Intermittent preventive treatment during pregnancy with sulphadoxine-pyrimethamine may promote plasmodium falciparum gametocytogenesis

Abstract

Objectives: To determine the incidence of gametocytes and the propensity of sulphadoxine-pyrimethamine to promote gametocytogenesis when used as intermittent preventive treatment in pregnancy. Subjects and Methods: This observational non-interventional study assessed the influence of intermittent preventive treatment with sulphadoxine-pyrimethamine on Plasmodium falciparum gametocytaemia among Nigerian pregnant women. A total of 306 pregnant women were enrolled in the study. Results: The 306 pregnant women had 711 events, of which 31 pure gametocytaemic episodes were documented and 27 were recorded among the intermittent preventive treatment users. Only 4 episodes of pure gametocytaemia were recorded in pregnant women who did not receive any dose of sulphadoxine-pyrimethamine (27/129 vs. 4/276, χ 2 = 15.9, p = 0.00006). Conclusion: Our findings show that intermittent preventive treatment in pregnancy with sulphadoxine-pyrimethamine may predispose to gametocyte carriage in pregnant women resident in the hyperendemic malaria region of southwest Nigeria. We therefore suggest that the use of insecticide-treated nets be encouraged among pregnant women resident in malaria-endemic sub-Saharan Africa in order to reduce malaria transmission. Copyright © 2011 S. Karger AG, Basel.