bill & Melinda Gates Foundation, and Worldwide Antimalarial Resistance Network. (Copyright © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.) |
| التعليقات: | Comment in: Lancet Glob Health. 2020 Jul;8(7):e871-e872. (PMID: 32562642) |
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| معلومات مُعتمدة: | F31 HD096861 United States HD NICHD NIH HHS; MC_PC_MR/P006914/1 United Kingdom MRC_ Medical Research Council; P01 HD059454 United States HD NICHD NIH HHS |
| المشرفين على المادة: | 0 (Antimalarials) 0 (Drug Combinations) 37338-39-9 (fanasil, pyrimethamine drug combination) 88463U4SM5 (Sulfadoxine) Z3614QOX8W (Pyrimethamine) |
| تواريخ الأحداث: | Date Created: 20200621 Date Completed: 20200831 Latest Revision: 20221214 |
| رمز التحديث: | 20221214 |
| مُعرف محوري في PubMed: | PMC7303957 |
| DOI: | 10.1016/S2214-109X(20)30119-4 |
| PMID: | 32562650 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 2214-109X |
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| DOI: | 10.1016/S2214-109X(20)30119-4 |