Evaluation of the usefulness of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine in a context with increased resistance of Plasmodium falciparum in Kingasani Hospital, Kinshasa in the Democratic Republic of Congo

Kayiba, Nadine Kalenda; Yobi, Doudou Malekita; Tchakounang, Vanessa Rodanis Kouoneyou; Mvumbi, Dieudonné Makaba; Kabututu, Pius Zakayi; Devleesschauwer, Brecht; Mukomena, Erick Sompwe; DeMol, Patrick; Hayette, Marie‐Pierre; Mvumbi, Georges Lelo; Rosas-Aguirre, Ángel; Lusamba, Paul; Speybroeck, Niko

doi:10.1016/j.meegid.2021.105009

Cited by 11 publications

(8 citation statements)

References 55 publications

(101 reference statements)

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“…In this study, A437G was the most prevalent point mutation (83.33%; 190/228) in Pfdhps in the majority of the countries in central Africa, except for Chad and the Central African Republic, where there was a higher proportion of the S436A mutation than the A437G mutation. Regarding K540E, the prevalence in Angola (6.38%) from our data was consistent with previously reported results (7%) ( 22 ), while the frequency in Congo DR (27.27%) was lower than those in previous reports (~32.6% to >50%) ( 27 , 28 ). These findings demonstrate the spatial heterogeneity of Pfdhps point mutations in central African countries.…”

Section: Discussionsupporting

confidence: 92%

Molecular Determinants of Sulfadoxine-Pyrimethamine Resistance in Plasmodium falciparum Isolates from Central Africa between 2016 and 2021: Wide Geographic Spread of Highly Mutated Pfdhfr and Pfdhps Alleles

et al. 2022

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Section: Discussionsupporting

confidence: 92%

Molecular Determinants of Sulfadoxine-Pyrimethamine Resistance in Plasmodium falciparum Isolates from Central Africa between 2016 and 2021: Wide Geographic Spread of Highly Mutated Pfdhfr and Pfdhps Alleles

et al. 2022

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“…The WHO recommends that SP should continue to be used for IPTp in areas of SP resistance [ 35 , 36 ]. However, another recent study found that IPTp with SP in areas with high prevalence of SP resistance markers was not associated with reduced maternal malaria although the there was evidence of prophylactic effect against adverse pregnancy outcomes [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

A non-randomized controlled trial to assess the protective effect of SMC in the context of high parasite resistance in Uganda

Nuwa

Baker

Bonnington

et al. 2023

Malar J

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Background Until recently, due to widespread prevalence of molecular markers associated with sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) resistance in east and southern Africa, seasonal malaria chemoprevention (SMC) has not been used at scale in this region. This study assessed the protective effectiveness of monthly administration of SP + AQ (SPAQ) to children aged 3–59 months in Karamoja sub-region, Uganda, where parasite resistance is assumed to be high and malaria transmission is seasonal. Methods A two-arm quasi-experimental, open-label prospective non-randomized control trial (nRCT) was conducted in three districts. In two intervention districts, 85,000 children aged 3–59 months were targeted to receive monthly courses of SMC using SPAQ during the peak transmission season (May to September) 2021. A third district served as a control, where SMC was not implemented. Communities with comparable malaria attack rates were selected from the three districts, and households with at least one SMC-eligible child were purposively selected. A total cohort of 600 children (200 children per district) were selected and followed using passive surveillance for breakthrough confirmed malaria episodes during the five-month peak transmission season. Malaria incidence rate per person-months and number of malaria episodes among children in the two arms were compared. Kaplan–Meier failure estimates were used to compare the probability of a positive malaria test. Other factors that may influence malaria transmission and infection among children in the two arms were also assessed using multivariable cox proportional hazards regression model. Results The malaria incidence rate was 3.0 and 38.8 per 100 person-months in the intervention and control groups, respectively. In the intervention areas 90.0% (361/400) of children did not experience any malaria episodes during the study period, compared to 15% (29/200) in the control area. The incidence rate ratio was 0.078 (95% CI 0.063–0.096), which corresponds to a protective effectiveness of 92% (95% CI 90.0–94.0) among children in the intervention area. Conclusion SMC using SPAQ provided high protective effect against malaria during the peak transmission season in children aged 3–59 months in the Karamoja sub-region of Uganda.

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“…However, in DRC, IPTp3+ implementation is less than the universal coverage and the majority of women attending at least four antenatal care visits receive less than three doses of IPTp [ 1 , 98 ]. Despite the increase in SP falciparum resistance in DRC [ 99 , 100 , 101 , 102 , 103 , 104 ], IPTp is still used for malaria prevention during pregnancy and protection against maternal anemia and low birthweight; especially when it is given in three or more doses [ 101 ], as shown in other countries [ 105 , 106 , 107 , 108 , 109 ].…”

Section: Current Drc Malaria Control Policymentioning

confidence: 99%

It Is Time to Strengthen the Malaria Control Policy of the Democratic Republic of Congo and Include Schools and School-Age Children in Malaria Control Measures

et al. 2022

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Despite a decade of sustained malaria control, malaria remains a serious public health problem in the Democratic Republic of Congo (DRC). Children under five years of age and school-age children aged 5–15 years remain at high risk of symptomatic and asymptomatic malaria infections. The World Health Organization’s malaria control, elimination, and eradication recommendations are still only partially implemented in DRC. For better malaria control and eventual elimination, the integration of all individuals into the national malaria control programme will strengthen malaria control and elimination strategies in the country. Thus, inclusion of schools and school-age children in DRC malaria control interventions is needed.

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Evaluation of the usefulness of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine in a context with increased resistance of Plasmodium falciparum in Kingasani Hospital, Kinshasa in the Democratic Republic of Congo

Cited by 11 publications

References 55 publications

Molecular Determinants of Sulfadoxine-Pyrimethamine Resistance in Plasmodium falciparum Isolates from Central Africa between 2016 and 2021: Wide Geographic Spread of Highly Mutated Pfdhfr and Pfdhps Alleles

Molecular Determinants of Sulfadoxine-Pyrimethamine Resistance in Plasmodium falciparum Isolates from Central Africa between 2016 and 2021: Wide Geographic Spread of Highly Mutated Pfdhfr and Pfdhps Alleles

A non-randomized controlled trial to assess the protective effect of SMC in the context of high parasite resistance in Uganda

It Is Time to Strengthen the Malaria Control Policy of the Democratic Republic of Congo and Include Schools and School-Age Children in Malaria Control Measures

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