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Ensayo aleatorizado, controlado con placebo, del tratamiento preventivo intermitente con sulfadoxina pirimetamina en mujeres multigrávidas en Gambia
Author(s) -
Mbaye A.,
Richardson K.,
Balajo B.,
Dunyo S.,
Shulman C.,
Milligan P.,
Greenwood B.,
Walraven G.
Publication year - 2006
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2006.01649.x
Subject(s) - medicine , pregnancy , placebo , pyrimethamine , malaria , sulfadoxine , randomized controlled trial , population , obstetrics , prenatal care , pediatrics , environmental health , surgery , chloroquine , biology , immunology , genetics , alternative medicine , pathology
Summary We investigated the ability of intermittent preventive treatment in pregnancy (IPTp) with sulphadoxine/pyrimethamine to prevent anaemia and low birthweight in Gambian multigravidae. Between July 2002 and February 2004, 2688 multigravidae living in a rural area of The Gambia received SP (1346 women) or placebo (1342 women) up to four times during pregnancy and were followed until 6‐weeks post‐partum. Shortly after delivery, 10.7% of women in the intervention group and 8.8% in the control group were severely anaemic [Hb < 7 g/dl, risk difference = 0.02 (95% CI −0.01, 0.04), P = 0.17]. The overall mean birthweight of infants born to women who had received SP (3103 g) was very similar to that observed in infants born to women in the control group [3075 g; difference = 28 g (95% CI −11 g, 67 g), P = 0.16]. However, among women who did not use a bednet (either insecticide treated or untreated), infants born to women who had received SP weighed more than infants born to women in the control group [3147 g vs. 3044 g; difference 143 g (95% CI 53 g, 232 g), interaction test P < 0.001]. This study did not show that IPTp with SP benefited Gambian multigravidae overall but that it may benefit a sub‐group of women who do not use a bednet. In areas such as The Gambia, provision of insecticide‐treated bednets to multigravidae may provide an adequate means of protection against malaria in pregnancy without the need for additional IPTp.