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Cited by 16Malaria Research and ControlHemoglobinopathies and Related DisordersBird parasitology and diseases

Intermittent preventive treatment with Sulphadoxine-Pyrimethamine (IPTp-SP) is associated with protection against sub-microscopic P. falciparum infection in pregnant women during the low transmission dry season in southwestern Cameroon: A Semi - longitudinal study

Open access
Apinjoh, Tobias O., Ntui, Vincent N., Chi, Hanesh F., Moyeh, Marcel N., Toussi, Cabrel T., Mayaba, Joel M., Tangi, Livinus N., Kwi, Pilate N. +6 more·2022·PLOS ONE
DOI 10.1371/journal.pone.0275370PMC PMC9524640
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Abstract

The current guidelines for malaria prevention and control during pregnancy in Africa is predicated on the prevention of infection and/or disease through intermittent preventive treatment in pregnancy (IPTp), insecticide-treated nets (ITNs) and effective malaria case diagnosis and management. Concerns that increasing SP resistance in some areas of SSA may have compromised IPTp-SP efficacy prompted this contemporaneous study, designed to assess the prevalence and risk factors of sub-microscopic infection in parturient women during the low transmission season in Mutengene, a rapidly growing semi-urban area in Southwest Region, Cameroon. Pregnant women originally reporting for the establishment of antenatal clinic care during the dry season were followed-up to term and their pregnancy outcomes recorded. About 2 ml of venous blood was collected for malaria diagnosis using PfHRP2/pLDH malaria rapid diagnostic kit and light microscopy. DNA was extracted from dried blood spots by the Chelex-100 method and the Plasmodium falciparum status detected by nested PCR amplification of the 18SrRNA gene using specific predesigned primers. Of the 300 women enrolled, the proportion of malaria parasite infected as determined by microscopy, RDT and PCR was 12.9%, 16.4% and 29.4% respectively, with 39.9% overall infected with P. falciparum by microscopy and/or RDT and/or PCR and a very low-density infection, averaging 271 parasites per microliter of blood. About 25.0% (68/272) of women who were negative by microscopy were positive by PCR (submicroscopic P. falciparum infection), with primigravidae and IPTp-SP non usage identified as independent risk factors for submicroscopic P. falciparum parasitaemia while fever history (aOR = 4.83, 95% CI = 1.28–18.22, p = 0.020) was associated with risk of malaria parasite infection overall. IPTp-SP use (p = 0.007) and dosage (p = 0.005) significantly influenced whether or not the participant will be malaria parasite negative or carry submicroscopic or microscopic infection. Although Infant birthweight and APGAR score were independent of the mother’s P. falciparum infection and submicroscopic status, infant’s birthweight varied with the gravidity status (p = 0.001) of the mother, with significantly lower birthweight neonates born to primigravidae compared to secundigravidae (p = 0.001) and multigravidae (p = 0.003). Even in holo-endemic dry season, there exists a large proportion of pregnant women with very low density parasitaemia. IPTp-SP seems to be relevant in controlling submicroscopic P. falciparum infections, which remains common in pregnant women, and are hard to diagnose, with potentially deleterious consequences for maternal and fetal health. Future studies should be carried out in hyperendemic malaria foci where the parasitemia levels are substantially higher in order to confirm the efficacy of IPTp-SP.

AI snapshot

Written from the paper’s full text.

TL;DR

In 300 pregnant women in Mutengene, southwestern Cameroon during the dry season, PCR detected P. falciparum in 29.4% versus 12.9% by microscopy and 16.4% by RDT, with 25.0% of microscopy-negative women having submicroscopic infection. IPTp-SP use was associated with lower odds of submicroscopic infection, while primigravidity was associated with higher odds.

Key findings

  • Among 300 enrolled women, malaria parasite prevalence was 12.9% (35/272) by microscopy, 16.4% (49/299) by RDT, and 29.4% (88/299) by PCR; overall infection by microscopy and/or RDT and/or PCR was 39.9% (110/276), with low-density infection averaging 271 parasites/µL (range 78–36,178; n=57).
  • Submicroscopic P. falciparum infection occurred in 25.0% (68/272) of microscopy-negative women. In multivariate analysis, primigravidae were more susceptible (aOR = 2.92, 95% CI = 1.19–7.18, p = 0.019) and IPTp-SP users were at lower risk (aOR = 0.12, 95% CI = 0.01–0.98, p = 0.048).
  • Overall malaria parasite infection was associated with fever history in the final multivariate model (aOR = 4.83, 95% CI = 1.28–18.22, p = 0.020). IPTp-SP use (p = 0.007) and dosage (p = 0.005) significantly influenced whether women were malaria negative or had submicroscopic or microscopic infection; no women had microscopic infection after at least two IPTp-SP doses.
  • Infant birthweight and APGAR score were independent of maternal P. falciparum infection and submicroscopic status, but birthweight varied with gravidity (p = 0.001), with significantly lower birthweight neonates born to primigravidae compared to secundigravidae (p = 0.001) and multigravidae (p = 0.003).

Methods

  • Prospective cohort/semi-longitudinal study at Mutengene Integrated Health Centre, October 2019–March 2020; 454 pregnant women were originally enrolled, the first 300 sequentially enrolled were screened by RDT, microscopy, and PCR and used for analyses, and 224 were followed to term.
  • About 2 ml venous blood was collected; malaria diagnosis used PfHRP2/pLDH RDT, light microscopy, and nested PCR amplification of the 18S rRNA gene from dried blood spots after Chelex-100 DNA extraction. Structured questionnaires and ANC/medical records captured demographic, clinical, IPTp-SP, and pregnancy outcome data.
  • Data were analyzed in SPSS Statistics 20 using chi-square tests, student’s t test or ANOVA, and logistic regression; variables with p < 0.25 in univariate analysis or known clinical relevance entered multivariate models, with p < 0.05 considered significant.

Limitations

  • The paper states that adherence to IPTp-SP could not be assessed because doses were self-reported or documented in ANC cards and plasma SP was not measured; few women had low birthweight or preterm delivery, potentially limiting power to detect associations with adverse outcomes; and some associations may be confounded by undocumented factors.
  • The paper also notes that self-reported ITN use may overestimate actual use, and that PCR-positive submicroscopic infections may sometimes represent phagocytized placental parasites without viable circulating parasites.
  • Evident from the text: the study was conducted in a semi-urban, dry-season setting, and the authors call for future studies in hyperendemic malaria foci with substantially higher parasitemia to confirm IPTp-SP efficacy.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1371/journal.pone.0275370

Cites

46 of 46 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 53 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Among 300 pregnant women enrolled in Mutengene during the dry season, the proportion with malaria parasite infection was 12.9% by microscopy, 16.4% by RDT, and 29.4% by PCR.

    “Of the 300 women enrolled, the proportion of malaria parasite infected as determined by microscopy, RDT and PCR was 12.9%, 16.4% and 29.4% respectively”
    • Also stated in: § Prevalence of malaria parasite infection as a function of diagnostic method · plain
      “The proportion of malaria parasite infected women as determined by microscopy, RDT and PCR was 12.9% (35/272), 16.4% (49/299) and 29.4% (88/299) respectively”
    Quote in the paperSubstantial claim
  • Findingown data

    Among women negative by microscopy, 25.0% (68/272) were positive by PCR, indicating submicroscopic P. falciparum infection.

    “About 25.0% (68/272) of women who were negative by microscopy were positive by PCR (submicroscopic P. falciparum infection)”
    • Also stated in: § Submicroscopic P. falciparum infection · plain
      “One out of every four (25.0%, 68/272) women who were negative by microscopy were positive by PCR (submicroscopic P. falciparum infection)”
    Quote in the paperSubstantial claim
  • Findingown data

    Overall, 39.9% of the women were infected with P. falciparum by microscopy and/or RDT and/or PCR.

    “with 39.9% overall infected with P. falciparum by microscopy and/or RDT and/or PCR”
    • Also stated in: § Prevalence of malaria parasite infection as a function of diagnostic method · plain
      “with 39.9% (110/276) overall infected with Plasmodium falciparum by microscopy and/or RDT and/or PCR”
    Quote in the paperNot a substantial claim
  • Findingown data

    Malaria parasite infected parturient women in the cohort had very low-density infection, with a geometric mean parasitaemia density of 271 parasites per microliter of blood.

    “a very low-density infection, averaging 271 parasites per microliter of blood”
    • Also stated in: § Prevalence of malaria parasite infection as a function of diagnostic method · plain
      “Malaria parasite infected parturient women in the cohort harbored very low-density infection, averaging 271 parasites per microliter of blood.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Primigravidae were at higher risk of submicroscopic P. falciparum parasitaemia (aOR = 2.92, 95% CI = 1.19-7.18, p = 0.019) compared to multigravidae, after adjusting for covariates.

    “with primigravidae more susceptible (aOR = 2.92, 95% CI = 1.19–7.18, p = 0.019)”
    • Also stated in: § Abstract · plain
      “primigravidae and IPTp-SP non usage identified as independent risk factors for submicroscopic P. falciparum parasitaemia”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 42
  • The quote only partly states this claim. 2
  • May combine two claims. 32

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Infant birthweight varied with the gravidity status of the mother (p = 0.001).

    “infant’s birthweight varied with the gravidity status (p = 0.001) of the mother”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    More than three quarters (78.9%, 235/298) of the women had taken IPTp-SP at term.

    “More than three quarters (78.9%, 235/298) of the women had taken IPTp-SP at term”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    More than half (55.7%, 166/298) of the women had taken at least 3 prophylactic doses of IPTp-SP at term.

    “with more than half (55.7%, 166/298) of them on at least 3 prophylactic doses.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The average gestational age at delivery was 39.4 weeks.

    “The average gestational age at delivery was 39.4 weeks”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The mean APGAR score of the 187 neonates assessed was 9.8 ± 0.9.

    “The mean birthweight and APGAR score of the 193 and 187 neonates duly assessed was 3.3 ± 0.4 kg and 9.8 ± 0.9 respectively.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    None of the women were infected, including microscopic infection, after taking at least 2 doses of IPTp-SP.

    “with none of the women infected after taking at least 2 doses of IPTp-SP.”
    • Also stated in: § IPTp-SP and malaria parasite infection · plain
      “none of the women harboring microscopic infection after at least two doses of the IPTp-SP (Fig 3).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    3.6% of neonates were premature.

    “although 3.1% and 3.6% neonates were low birthweight or premature respectively.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    The overall 39.9% prevalence of Plasmodium falciparum infection in this study mirrors previous reports.

    “The overall 39.9% prevalence of Plasmodium falciparum infection in this study mirrors previous reports [6]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] MA Elbadry, 2017, Submicroscopic malaria infections in pregnant women from six departments in Haiti, Trop Med Int Health source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    In univariate analysis, the overall prevalence of malaria parasite (submicroscopic and microscopic) infection was associated with IPTp-SP usage, cumulative number of IPTp doses, reported history of fever, and trimester of gestation.

    “Following univariate analysis, the overall prevalence of malaria parasite (submicroscopic and microscopic) infection was associated with IPTp-SP usage (p = 0.005), cumulative number of IPTp doses (p = 0.022), reported history of fever (p = 0.027) and trimester of gestation (p = 0.028)”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The mean birthweight of the 193 neonates assessed was 3.3 ± 0.4 kg.

    “The mean birthweight and APGAR score of the 193 and 187 neonates duly assessed was 3.3 ± 0.4 kg and 9.8 ± 0.9 respectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The prevalence of malaria parasite infections by mRDT, light microscopy, and overall was significantly lower in IPTp-SP users compared to non-users.

    “The prevalence of malaria parasite infections by mRDT (p = 0.018) and light microscopy (p = 0.040) as well as overall (p = 0.005) was significantly lower in IPTp-SP users when compared to non-users”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Low birthweight was significantly associated with gravidity (p = 0.012), with higher prevalence in primigravidae.

    “Apart from the significant association (p = 0.012) between low birthweight and gravidity, with higher prevalence in primigravidae”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Babies born to nulliparous women had significantly lower birthweights compared to those with 1-3 live births (p = 0.003) and at least 4 children (p = 0.002).

    “Similarly, babies born to nulliparous women (3.14 ± 0.39) had significantly lower birthweights when compared to their counterparts with 1–3 live births (3.34 ± 0.42, p = 0.003) and at least 4 children (3.53 ± 0.31, p = 0.002) counterparts.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    APGAR score did not vary with any of the risk factors assessed.

    “APGAR score did not vary with any of the risk factors assessed.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    IPTp-SP use and dosage significantly influenced whether a participant would be malaria parasite negative or carry submicroscopic or microscopic infection.

    “Additionally, IPTp-SP use (p = 0.007) and dosage (p = 0.005) significantly influenced whether or not the participant will be malaria parasite negative or carry submicroscopic or microscopic infection (Fig 3).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    There was no association between infection status by mRDT, PCR, overall parasitaemia, or submicroscopic infection status and the dosage of SP taken.

    “Nevertheless, there was no association between infection status by mRDT (p = 0.986) and PCR (p = 0.217) as well as the overall parasitaemia (p = 0.334) and submicroscopic infection status (p = 0.306) and the dosage of SP taken.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    3.1% of neonates were low birthweight.

    “although 3.1% and 3.6% neonates were low birthweight or premature respectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Malaria parasite negative women had similar birthweights and APGAR scores compared to those with submicroscopic or microscopic infection.

    “Malaria parasite negative women had similar birthweights (p = 0.158) and APGAR scores (p = 0.672) when compared to those with submicroscopic or microscopic infection.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    This moderate uptake is better than previous reports of 20-26% use of ≥3 doses of IPTp-SP in the country and Tanzania but still below the 60% target by the Ministry of Health.

    “This moderate uptake though better than previous reports of 20–26% use of ≥ 3 doses of IPTp-SP in the country [39] and Tanzania is still below the 60% target by the Ministry of Health [40].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [39] J Dionne-Odom, 2017, Predictors of the use of interventions to prevent malaria in pregnancy in Cameroon, Malar J source

      Not checked in the free run.

    • cites [40] Tanzania—Malaria Operational Plan FY 2019.: 113.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Self-reported ITN use was 65.4% among pregnant women.

    “Self-reported ITNs use of 65.4% by pregnant women”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    Most peripheral malaria infections were asymptomatic and below the detection limit of conventional microscopy and/or rapid diagnostic tests.

    “since most of these peripheral malaria infections were asymptomatic and below the detection limit of conventional microscopy and/or rapid diagnostic tests”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Findingnone given

    Conventional microscopy and rapid diagnostic tests are unable to identify a large proportion of pregnant women with very low density parasitaemia.

    “with conventional microscopy and rapid diagnostic tests unable to identify a large proportion of pregnant women with very low density parasitaemia.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    Neither microscopic nor submicroscopic P. falciparum infection detected at study inclusion were associated with adverse birth outcomes.

    “The fact that neither microscopic or submicroscopic P. falciparum infection detected at study inclusion were associated with adverse birth outcomes”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Submicroscopic P. falciparum infections may negatively affect health and constitute reservoirs for continued disease transmission because they are usually asymptomatic and remain untreated during pregnancy.

    “Such submicroscopic infections may negatively affect health and constitute reservoirs for continued disease transmission [10] since they are usually asymptomatic and therefore remain untreated during pregnancy.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [10] JF Mosha, 2013, Epidemiology of subpatent Plasmodium falciparum infection: implications for detection of hotspots with imperfect diagnostics, Malar J source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Current guidelines for malaria prevention and control during pregnancy in Africa emphasize prevention of infection and/or disease through IPTp, ITNs, and prompt and effective malaria case management.

    “Current guidelines for malaria prevention and control during pregnancy in Africa emphasize on the prevention of infection and/or disease through intermittent preventive treatment (IPTp), the use of insecticide-treated nets (ITNs) and prompt and effective malaria case management [1].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] WHO | A strategic framework for malaria prevention and control during pregnancy in the African region (archived). In: WHO [Internet]. World Health Organization; [cited 13 Mar 2021]. Available: http://www.who.int/malaria/publications/atoz/afr_mal_04_01/en/

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Pregnancy poses a unique challenge for falciparum malaria diagnosis because parasites sequester in the placenta and circulating parasitaemia is very low and therefore undetectable by peripheral blood smear microscopy or rapid diagnostic test.

    “Pregnancy poses a unique challenge for falciparum malaria diagnosis, as parasites sequester in the placenta and the circulating parasitaemia is very low and therefore undetectable by peripheral blood smear microscopy or rapid diagnostic test [7–10].”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [7] CJ Uneke, 2008, Diagnosis of Plasmodium falciparum malaria in pregnancy in sub-Saharan Africa: the challenges and public health implications, Parasitol Res source

      Not checked in the free run.

    • cites [8] RFG Leke, 1999, Detection of the Plasmodium falciparum Antigen Histidine-Rich Protein 2 in Blood of Pregnant Women: Implications for Diagnosing Placental Malaria, J Clin Microbiol source

      Not checked in the free run.

    • cites [9] A Mayor, 2012, How hidden can malaria be in pregnant women? Diagnosis by microscopy, placental histology, polymerase chain reaction and detection of histidine-rich protein 2 in plasma, Clin Infect Dis Off Publ Infect Dis Soc Am source

      Not checked in the free run.

    • cites [10] JF Mosha, 2013, Epidemiology of subpatent Plasmodium falciparum infection: implications for detection of hotspots with imperfect diagnostics, Malar J source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Submicroscopic P. falciparum infections remain common in pregnant women and are hard to diagnose, with potentially deleterious consequences for maternal and fetal health.

    “IPTp-SP seems to be relevant in controlling submicroscopic P. falciparum infections, which remains common in pregnant women, and are hard to diagnose, with potentially deleterious consequences for maternal and fetal health.”
    • Also stated in: § Conclusion · plain
      “which remains common in pregnant women, and are hard to diagnose, with potentially deleterious consequences for maternal and fetal health.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Malaria in pregnancy adversely affects both the mother and her progeny.

    “Malaria in pregnancy (MiP) is known to adversely affect both the mother and her progeny [1]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] WHO | A strategic framework for malaria prevention and control during pregnancy in the African region (archived). In: WHO [Internet]. World Health Organization; [cited 13 Mar 2021]. Available: http://www.who.int/malaria/publications/atoz/afr_mal_04_01/en/

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Falciparum infection and disease in pregnancy are commonly manifested as maternal anaemia, pre-term delivery and low birth weight, and are linked to poor infant development and increased neonatal and infant morbidity and mortality, especially in low transmission settings.

    “with falciparum infection and disease, commonly manifested as maternal anaemia, pre-term delivery and low birth weight [2–4] linked to poor infant development, increased neonatal and infant morbidity and mortality especially in low transmission settings [1, 5].”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [2] G Cottrell, 2015, Submicroscopic Plasmodium falciparum Infections Are Associated With Maternal Anemia, Premature Births, and Low Birth Weight, Clin Infect Dis Off Publ Infect Dis Soc Am source

      Not checked in the free run.

    • cites [3] B-T Huynh, 2015, Burden of Malaria in Early Pregnancy: A Neglected Problem?, Clin Infect Dis source

      Not checked in the free run.

    • cites [4] C Menendez, 2000, The Impact of Placental Malaria on Gestational Age and Birth Weight, J Infect Dis source

      Not checked in the free run.

    • cites [1] WHO | A strategic framework for malaria prevention and control during pregnancy in the African region (archived). In: WHO [Internet]. World Health Organization; [cited 13 Mar 2021]. Available: http://www.who.int/malaria/publications/atoz/afr_mal_04_01/en/

      Not checked in the free run.

    • cites [5] SJ Rogerson, 2018, Burden, pathology, and costs of malaria in pregnancy: new developments for an old problem, Lancet Infect Dis source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Pregnant women are at higher risk for severe malaria, pregnancy loss and death compared to non-pregnant peers, with a mortality rate up to 50% for severe infections.

    “Expectant mothers are also at higher risk for severe malaria, pregnancy loss and death compared to their non-pregnant peers, with a mortality rate up to 50% for severe infections [6].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] MA Elbadry, 2017, Submicroscopic malaria infections in pregnant women from six departments in Haiti, Trop Med Int Health source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In Mutengene, IPTp-SP from 4 months was implemented since 2006 in line with WHO guidelines.

    “Intermittent preventive treatment in pregnancy with SP from 4 months was implemented in Mutengene since 2006, in line with the World Health Organization guidelines for the delivery of IPTp at each scheduled visit after “quickening” (16 weeks) to ensure that a high proportion of women receive a minimum of 2 doses of IPT [15].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] TO Apinjoh, 2015, Determinants of Infant Susceptibility to Malaria During the First Year of Life in South Western Cameroon, Open Forum Infect Dis

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Plasmodium spp transmission is perennial in Mutengene, with Anopheles gambiae being the dominant vector species and P. falciparum accounting for most malaria infections.

    “Plasmodium spp transmission is perennial in the area, with Anopheles gambiae being the dominant vector species and P. falciparum accounting for most malaria infections [19, 20].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [19] JD Bigoga, 2007, Malaria vectors and transmission dynamics in coastal south-western Cameroon, Malar J source

      Not checked in the free run.

    • cites [20] S Wanji, 2003, Anopheles species of the mount Cameroon region: biting habits, feeding behaviour and entomological inoculation rates, Trop Med Int Health TM IH source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Previous MIP studies in the southwest region of Cameroon have documented IPTp-SP coverage and its effectiveness on adverse pregnancy outcomes and malaria parasitaemia.

    “Previous MIP studies in the southwest region of Cameroon have documented IPTp-SP coverage [15, 16] as well as its effectiveness on adverse pregnancy outcomes [16] and malaria parasitaemia [15].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [15] TO Apinjoh, 2015, Determinants of Infant Susceptibility to Malaria During the First Year of Life in South Western Cameroon, Open Forum Infect Dis

      Not checked in the free run.

    • cites [16] JK Anchang-Kimbi, 2020, Coverage and effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) on adverse pregnancy outcomes in the Mount Cameroon area, South West Cameroon, Malar J

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Several studies have demonstrated submicroscopic P. falciparum infection detectable only by sensitive molecular (PCR) methods in Sub-Saharan Africa and documented high prevalence rates of low-density parasitaemia, especially in pregnant women.

    “Over the past decades, several studies have demonstrated submicroscopic P. falciparum infection, detectable only by sensitive molecular (PCR) methods in Sub-Saharan Africa (SSA) and documented high prevalence rates of low-density parasitaemia, shedding new light on the real prevalence of malaria infections [11], especially in pregnant women [2].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [11] LC Okell, 2009, Submicroscopic infection in Plasmodium falciparum-endemic populations: a systematic review and meta-analysis, J Infect Dis source

      Not checked in the free run.

    • cites [2] G Cottrell, 2015, Submicroscopic Plasmodium falciparum Infections Are Associated With Maternal Anemia, Premature Births, and Low Birth Weight, Clin Infect Dis Off Publ Infect Dis Soc Am source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Only variables of known clinical relevance or with p-value < 0.25 in univariate analysis were included in multivariate models.

    “only variables of known clinical relevance or with p-value < 0.25 in univariate analysis were included in multivariate models.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Increasing SP resistance in SSA may have compromised the efficacy of IPTp-SP.

    “Concerns that increasing SP resistance in SSA [13] may have compromised the efficacy of this chemoprophylactic control measure [14], makes WHO’s call for enhanced regular monitoring of IPTp effectiveness ever more relevant in all malaria-endemic ecosystems.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [13] S Sridaran, 2010, Anti-folate drug resistance in Africa: meta-analysis of reported dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) mutant genotype frequencies in African Plasmodium falciparum parasite populations, Malar J source

      Not checked in the free run.

    • cites [14] WE Harrington, 2011, Intermittent treatment to prevent pregnancy malaria does not confer benefit in an area of widespread drug resistance, Clin Infect Dis Off Publ Infect Dis Soc Am source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    IPTp-SP usage and dosage were confirmed at each scheduled visit by directly observed administration.

    “Subsequent IPTp-SP usage and dosage was confirmed at each scheduled visit by directly observed administration of the drug by nurses/midwives in line with national guidelines.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    The study was a prospective cohort study.

    “This was a prospective cohort study carried out in the Mutengene Integrated Health Centre between October 2019 to March 2020.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Each slide was examined by two independent microscopists.

    “Each slide was examined by two independent microscopists and was considered negative if no parasite was seen after observing 200 high power fields.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    P. falciparum 3D7 and distilled water served as positive and negative control in every set of PCR reactions.

    “P. falciparum 3D7 and distilled water served as positive and negative control respectively in every set of reactions.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    IPTp-SP is effective in preventing pregnancy-associated malaria in areas with moderate to high transmission but not so much in areas with substantial reduction of malaria transmission.

    “Several studies have reported the effectiveness of IPTp with sulphadoxine-pyrmethamine (SP) (IPTp-SP) in the prevention of pregnancy associated malaria in areas with moderate to high transmission but not so much in areas with substantial reduction of malaria transmission [12].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [12] WP Mikomangwa, 2020, Effect of sulfadoxine-pyrimethamine doses for prevention of malaria during pregnancy in hypoendemic area in Tanzania, Malar J source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Previous studies in Cameroon and other malaria endemic settings have reported similarly large proportions of asymptomatic/sub-microscopic individuals using molecular diagnostic methods compared to RDT or microscopy.

    “Previous studies in Cameroon [8] and other malaria endemic settings have also reported similarly large proportions of asymptomatic/sub-microscopic individuals using molecular diagnostic methods compared to affordable tools such as RDT or microscopy [29]”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [8] RFG Leke, 1999, Detection of the Plasmodium falciparum Antigen Histidine-Rich Protein 2 in Blood of Pregnant Women: Implications for Diagnosing Placental Malaria, J Clin Microbiol source

      Not checked in the free run.

    • cites [29] HW Unger, 2019, Microscopic and submicroscopic Plasmodium falciparum infection, maternal anaemia and adverse pregnancy outcomes in Papua New Guinea: a cohort study, Malar J source

      Not checked in the free run.

  • May combine two claims. The quote only partly states this claim.

    Interpretationown data

    SP is highly effective in controlling malaria parasite infection in pregnancy and thereby preventing negative outcomes such as low birthweight, pre-term delivery, and stillbirth.

    “demonstrating that SP is highly effective in controlling malaria parasite infection in pregnancy and thereby preventing negative outcomes such as low birthweight, pre-term delivery and stillbirth.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The possibility of overestimating ITN use due to self-reporting cannot be excluded.

    “The possibility of overestimating ITNs use due to self-reporting cannot be excluded as the participant may try to please the interviewer [10].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] JF Mosha, 2013, Epidemiology of subpatent Plasmodium falciparum infection: implications for detection of hotspots with imperfect diagnostics, Malar J source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Pregnant women may become asymptomatic reservoirs with low density infections and remain unidentified during routine passive surveillance because P. falciparum sequestration in the placenta hinders detection by RDT or microscopy.

    “Pregnant women may become asymptomatic reservoirs with low density infections; remain unidentified during routine passive surveillance since P. falciparum sequestration in the placenta hinders their detection by RDT or microscopy”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [7] CJ Uneke, 2008, Diagnosis of Plasmodium falciparum malaria in pregnancy in sub-Saharan Africa: the challenges and public health implications, Parasitol Res source

      Not checked in the free run.

    • cites [30] A Mayor, 2012, How hidden can malaria be in pregnant women? Diagnosis by microscopy, placental histology, polymerase chain reaction and detection of histidine-rich protein 2 in plasma, Clin Infect Dis Off Publ Infect Dis Soc Am source

      Not checked in the free run.

    • cites [31] FP Mockenhaupt, 2000, Submicroscopic Plasmodium falciparum infections in pregnancy in Ghana, Trop Med Int Health TM IH source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationcitation

    Higher optimal IPTp-SP uptake was expected because the main healthcare facility was located close to households and parturient were expected to frequently attend ANC and be sensitized about SP by well-trained health care personnel.

    “Higher optimal IPTp-SP uptake was expected as reported recently in a hypoendemic area in Tanzania [12] since the main healthcare facility was located close to the households and parturient expected to frequently attend ANC and be sensitized about SP by well-trained health care personnel [41].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [12] WP Mikomangwa, 2020, Effect of sulfadoxine-pyrimethamine doses for prevention of malaria during pregnancy in hypoendemic area in Tanzania, Malar J source

      Not checked in the free run.

    • cites [41] A Exavery, 2014, Factors affecting uptake of optimal doses of sulphadoxine-pyrimethamine for intermittent preventive treatment of malaria in pregnancy in six districts of Tanzania, Malar J source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Low parasite densities are expected because the majority of parturients were multigravidae and antibodies against specific placental tissue-adhering P. falciparum strains are gradually acquired with successive pregnancies.

    “are expected since majority of the parturients were multigravidae and antibodies against specific placental tissue-adhering P. falciparum strains [44, 45] are thought to be gradually acquired with successive pregnancies [46].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [44] JC Reeder, 1999, The adhesion of Plasmodium falciparum-infected erythrocytes to chondroitin sulfate A is mediated by P. falciparum erythrocyte membrane protein 1, Proc Natl Acad Sci U S A source

      Not checked in the free run.

    • cites [45] M Fried, 1996, Adherence of Plasmodium falciparum to chondroitin sulfate A in the human placenta, Science source

      Not checked in the free run.

    • cites [46] M Fried, 1998, Maternal antibodies block malaria, Nature source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationown data

    Suboptimal uptake and bednet usage may accrue to late presentation to ANC care, since the majority of women were in the third trimester.

    “The suboptimal uptake and bednet usage may accrue to the late presentation to ANC care, since majority of the women were in the third trimester.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Subpatent P. falciparum infections are highly prevalent in nonpregnant adults and children.

    “since subpatent P. falciparum infections are also highly prevalent in nonpregnant adults and children [33, 34].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [33] E Bottius, 1996, Malaria: even more chronic in nature than previously thought; evidence for subpatent parasitaemia detectable by the polymerase chain reaction, Trans R Soc Trop Med Hyg source

      Not checked in the free run.

    • cites [34] G Wagner, 1998, High incidence of asymptomatic malara infections in a birth cohort of children less than one year of age in Ghana, detected by multicopy gene polymerase chain reaction, Am J Trop Med Hyg source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    This suggests an improvement of immune protection during subsequent pregnancies, limiting P. falciparum not only to low parasite densities but even to submicroscopic levels.

    “This suggests an improvement of immune protection during subsequent pregnancies, limiting P. falciparum not only to low parasite densities but even to submicroscopic levels [8].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [8] RFG Leke, 1999, Detection of the Plasmodium falciparum Antigen Histidine-Rich Protein 2 in Blood of Pregnant Women: Implications for Diagnosing Placental Malaria, J Clin Microbiol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The use of long-lasting insecticide treated nets and IPTp-SP remain the key interventions for the protection of pregnant women and their offspring against malaria and its attendant consequences.

    “The use of long-lasting insecticide treated nets and IPTp-SP remain the key interventions for the protection of pregnant women and their offspring against malaria and its attendant consequences [37].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [37] C Menéndez, 2010, Malaria prevention with IPTp during pregnancy reduces neonatal mortality, PloS One source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationcitation

    These infections could become an emergency or evolve to severe disease if undetected or diagnosis was delayed.

    “and could, therefore, become an emergency [10] or evolve to severe disease if undetected or diagnosis was delayed.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [10] JF Mosha, 2013, Epidemiology of subpatent Plasmodium falciparum infection: implications for detection of hotspots with imperfect diagnostics, Malar J source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Some of the observed associations may be confounded by factors not documented in this study.

    “Additionally, some of the observed associations may be confounded by factors not documented in this study.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Adherence to IPTp-SP could not be assessed because the number of doses reported was based on self-reported SP dosage or documented in ANC cards and plasma SP was not measured.

    “Adherence on the use of IPTp-SP could not be assessed as the number of doses reported was based on self-reported SP dosage or documented in the ANC cards and plasma SP not measured to authenticating the information on the use of IPTp-SP among study participants.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Very few women had LBW infants and preterm delivery, potentially affecting the power of the study to detect associations between infection and adverse outcomes.

    “The fact that very few women had LBW infants and preterm delivery, potentially affected the power of the study to detect associations between infection and adverse outcomes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In endemic countries, maternal malaria is thought to contribute to neonatal mortality indirectly through low birthweight and prematurity, though no strong evidence exists to support this association.

    “In endemic countries, maternal malaria is thought to contribute to neonatal mortality indirectly through low birthweight and prematurity, though, to our knowledge, no strong evidence exists to support this association [49].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [49] C Menéndez, 2007, Reducing the burden of malaria in pregnancy by preventive strategies, Lancet Infect Dis source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given

    It is possible that the time interval between the last administrated IPTp dose and screening for parasite infection may be a stronger determinant for detecting parasitaemia rather than the cumulative number of doses a woman has received.

    “or that the time interval between the last administrated IPTp dose and screening for parasite infection may be a stronger determinant for detecting parasitaemia rather than the cumulative number of doses a woman has received.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    The control strategy is still effective and P. falciparum populations in the area remain susceptible to SP despite documented high prevalence of molecular markers against the drug.

    “This suggests that the control strategy is still effective and P. falciparum populations in the area remain susceptible to the SP despite the documented high prevalence of molecular markers against the drug.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    The lack of statistical difference between optimal and sub-optimal doses suggests that the effect of the chemoprophylaxis may not be translated clinically.

    “Although the lack of statistical difference between those who received optimal and sub-optimal doses for IPTp-SP suggests that the effect of the chemoprophylaxis may not be translated clinically [12]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] WP Mikomangwa, 2020, Effect of sulfadoxine-pyrimethamine doses for prevention of malaria during pregnancy in hypoendemic area in Tanzania, Malar J source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    Reductions in birthweight in first pregnancies are possibly due to lack of pregnancy-specific immunity, or the lower general risk of LBW associated with increased gravidity.

    “possibly due to their lack of pregnancy-specific immunity, or the lower general risk of LBW associated with increased gravidity.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    It is possible that the study was not powered to determine the effect of increasing dose on peripheral parasitaemia.

    “it is possible that our study was not powered to determine the effect of increasing dose on peripheral parasitaemia”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    Anti-malarial treatments taken to manage infection cleared most infections or reduced parasite densities, limiting deleterious downstream effects.

    “suggests the anti-malarial treatments taken to manage infection, cleared most infections or reduced parasite densities, limiting deleterious downstream effects [29].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [29] HW Unger, 2019, Microscopic and submicroscopic Plasmodium falciparum infection, maternal anaemia and adverse pregnancy outcomes in Papua New Guinea: a cohort study, Malar J source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given

    Malaria remains a significant public health concern, even in low transmission season.

    “Malaria still remains a significant public health concern, even in low transmission season”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The relationship between submicroscopic P. falciparum and pregnancy outcomes remains contentious.

    “The relationship between submicroscopic P. falciparum and pregnancy outcomes remains contentious”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [50] RM Chico, 2015, Global Call to Action: maximize the public health impact of intermittent preventive treatment of malaria in pregnancy in sub-Saharan Africa, Malar J source

      Not checked in the free run.

    • cites [51] U Fiedler, 2006, Angiopoietins: a link between angiogenesis and inflammation, Trends Immunol source

      Not checked in the free run.

64 of 64

  • The paper relies on this without support.

    Information on the effectiveness of intervention strategies in limiting disease morbidity and/or mortality in some endemic settings remains limited.

    “Although the consequences of malaria in pregnancy (MiP) on the mother and her progeny are known, information on the effectiveness of intervention strategies in limiting the disease morbidity and/or mortality in some endemic settings remain limited.”

  • The paper relies on this without support.

    Currently no data exist on the prevalence of submicroscopic infection and any perinatal/prenatal risk factors in the context of IPTp-SP in the study area.

    “Nonetheless, all assessments of malaria parasite infection, relevant for the management of the disease, accrue mainly to light microscopy, with currently no data on the prevalence of submicroscopic infection and any perinatal/prenatal risk factors in the context of IPTp-SP.”

  • The paper relies on this without support.

    Mutengene is representative of a rapidly growing semi-urban area where more than 50% of Cameroonians live.

    “The present study is undertaken in a multi-ethnic and urban town, Mutengene, which is representative of a rapidly growing semi-urban area where more than 50% of Cameroonians live.”

  • The paper relies on this without support.

    Results obtained in this study will be reflective of similar locations in the same ecosystem.

    “Results obtained here will be reflective of similar locations in the same ecosystem.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In areas of high seasonal malaria transmission, seasonal malaria chemoprevention with a combination of mefloquine, or amodiaquine and SP is being used as a strategy to reduce the incidence of malaria in pregnancy.

    “To support this, in areas of high seasonal malaria transmission, seasonal malaria chemoprevention with a combination of mefloquine, or amodiaquine and SP is being used as a strategy to reduce the incidence of malaria in pregnancy [206, 211–213].”

    From Current update on malaria in pregnancy: a systematic review (2025) · cites this paper as [212]

    The Introduction (page unavailable) describes IPTp-SP as a preventive strategy for malaria in pregnancy in moderate- to high-transmission areas, and the Discussion reports protection against submicroscopic infection in the study population. It does not describe seasonal chemoprevention combining mefloquine or amodiaquine with SP, or establish reduced malaria incidence from those regimens in high seasonal-transmission areas. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Submicroscopic cases with fever history exceed all women reporting that history

    Minor

    Table 3 lists 63 submicroscopic cases in the history-of-fever "Yes" group, whereas Table 2 records only 16 women with a history of fever.

  • Birthweight comparison P values differ between text and table note

    Minor

    For the same primigravidae-versus-secundigravidae and primigravidae-versus-multigravidae comparisons, the results give P values of 0.001 and 0.003, while the Table 4 note gives 0.008 and 0.005.

  • Reported mean APGAR score conflicts with the table

    Minor

    The results report a mean APGAR score of 9.8 for 187 neonates, whereas Table 2 reports 8.5 for 219. Even if the samples differ, the remaining 32 scores could not lower the overall mean to 8.5 given the table's minimum score of 5.0.

  • Parity counts exceed the stated total

    Minor

    The three parity categories contain 377 women, but the table gives 296 as the total. The reported count of 249 also cannot represent 59.1% of 296.

    Reported 296 · recomputed 377

  • Table 3 implies more bednet non-users than Table 2 permits

    Minor

    The Table 3 percentage and count imply about 174 bednet non-users in that analysis. Table 2 records 195 users among 298 women, leaving at most 103 non-users in the baseline group.

5 of 5

Cites

Flagged first, then by citations

Research works printed but not linked: 3

  1. World Health Organization, 2016, Malaria microscopy quality assurance manual. Version 2
  2. JF Mosha, 2013, Epidemiology of subpatent Plasmodium falciparum infection: implications for detection of hotspots with imperfect diagnostics, Malar J, 12, 221, 10.1186/1475-2875-12-221 · DOI · Paper page
  3. A Mayor, 2012, How hidden can malaria be in pregnant women? Diagnosis by microscopy, placental histology, polymerase chain reaction and detection of histidine-rich protein 2 in plasma, Clin Infect Dis Off Publ Infect Dis Soc Am, 54, 1561, 10.1093/cid/cis236 · DOI · Paper page

Cited by

Sorted by citations

Related

Authors
Apinjoh, T. O., Ntui, V. N., Chi, H. F., Moyeh, M. N., Toussi, C. T., Mayaba, J. M., Tangi, L. N., Kwi, P. N., Anchang-Kimbi, J. K., Dionne-Odom, J., Tita, A. T. N., Achidi, E. A., Amambua-Ngwa, A., & Titanji, V. P. K.
Affiliations
  • University of Buea (CM)
  • University of Alabama at Birmingham (US)
Corresponding author
Apinjoh, Tobias O.
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2022-09-30
Volume
17
Issue
9
Pages
e0275370
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0275370
PMC
PMC9524640
OpenAlex
W4298087140
Semantic Scholar
f45914560e52492ece01c55cd23c4b4a9081ad12
Cited by
13
References
46
Citations by year
2025: 6 · 2024: 7
FWCI
2.87
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, public-domain)
  • PubMed Central (publishedVersion, public-domain)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • H3Africa (H3AFull/17/008)
  • DELTAS Africa (107740/Z/15/Z)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
  • Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
  • Life Sciences › Immunology and Microbiology › Parasitology › Bird parasitology and diseases
Keywords
intermittent preventive treatment in pregnancy, sulfadoxine-pyrimethamine, Plasmodium falciparum, malaria in pregnancy, dry season, primigravida, malaria parasite density, birth weight, Apgar score
MeSH terms
Antimalarials, Birth Weight, Cameroon, Drug Combinations, Female, Humans, Infant, Newborn, Insecticides, Longitudinal Studies, Malaria, Plasmodium falciparum, Pregnancy, Pregnancy Outcome, Pyrimethamine, Seasons, Sulfadoxine, Malaria, Falciparum, Parasitemia, Pregnant Women, Pregnant People

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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