Intermittent sulphadoxine-pyrimethamine to prevent severe anaemia secondary to malaria in pregnancy: a randomised placebo-controlled trial.
Background: In areas of endemic transmission, malaria in pregnancy is associated with severe maternal anaemia and low-birthweight babies. We studied the efficacy of intermittent treatment doses of sulphadoxine-pyrimethamine in preventing malaria and severe anaemia in pregnancy in a double-blind plac...
| Published in: | Lancet Vol. 353; no. 9153; pp. 632 - 637 |
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| Main Authors: | , , , , , , |
| Format: | clinical trial research randomized controlled trial Journal Article |
| Published: |
Lancet
2/20/1999
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=1569082&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 1569082 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01406736 LAN jtl: Lancet issn: 01406736 maglogo: N pubinfo: dt: 2/20/1999 vid: 353 iid: 9153 pid: 1297 pub: Lancet place: Philadelphia, Pennsylvania artinfo: ui: 1569082 1569082 NLM10030329 1569082 10.1016/S0140-6736(98)07318-8 NLM10030329 1569082 ppf: 632 ppct: 5 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Intermittent sulphadoxine-pyrimethamine to prevent severe anaemia secondary to malaria in pregnancy: a randomised placebo-controlled trial. aug: au: Shulman, C.E. Dorman, E.K. Cutts, F. Kawuondo, K. Bulmer, J.N. Peshu, N. Marsh, K. sug: subj: Sulfadoxine Therapeutic Use Pregnancy Complications, Parasitic Prevention and Control Anemia Prevention and Control Pyrimethamine Therapeutic Use Antimalarials Therapeutic Use Malaria Prevention and Control Malaria Complications Placebos Sulfadoxine Administration and Dosage Parasitemia Prevention and Control Pregnancy Drug Combinations Double-Blind Studies Kenya Drug Administration Schedule Parity Public Health Human Insecticides Anemia Etiology Pyrimethamine Administration and Dosage Antimalarials Administration and Dosage Treatment Outcomes Bedding and Linens Hemoglobins Analysis Female Clinical Trials Validation Studies Comparative Studies Evaluation Research Multicenter Studies Randomized Controlled Trials Questionnaires Female ab: Background: In areas of endemic transmission, malaria in pregnancy is associated with severe maternal anaemia and low-birthweight babies. We studied the efficacy of intermittent treatment doses of sulphadoxine-pyrimethamine in preventing malaria and severe anaemia in pregnancy in a double-blind placebo-controlled trial among primigravid women living in Kilifi District, Kenya.Methods: Between January, 1996, and April, 1997, 1264 primigravid women were recruited when they attended for antenatal care, and randomly assigned sulphadoxine-pyrimethamine (640) or placebo (624). Women received one, two, or three doses of study medication depending on the duration of gestation at enrolment. Primary outcome measures were severe anaemia (haemoglobin <8 g/dL) and malaria parasitaemia, assessed at 34 weeks of gestation. Analyses were based on intention to treat among women who had study blood tests at 34 weeks.Findings: 30 (5.3%) of 567 women in the sulphadoxine-pyrimethamine group and 199 (35.3%) of 564 in the placebo group had peripheral parasitaemia (protective efficacy 85% [95% CI 78-90], p<0.0001). 82 (14.5%) and 134 (23.7%) had severe anaemia (protective efficacy 39% [22-52], p<0.0001). Even women who booked late and received only one dose of sulphadoxine-pyrimethamine benefited significantly from the intervention. The effects were seen both in women who owned insecticide-treated bednets and in women who did not.Interpretation: Intermittent presumptive treatment with sulphadoxine-pyrimethamine is an effective, practicable strategy to decrease the risk of severe anaemia in primigravidae living in malarious areas. pubtype: Academic Journal doctype: clinical trial research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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