Imperial College London
Alternate

DrLucyOkell

Faculty of Medicine, School of Public Health

Senior Lecturer & Royal Society Dorothy Hodgkin Fellow
 
 
 
//

Contact

 

l.okell Website

 
 
//

Location

 

410School of Public HealthWhite City Campus

//

Summary

 

Publications

Citation

BibTex format

@article{van:2019:10.1016/S1473-3099(18)30732-1,
author = {van, Eijk AM and Larsen, DA and Kayentao, K and Koshy, G and Slaughter, DEC and Roper, C and Okell, LC and Desai, M and Gutman, J and Khairallah, C and Rogerson, SJ and Hopkins, Sibley C and Meshnick, SR and Taylor, SM and Ter, Kuile FO},
doi = {10.1016/S1473-3099(18)30732-1},
journal = {Lancet Infectious Diseases},
pages = {546--556},
title = {Effect of Plasmodium falciparum sulfadoxine-pyrimethamine resistance on the effectiveness of intermittent preventive therapy for malaria in pregnancy in Africa: a systematic review and meta-analysis.},
url = {http://dx.doi.org/10.1016/S1473-3099(18)30732-1},
volume = {19},
year = {2019}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Resistance of Plasmodium falciparum to sulfadoxine-pyrimethamine threatens the antimalarial effectiveness of intermittent preventive treatment during pregnancy (IPTp) in sub-Saharan Africa. We aimed to assess the associations between markers of sulfadoxine-pyrimethamine resistance in P falciparum and the effectiveness of sulfadoxine-pyrimethamine IPTp for malaria-associated outcomes. METHODS: For this systematic review and meta-analysis, we searched databases (from Jan 1, 1990 to March 1, 2018) for clinical studies (aggregated data) or surveys (individual participant data) that reported data on low birthweight (primary outcome) and malaria by sulfadoxine-pyrimethamine IPTp dose, and for studies that reported on molecular markers of sulfadoxine-pyrimethamine resistance. Studies that involved only HIV-infected women or combined interventions were excluded. We did a random-effects meta-analysis (clinical studies) or multivariate log-binomial regression (surveys) to obtain summarised dose-response data (relative risk reduction [RRR]) and multivariate meta-regression to explore the modifying effects of sulfadoxine-pyrimethamine resistance (as indicated by Ala437Gly, Lys540Glu, and Ala581Gly substitutions in the dhps gene). This study is registered with PROSPERO, number 42016035540. FINDINGS: Of 1097 records screened, 57 studies were included in the aggregated-data meta-analysis (including 59457 births). The RRR for low birthweight declined with increasing prevalence of dhps Lys540Glu (ptrend=0·0060) but not Ala437Gly (ptrend=0·35). The RRR was 7% (95% CI 0 to 13) in areas of high resistance to sulfadoxine-pyrimethamine (Lys540Glu ≥90% in east and southern Africa; n=11), 21% (14 to 29) in moderate-resistance areas (Ala437Gly ≥90% [central and west Africa], or Lys540Glu ≥30% to <90% [east and southern Africa]; n=16), and 27% (21 to 33) in low-resistance areas (Ala437Gly <90% [central and west Africa], or Lys540Glu <30% [east and
AU  - van,Eijk AM
AU  - Larsen,DA
AU  - Kayentao,K
AU  - Koshy,G
AU  - Slaughter,DEC
AU  - Roper,C
AU  - Okell,LC
AU  - Desai,M
AU  - Gutman,J
AU  - Khairallah,C
AU  - Rogerson,SJ
AU  - Hopkins,Sibley C
AU  - Meshnick,SR
AU  - Taylor,SM
AU  - Ter,Kuile FO
DO  - 10.1016/S1473-3099(18)30732-1
EP  - 556
PY  - 2019///
SN  - 1473-3099
SP  - 546
TI  - Effect of Plasmodium falciparum sulfadoxine-pyrimethamine resistance on the effectiveness of intermittent preventive therapy for malaria in pregnancy in Africa: a systematic review and meta-analysis.
T2  - Lancet Infectious Diseases
UR  - http://dx.doi.org/10.1016/S1473-3099(18)30732-1
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30922818
UR  - http://hdl.handle.net/10044/1/68685
VL  - 19
ER  -
Download