The Effect of Intermittent Preventive Treatment of Malaria During Pregnancy and Placental Malaria on Infant Risk of Malaria

Jul 3, 2021The Journal of infectious diseases

How Malaria Prevention During Pregnancy and Placental Malaria Affect Babies’ Risk of Malaria

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Abstract

A total of 387 infants were followed to assess the impact of two malaria prevention treatments on infection rates.

Infants born to mothers receiving intermittent preventive treatment with either sulfadoxine-pyrimethamine (IPTp-SP) or dihydroartemisinin-piperaquine (IPTp-DP) showed no significant difference in the incidence of clinical malaria.
The incidence rate ratio for clinical malaria between the IPTp exposure groups was 1.03, indicating similar rates of malaria episodes.
Placental malaria exposure did not show a significant association with the incidence of clinical malaria or infection in infants.
Infant sex, season of birth, and maternal gravidity were not found to confound the results.

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BACKGROUND: Intermittent preventive treatment of malaria during pregnancy (IPTp) with dihydroartemisinin-piperaquine (DP) provides greater protection from placental malaria than sulfadoxine-pyrimethamine (SP). Some studies suggest placental malaria alters risk of malaria infection in infants, but few have quantified the effect of IPTp on infant susceptibility to malaria.

METHODS: Infants born to women enrolled in a randomized clinical trial comparing IPTp-SP and IPTp-DP in Malawi were followed from birth to 24 months to assess effect of IPTp and placental malaria on time to first malaria episode and Plasmodium falciparum incidence.

RESULTS: In total, 192 infants born to mothers randomized to IPTp-SP and 195 randomized to IPTp-DP were enrolled. Infants in IPTp exposure groups did not differ significantly regarding incidence of clinical malaria (incidence rate ratio [IRR], 1.03; 95% confidence interval [CI], .58-1.86) or incidence of infection (IRR, 1.18; 95% CI, .92-1.55). Placental malaria exposure was not associated with incidence of clinical malaria (IRR, 1.03; 95% CI, .66-1.59) or infection (IRR, 1.15; 95% CI, .88-1.50). Infant sex, season of birth, and maternal gravidity did not confound results.

CONCLUSIONS: We did not find evidence that IPTp regimen or placental malaria exposure influenced risk of malaria during infancy in this population. Clinical Trials Registration. NCT03009526.

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The Effect of Intermittent Preventive Treatment of Malaria During Pregnancy and Placental Malaria on Infant Risk of Malaria

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