Malaria preventive therapy in pregnancy and its potential impact on immunity to malaria in an area of declining transmission.

Abstract

BACKGROUND:

Regular anti-malarial therapy in pregnancy, a pillar of malaria control, may affect malaria immunity, with therapeutic implications in regions of reducing transmission.

METHODS:

Plasma antibodies to leading vaccine candidate merozoite antigens and opsonizing antibodies to endothelial-binding and placental-binding infected erythrocytes were quantified in pregnant Melanesian women receiving sulfadoxine-pyrimethamine (SP) with chloroquine taken once, or three courses of SP with azithromycin.

RESULTS:

Malaria prevalence was low. Between enrolment and delivery, antibodies to recombinant antigens declined in both groups (p<0.0001). In contrast, median levels of opsonizing antibodies did not change, although levels for some individuals changed significantly. In multivariate analysis, the malaria prevention regimen did not influence antibody levels.

CONCLUSION:

Different preventive anti-malarial chemotherapy regimens used during pregnancy had limited impact on malarial-immunity in a low-transmission region of Papua New Guinea.

TRIAL REGISTRATIONS:

NCT01136850.

• Authors: Andrew Teo, Wina Hasang, Louise M Randall, Holger W Unger, Peter M Siba, Ivo Mueller, Graham V Brown, Stephen J Rogerson
• Journal: Malaria journal (Malar J) Vol. 14 Pg. 215 (May 26 2015) ISSN: 1475-2875 [Electronic] England
• PMID: 26006260 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Protozoan
• Antimalarials
• Drug Combinations
• fanasil, pyrimethamine drug combination
• Azithromycin
• Sulfadoxine
• Chloroquine
• Pyrimethamine

Topics

• Adult
• Antibodies, Protozoan (blood)
• Antimalarials (administration & dosage, adverse effects)
• Azithromycin (administration & dosage, adverse effects)
• Chloroquine (administration & dosage, adverse effects)
• Drug Combinations
• Erythrocytes
• Female
• Humans
• Malaria, Falciparum (prevention & control)
• Papua New Guinea
• Pregnancy
• Pregnancy Complications, Parasitic (chemically induced, immunology)
• Pyrimethamine (administration & dosage, adverse effects)
• Sulfadoxine (administration & dosage, adverse effects)
• Young Adult