Large drop in malaria infection and anemia in pregnant women with HIV taking cotrimoxazole, with or without malaria prevention drugs, in Malawi

In a study of 1,142 HIV-infected pregnant women, daily cotrimoxazole (CTX) was associated with reduced malaria parasitemia and anemia compared to sulfadoxine-pyrimethamine (SP) intermittent-preventive-therapy (IPTp).

• Among the participants, 49.7% reported taking SP-IPTp only, 29.8% took CTX only, and 15.4% received both SP-IPTp and CTX.
• Women taking SP-IPTp plus CTX were less likely to have malaria parasitemia compared to those taking SP-IPTp alone (odds ratio 0.09).
• Women taking CTX only also showed reduced malaria parasitemia compared to those on SP-IPTp alone (odds ratio 0.43).
• Both CTX plus SP-IPTp and CTX alone were associated with lower rates of anemia compared to SP-IPTp alone (prevalence ratios 0.67 and 0.72, respectively).
• The safety of combining CTX with SP-IPTp was not fully assessed in this study.

Simplified