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Cited by 19Malaria Research and ControlHIV/AIDS Research and InterventionsGlobal Maternal and Child Health

The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.

Intermittent preventive treatment regimens for malaria in HIV-positive pregnant women

Open access
Mathanga, Don P, Uthman, Olalekan A, Chinkhumba, Jobiba·2011·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd006689.pub2PMC PMC6532702
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Abstract

BACKGROUND: Intermittent preventive treatment is recommended for pregnant women living in malaria endemic countries due to benefits for both mother and baby. However, the impact may not be the same in HIV-positive pregnant women, as HIV infection impairs a woman's immunity. OBJECTIVES: To compare intermittent preventive treatment regimens for malaria in HIV-positive pregnant women living in malaria-endemic areas. SEARCH STRATEGY: In June 2011, we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL, MEDLINE; EMBASE; LILACS, the metaRegister of Controlled Trials (mRCT), reference lists and conference abstracts. We also contacted researchers and organizations for information on relevant trials. SELECTION CRITERIA: Randomized controlled trials comparing different intermittent preventive treatment regimens for preventing malaria in HIV-positive pregnant women in malaria-endemic areas. DATA COLLECTION AND ANALYSIS: Two authors extracted data and assessed risk bias. Dichotomous variables were combined using risk ratios (RR) and mean differences (MD) for continuous outcomes, both with 95% confidence intervals (CI). MAIN RESULTS: Two randomized trials with 722 HIV-positive pregnant women were included, comparing monthly regimens of sulfadoxine-pyrimethamine (SP) to the standard 2-dose regimen in the second and third trimesters. There were no statistically significant differences between monthly SP and 2-dose SP in rates of maternal anaemia, low birth weight, and neonatal mortality. In primigravidae and secondigravidiae, the monthly regimen was associated with less placental parasitaemia (RR 0.38, 95% CI 0.21 to 0.70, two trials) and less peripheral parasitaemia (RR 0.25, 95% CI 0.14 to 0.43, two trials), but no effect was demonstrated in multigravid women. Babies born to primigravidae and secundigravida women on monthly SP had a higher mean birth weight (weighted mean difference (WMD) 130 g; 95% CI 120 g to 150 g, two trials) than babies born to mothers on 2-dose SP. Multigravidae women treated with monthly SP had significant higher haemoglobin level than those treated with treated 2 dose SP (WMD 0.21 g/dL, 95% CI 0.15 g/dL to 0.27 g/dL, one trial). There were no trials that assessed other treatment regimens for intermittent preventive treatment in HIV-positive pregnant women. AUTHORS' CONCLUSIONS: Three or more doses of SP is superior to the standard two doses in HIV-positive pregnant women. However, since SP cannot be administered concurrently with co-trimoxazole - a drug often recommended for infection prophylaxis in HIV-positive pregnant women, new drugs and research is needed to address needs of HIV-positive pregnant women.

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  • In HIV-positive women, monthly SP regimens are superior to the standard two-dose regimen, with lower rates of placental and peripheral malaria parasitemia, particularly in primigravidae and secundigravidae.

    “In HIV-positive women, monthly SP regimens have been shown to be superior to the standard two-dose regimen, with lower rates of placental and peripheral malaria parasitemia, particularly in primigravidae and secundigravidae [146, 152, 153].”

    From Current update on malaria in pregnancy: a systematic review (2025) · cites this paper as [152]

    The Peripheral parasitaemia and Placental parasitaemia sections report lower rates with monthly SP than with two-dose SP, with significant reductions in women in their first or second pregnancy. However, the Main results characterize this as low-quality evidence that monthly SP *may* reduce parasitaemia, and find insufficient evidence to draw conclusions for women in their third or later pregnancy. The claim’s unqualified statement of superiority overstates those conclusions; page numbers are unavailable in our copy. (LLM, conf=0.86)

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  • SP cannot be administered concomitantly with co-trimoxazole, a drug often recommended for infection prophylaxis in HIV-positive pregnant women.

    “Additionally, SP cannot be administered concomitantly with co-trimoxazole, a drug often recommended for infection prophylaxis in HIV-positive pregnant women [152].”

    From Current update on malaria in pregnancy: a systematic review (2025) · cites this paper as [152]

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Research works printed but not linked: 8

  1. Higgins, 2011, Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011)
  2. Lefebvre, 2011, Chapter 6: Searching for studies.
  3. Parise, 1998, Efficacy of sulfadoxine-pyrimethamine for prevention of placental malaria in an area of Kenya with a high prevalence of malaria and human immunodeficiency virus infection, American Journal of Tropical Medicine and Hygiene, 59, 813, 10.4269/ajtmh.1998.59.813 · DOI
  4. The Nordic Cochrane Centre, The Cochrane Collaboration Review Manager (RevMan) 2008
  5. United Nations Programme on HIV/AIDS, 2010, Epidemic update, 16
  6. World Health Organization, 2004, A strategic framework for malaria prevention and control during pregnancy in the African region [AFR/MAL/04/01]
  7. World Health Organization, 2010, Antiretroviral therapy for HIV infection in adults and adolescents: Recommendations for a public health approach
  8. WHO/UNAIDS/UNICEF, 2010, Towards Universal Access: Scaling up priority HIV/AIDS interventions in the health sector

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Metadata

Authors
Mathanga, D. P., Uthman, O. A., & Chinkhumba, J.
Affiliations
  • University of Malawi (MW)
  • Stellenbosch University (ZA)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2011-10-05
Issue
10
Pages
CD006689-CD006689
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd006689.pub2
PMC
PMC6532702
OpenAlex
W1868480042
Cited by
19
References
32
Citations by year
2025: 2 · 2024: 1 · 2023: 2 · 2020: 2 · 2016: 3 · 2015: 2 · 2014: 4 · 2013: 2
FWCI
0.30
Type
journal article
Language
en
Update notices
new_version (2024-09-26)
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • University of Warwick (cc-by)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
Keywords
intermittent preventive treatment, malaria in pregnancy, HIV-positive pregnant women, sulfadoxine-pyrimethamine, anemia in pregnancy, low birth weight, neonatal mortality, primigravida, multigravidae, malaria endemic areas, malaria prophylaxis, hemoglobin
MeSH terms
Antimalarials, Drug Combinations, Female, HIV Seropositivity, Humans, Malaria, Pregnancy, Pregnancy Complications, Infectious, Pyrimethamine, Sulfadoxine, Pregnancy Complications, Parasitic, Randomized Controlled Trials as Topic

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