Project Details

A novel prenatal malaria intervention to prevent malaria and ill-health in infancy (SAPOT-I)

Holger Unger, MBChB, DTM&H, MSc, PhD

Summary

BACKGROUND: Malarial and non-malarial febrile illness drives ill-health and death in young children in many low-resource settings. Maternal malaria infection has been associated with malarial and non-malarial febrile illness in early childhood, and enhanced malaria control during pregnancy appears to substantially reduce adverse health events in infancy. GAP: There is a paucity of tools to protect infants from malarial and non-malarial febrile illness. Combining the substantial non-malarial benefits of sulfadoxine-pyrimethamine (SP) with superior antimalarial efficacy of dihydroartemisinin-piperaquine (DP) for intermittent preventive treatment in pregnancy (IPTp) may not only reduce adverse pregnancy outcomes but also translate into substantial gains for child health. HYPOTHESIS: Enhanced prevention of malaria in pregnancy through IPT with SP combined with DP reduces the risk of adverse child health outcomes during the first year of life in Papua New Guinea, compared the current standard of care (IPTp-SP). METHODS: Infants of mothers randomized to IPTp with SP or SP plus DP will be closely observed during the first year of life to document episodes of febrile illness and assess the burdens of malaria parasitemia, anemia and growth faltering. Clinical studies will be complemented by studies of malaria immunology. RESULTS: Pending. IMPACT: The proposed research will generate unique and high-quality data to inform regional and global WHO policy for malaria control. IPTp with the combination of SP plus DP can be rapidly implemented and scaled up as the delivery system already exists in PNG and Africa and thus has significant potential to reduce child and maternal mortality by 2030 (Sustainable Development Goal 3). Website Link: https: //www.menzies.edu.au/page/Research/Projects/Malaria/SAPOT_Clinical_Trial_Treatment_in_pregnancy_to_prevent_malaria/