Document Detail

Intermittent preventive treatment of malaria in pregnancy: at the crossroads of public health policy.
MedLine Citation:
PMID:  21477099     Owner:  NLM     Status:  Publisher    
The intermittent preventive treatment of malaria in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) has been a key component of the focused antenatal care package for nearly a decade, reducing the burden of low birthweight attributable to malaria in sub-Saharan Africa. However, SP has lost parasite sensitivity in many sub-Saharan locations during the same period, rendering its beneficial effect in IPTp debatable. Malaria transmission has also declined in some epidemiological settings. There is no evidence to suggest, however, that the risk of malaria in pregnancy without preventive measures has declined in the same locations. Thus, the urgency to identify efficacious drugs and/or new strategies to prevent malaria in pregnancy remains as great as ever. We summarise the results of recently published SP-IPTp studies from areas of high drug resistance and/or low malaria transmission. We also present the evidence for mefloquine and azithromycin-based combinations (ABCs), two leading drug options to replace SP in IPTp. We discuss optimal dosing for ABCs and their likely protection against several sexually transmitted and reproductive tract infections. We also summarise data from a diagnosis-based alternative to IPTp known as the intermittent screening and treatment (IST) for malaria. Clinical and operational research is urgently needed to compare birth outcomes achieved by IPTp with ABCs vs. IST using an efficacious antimalarial therapy.
R Matthew Chico; Daniel Chandramohan
Related Documents :
21477689 - Breaking the barrier: the health belief model and patient perceptions regarding contrac...
19916889 - Group b streptococcus colonization during pregnancy and maternal-fetal transmission in ...
22527899 - Cumulus cell-oocyte complexes retrieved from antral follicles in ivm cycles: relationsh...
19067079 - Volatile signals during pregnancy: a possible chemical basis for mother-infant recognit...
632359 - Effect of bacterial flora on staphylococcal colonisation of the newborn.
21153649 - Non-surgical management of ectopic pregnancy: appropriate risk management must be in pl...
17983919 - Pregnancy rates after conservative treatment for borderline ovarian tumours: a systemat...
25287569 - Is tissue an issue? current practice and opinion in western australia for routine histo...
12166639 - Vitrification of human blastocysts using the cryoloop method: successful clinical appli...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-7
Journal Detail:
Title:  Tropical medicine & international health : TM & IH     Volume:  -     ISSN:  1365-3156     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9610576     Medline TA:  Trop Med Int Health     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Eosinophilia as an early indicator of pancreatic allograft rejection.
Next Document:  Neurocognition in bulimic eating disorders: a systematic review.