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Low prevalence of highly sulfadoxine‐resistant dihydropteroate synthase alleles in Plasmodium falciparum isolates in Benin

February 8, 2021 - 10:52 -- Open Access
Samaly Souza Svigel, Adicath Adeothy, Naomi W. Lucchi, et al.
Malaria Journal 2021 20:72, 5 February 2021

In 2004, in response to high levels of treatment failure associated with sulfadoxine-pyrimethamine (SP) resistance, Benin changed its first-line malaria treatment from SP to artemisinin-based combination therapy for treatment of uncomplicated Plasmodium falciparum malaria. Resistance to SP is conferred by accumulation of single nucleotide polymorphisms (SNPs) in P. falciparum genes involved in folate metabolism, dihydrofolate reductase (Pfdhfr) and dihydropteroate synthase (Pfdhps), targeted by pyrimethamine and sulfadoxine, respectively. Because SP is still used for intermittent preventive treatment in pregnant women (IPTp) and seasonal malaria chemoprevention (SMCP) in Benin, the prevalence of Pfdhfr and Pfdhps SNPs in P. falciparum isolates collected in 2017 were investigated.

Drug treatment and prevention of malaria in pregnancy: a critical review of the guidelines

January 27, 2021 - 15:49 -- Open Access
Khalid A. J. Al Khaja and Reginald P. Sequeira
Malaria Journal 2021 20:62, 23 January 2021

Malaria caused by Plasmodium falciparum in pregnancy can result in adverse maternal and fetal sequelae. This review evaluated the adherence of the national guidelines drawn from World Health Organization (WHO) regions, Africa, Eastern Mediterranean, Southeast Asia, and Western Pacific, to the WHO recommendations on drug treatment and prevention of chloroquine-resistant falciparum malaria in pregnant women.

Sulfadoxine-pyrimethamine parasitological efficacy against Plasmodium falciparum among pregnant women and molecular markers of resistance in Zambia: an observational cohort study

January 27, 2021 - 15:46 -- Open Access
Enesia Banda Chaponda, Sungano Mharakurwa, Charles Michelo, Jane Bruce, Daniel Chandramoha and R. Matthew Chico
Malaria Journal 2021 20:61, 22 January 2021

The World Health Organization recommends the provision of intermittent preventive treatment during pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) at 4-week intervals from gestational week 13 to delivery in areas of moderate to high malaria transmission intensity. However, the effect of IPTp-SP has been compromised in some areas due to parasite resistance, raising the importance of parasitological and chemoprophylactic surveillance, and monitoring SP-resistance markers in the Plasmodium falciparum population.

Polymorphisms in Plasmodium falciparum dihydropteroate synthetase and dihydrofolate reductase genes in Nigerian children with uncomplicated malaria using high-resolution melting technique

January 16, 2021 - 09:38 -- Open Access
Kayode AT, Ajogbasile FV, Akano K, Uwanibe JN, Oluniyi PE, Eromon PJ, Folarin OA, Sowunmi A, Wirth DF, Happi CT
Sci Rep. 2021 Jan 12;11(1):471

In 2005, the Nigerian Federal Ministry of Health revised the treatment policy for uncomplicated malaria with the introduction of artemisinin-based combination therapies (ACTs). This policy change discouraged the use of Sulphadoxine-pyrimethamine (SP) as the second-line treatment of uncomplicated falciparum malaria. However, SP is used as an intermittent preventive treatment of malaria in pregnancy (IPTp) and seasonal malaria chemoprevention (SMC) in children aged 3-59 months. There have been increasing reports of SP resistance especially in the non-pregnant population in Nigeria, thus, the need to continually monitor the efficacy of SP as IPTp and SMC by estimating polymorphisms in dihydropteroate synthetase (dhps) and dihydrofolate reductase (dhfr) genes associated with SP resistance.

Determinants of uptake of malaria preventive interventions among pregnant women in eastern Uganda

January 6, 2021 - 11:43 -- Open Access
Solomon Tsebeni Wafula, Hilbert Mendoza, Aisha Nalugya, David Musoke and Peter Waiswa
Malaria Journal 2021 20:5, 3 January 2021

Consistent use of insecticide-treated nets (ITNs) and intermittent preventive treatment in pregnancy (IPTp) have been recommended as cost-effective interventions for malaria prevention during pregnancy in endemic areas. However, the coverage and utilization of these interventions during pregnancy in sub-Saharan Africa is still suboptimal. This study aimed to determine the uptake of IPTp and ITNs and associated factors among women during their recent pregnancy in Eastern Uganda.

Piperaquine pharmacokinetics during intermittent preventive treatment for malaria in pregnancy

December 29, 2020 - 15:37 -- Open Access
Chotsiri P, Gutman J, Tarning J, et al.
Antimicrob Agents Chemother. 2020 Dec 23:AAC.01150-20

Dihydroartemisinin-piperaquine (DP) is a long-acting artemisinin combination treatment that provides effective chemoprevention and has been proposed as an alternative antimalarial drug for intermittent-preventive therapy in pregnancy (IPTp). Several pharmacokinetic studies have shown that dose adjustment may not be needed for the treatment of malaria in pregnancy with DP. However, there are limited data on the optimal dosing for IPTp.

Infant sex modifies associations between placental malaria and risk of malaria in infancy

December 3, 2020 - 13:06 -- Open Access
Abel Kakuru, Michelle E. Roh, Prasanna Jagannathan, et al.
Malaria Journal 2020 19:449, 3 December 2020

Placental malaria (PM) has been associated with a higher risk of malaria during infancy. However, it is unclear whether this association is causal, and is modified by infant sex, and whether intermittent preventive treatment in pregnancy (IPTp) can reduce infant malaria by preventing PM.

Not Open Access | Effects of Malaria Interventions During Pregnancy on Low Birth Weight in Malawi

December 2, 2020 - 08:48 -- NOT Open Access
Nkoka O, Chuang TW, Chen YH
Am J Prev Med. 2020 Dec;59(6):904-913

In malaria-endemic countries, malaria during pregnancy is associated with adverse birth outcomes, including low birth weight (i.e., <2.5 kg). However, the effects of the widely promoted and recommended approaches of intermittent preventive treatment for malaria in pregnancy and insecticide-treated nets for pregnant women on low birth weight have been insufficiently examined. This analysis investigates the independent and combined effects of intermittent preventive treatment for malaria in pregnancy and insecticide-treated nets on low birth weight among Malawian children.

Estimating malaria chemoprevention and vector control coverage using program and campaign data: A scoping review of current practices and opportunities

December 2, 2020 - 08:41 -- Open Access
Nice J, Nahusenay H, Eckert E, Eisele TP, Ashton RA
J Glob Health. 2020 Dec;10(2):020413

Accurate estimation of intervention coverage is a vital component of malaria program monitoring and evaluation, both for process evaluation (how well program targets are achieved), and impact evaluation (whether intervention coverage had an impact on malaria burden). There is growing interest in maximizing the utility of program data to generate interim estimates of intervention coverage in the periods between large-scale cross-sectional surveys (the gold standard). As such, this study aimed to identify relevant concepts and themes that may guide future optimization of intervention coverage estimation using routinely collected data, or data collected during and following intervention campaigns, with a particular focus on strategies to define the denominator.

Reaching the unreached: effectiveness and satisfaction with community-directed distribution of sulfadoxine-pyrimethamine for preventing malaria in pregnancy in rural South-East, Nigeria

November 10, 2020 - 13:58 -- Open Access
Ijeoma Nkem Okedo-Alex, Ifeyinwa Chizoba Akamike, Chigozie Jesse Uneke, et al.
Malaria Journal 2020 19:394, 7 November 2020

Innovative community strategies to increase intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) coverage is advocated particularly in rural areas, where health infrastructure is weakest and malaria transmission highest. This study involved proof-of-concept implementation research to determine satisfaction with and effectiveness of community-directed distribution of IPTp-SP on uptake among pregnant women in Ebonyi State, Nigeria.


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