Lack of inhibition of the anti-malarial action of sulfadoxine-pyrimethamine by folic Acid supplementation when used for intermittent preventive treatment in gambian primigravidae.


Mbaye, A; Richardson, K; Balajo, B; Dunyo, S; Shulman, C; Milligan, P; Greenwood, B; Walraven, G; (2006) Lack of inhibition of the anti-malarial action of sulfadoxine-pyrimethamine by folic Acid supplementation when used for intermittent preventive treatment in gambian primigravidae. The American journal of tropical medicine and hygiene, 74 (6). pp. 960-4. ISSN 0002-9637

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Abstract

: Folic acid is frequently given to pregnant women at the same time as intermittent preventive treatment (IPTp) with sulfadoxine/pyrimethamine (SP), but it is not known if it interferes with the anti-malarial activity of SP. To investigate this concern, 1,035 Gambian primigravidae were randomized to receive either folic acid (500-1,500 microg/day) together with oral iron (522) or oral iron alone (513) for 14 days at the same time as they received IPTp with SP. On presentation, 261 women (25%) had Plasmodium falciparum asexual parasitemia. Prevalences of parasitemia on day 14 after treatment were similar in both groups: 5.7% (26 of 458) in the iron plus folic acid group and 4.9% (22 of 446) in the iron alone group (risk difference = 0.74%, 95% confidence interval [CI] = -2.2% to 3.7%). Parasitologic cure was observed in 116 (91%) of 128 of women who were parasitemic on presentation and who received iron and folic acid and in 122 (92%) of 133 women who received iron alone (difference = 1.1%, 95% CI = -5.6% to 8.0%). Women who received folic acid and iron had a slightly higher mean hemoglobin concentration at day 14 than women who had received iron alone (difference = 0.14 g/dL, 95% CI = 0.01-0.27 g/dL). The results of this study suggest that in an area of low SP resistance, administration of folic acid to pregnant women in a dose of 500-1,500 mug/day will not interfere with the protective effect of SP when used for IPTp.<br/>

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Research Centre: Malaria Centre
Tropical Epidemiology Group
PubMed ID: 16760504
Web of Science ID: 238200900007
URI: http://researchonline.lshtm.ac.uk/id/eprint/11815

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