LSTM Home > LSTM Research > LSTM Online Archive

Effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine: An in silico pharmacological model

Htay, Mila, Hastings, Ian ORCID: https://orcid.org/0000-0002-1332-742X, Hodel, EvaMaria ORCID: https://orcid.org/0000-0001-5821-1685 and Kay, Katherine (2020) 'Effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine: An in silico pharmacological model'. Asian Pacific journal of tropical medicine, Vol 13, Issue 8, pp. 366-374.

[img]
Preview
Text
Htay at al 2020.pdf - Published Version
Available under License Creative Commons Attribution Non-commercial Share Alike.

Download (1MB) | Preview

Abstract

Objective:
To explore the efficacy of intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine and pyrimethamine (SP) against sensitive parasites.
Methods:
A pharmacological model was used to investigate the effectiveness of the previous recommended at least two-dose regimen, currently recommended three-dose regimen and 4, 6, 8-weekly regimens with specific focus on the impact of various nonadherence patterns in multiple transmission settings.
Results:
The effectiveness of the recommended three-dose regimen is high in all the transmission intensities, i.e. >99%, 98% and 92% in low, moderate and high transmission intensities respectively. The simulated 4 and 6 weekly IPTp-SP regimens were able to prevent new infections with sensitive parasites in almost all women (>99%) regardless of transmission intensity. However, 8 weekly interval dose schedules were found to have 71% and 86% protective efficacies in high and moderate transmission areas, respectively. It highlights that patients are particularly vulnerable to acquiring new infections if IPTp-SP doses are missed.
Conclusions:
The pharmacological model predicts that full adherence to the currently recommended three-dose regimen should provide almost complete protection from malaria infection in moderate and high transmission regions. However, it also highlights that patients are particularly vulnerable to acquiring new infections if IPTp doses are spaced too widely or if doses are missed. Adherence to the recommended IPTp-SP schedules is recommended.

Item Type: Article
Subjects: QX Parasitology > QX 20 Research (General)
QX Parasitology > QX 4 General works
WA Public Health > Preventive Medicine > WA 240 Disinfection. Disinfestation. Pesticides (including diseases caused by)
Faculty: Department: Biological Sciences > Department of Tropical Disease Biology
Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.4103/1995-7645.289441
Depositing User: Cathy Waldron
Date Deposited: 17 Aug 2020 11:53
Last Modified: 17 Aug 2020 11:53
URI: https://archive.lstmed.ac.uk/id/eprint/15315

Statistics

View details

Actions (login required)

Edit Item Edit Item