Abstract | BACKGROUND: METHODS: RESULTS: The prevalence of histopathologically confirmed placental malaria was significantly higher in the sulfadoxine-pyrimethamine group (50.0%) than in the three-dose dihydroartemisinin- piperaquine group (34.1%, P=0.03) or the monthly dihydroartemisinin- piperaquine group (27.1%, P=0.001). The prevalence of a composite adverse birth outcome was lower in the monthly dihydroartemisinin- piperaquine group (9.2%) than in the sulfadoxine-pyrimethamine group (18.6%, P=0.05) or the three-dose dihydroartemisinin- piperaquine group (21.3%, P=0.02). During pregnancy, the incidence of symptomatic malaria was significantly higher in the sulfadoxine-pyrimethamine group (41 episodes over 43.0 person-years at risk) than in the three-dose dihydroartemisinin- piperaquine group (12 episodes over 38.2 person-years at risk, P=0.001) or the monthly dihydroartemisinin- piperaquine group (0 episodes over 42.3 person-years at risk, P<0.001), as was the prevalence of parasitemia (40.5% in the sulfadoxine-pyrimethamine group vs. 16.6% in the three-dose dihydroartemisinin- piperaquine group [P<0.001] and 5.2% in the monthly dihydroartemisinin- piperaquine group [P<0.001]). In each treatment group, the risk of vomiting after administration of any dose of the study agents was less than 0.4%, and there were no significant differences among the groups in the risk of adverse events. CONCLUSIONS:
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Authors | Abel Kakuru, Prasanna Jagannathan, Mary K Muhindo, Paul Natureeba, Patricia Awori, Miriam Nakalembe, Bishop Opira, Peter Olwoch, John Ategeka, Patience Nayebare, Tamara D Clark, Margaret E Feeney, Edwin D Charlebois, Gabrielle Rizzuto, Atis Muehlenbachs, Diane V Havlir, Moses R Kamya, Grant Dorsey |
Journal | The New England journal of medicine
(N Engl J Med)
Vol. 374
Issue 10
Pg. 928-39
(Mar 10 2016)
ISSN: 1533-4406 [Electronic] United States |
PMID | 26962728
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
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Chemical References |
- Antimalarials
- Artemisinins
- Drug Combinations
- Quinolines
- fanasil, pyrimethamine drug combination
- artenimol
- Sulfadoxine
- piperaquine
- Pyrimethamine
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Topics |
- Adolescent
- Adult
- Antimalarials
(adverse effects, therapeutic use)
- Artemisinins
(administration & dosage, adverse effects)
- Double-Blind Method
- Drug Administration Schedule
- Drug Combinations
- Drug Resistance
- Female
- Humans
- Incidence
- Malaria
(epidemiology, prevention & control)
- Parasitemia
(epidemiology)
- Pregnancy
- Pregnancy Complications, Parasitic
(prevention & control)
- Pregnancy Outcome
- Pyrimethamine
(adverse effects, therapeutic use)
- Quinolines
(administration & dosage, adverse effects)
- Sulfadoxine
(adverse effects, therapeutic use)
- Uganda
- Vomiting
(chemically induced)
- Young Adult
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