scholarly journals Infant sex modifies associations between placental malaria and risk of malaria in infancy

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Abel Kakuru ◽  
Michelle E. Roh ◽  
Richard Kajubi ◽  
Teddy Ochieng ◽  
John Ategeka ◽  
...  
Keyword(s):  
Malaria Incidence ◽  
Placental Malaria ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Adverse Outcomes ◽  
Adjusted Incidence Rate ◽  
Causal Mediation Analysis ◽  
Infant Sex ◽  
Adjusted Incidence

Abstract Background Placental malaria (PM) has been associated with a higher risk of malaria during infancy. However, it is unclear whether this association is causal, and is modified by infant sex, and whether intermittent preventive treatment in pregnancy (IPTp) can reduce infant malaria by preventing PM. Methods Data from a birth cohort of 656 infants born to HIV-uninfected mothers randomised to IPTp with dihydroartemisinin–piperaquine (DP) or Sulfadoxine–pyrimethamine (SP) was analysed. PM was categorized as no PM, active PM (presence of parasites), mild-moderate past PM (> 0–20% high powered fields [HPFs] with pigment), or severe past PM (> 20% HPFs with pigment). The association between PM and incidence of malaria in infants stratified by infant sex was examined. Causal mediation analysis was used to test whether IPTp can impact infant malaria incidence via preventing PM. Results There were 1088 malaria episodes diagnosed among infants during 596.6 person years of follow-up. Compared to infants born to mothers with no PM, the incidence of malaria was higher among infants born to mothers with active PM (adjusted incidence rate ratio [aIRR] 1.30, 95% CI 1.00–1.71, p = 0.05) and those born to mothers with severe past PM (aIRR 1.28, 95% CI 0.89–1.83, p = 0.18), but the differences were not statistically significant. However, when stratifying by infant sex, compared to no PM, severe past PM was associated a higher malaria incidence in male (aIRR 2.17, 95% CI 1.45–3.25, p < 0.001), but not female infants (aIRR 0.74, 95% CI 0.46–1.20, p = 0.22). There were no significant associations between active PM or mild-moderate past PM and malaria incidence in male or female infants. Male infants born to mothers given IPTp with DP had significantly less malaria in infancy than males born to mothers given SP, and 89.7% of this effect was mediated through prevention of PM. Conclusion PM may have more severe consequences for male infants, and interventions which reduce PM could mitigate these sex-specific adverse outcomes. More research is needed to better understand this sex-bias between PM and infant malaria risk. Trial registration ClinicalTrials.gov, NCT02793622. Registered 8 June 2016, https://clinicaltrials.gov/ct2/show/NCT02793622

scholarly journals Infant sex modifies associations between placental malaria and risk of malaria in infancy

2020 ◽  
Author(s):  
Abel Kakuru ◽  
Michelle E. Roh ◽  
Richard Kajubi ◽  
Teddy Ochieng ◽  
John Ategeka ◽  
...  
Keyword(s):  
Malaria Incidence ◽  
Placental Malaria ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Adverse Outcomes ◽  
Adjusted Incidence Rate ◽  
Causal Mediation Analysis ◽  
Infant Sex ◽  
Adjusted Incidence

Abstract Background Placental malaria (PM) has been associated with a higher risk of malaria during infancy. However, it is unclear whether this association is causal, and is modified by infant sex, and whether intermittent preventive treatment in pregnancy (IPTp) can reduce infant malaria by preventing PM. Methods Data from a birth cohort of 656 infants born to HIV-uninfected mothers randomised to IPTp with dihydroartemisinin-piperaquine (DP) or sulfadoxine-pyrimethamine (SP) was analysed. PM was categorized as no PM, active PM (presence of parasites), mild-moderate past PM (>0-20% high powered fields [HPFs] with pigment), or severe past PM (>20% HPFs with pigment). The association between PM and incidence of malaria in infants stratified by infant sex was examined. Causal mediation analysis was used to test whether IPTp can impact infant malaria incidence via preventing PM. Results There were 1088 malaria episodes diagnosed among infants during 596.6 person years of follow-up. Compared to infants born to mothers with no PM, the incidence of malaria was higher among infants born to mothers with active PM (adjusted incidence rate ratio [aIRR] 1.30, 95% CI 1.00-1.71, p=0.05) and those born to mothers with severe past PM (aIRR 1.28, 95% CI 0.89-1.83, p=0.18), but the differences were not statistically significant. However, when stratifying by infant sex, compared to no PM, severe past PM was associated a higher malaria incidence in male (aIRR 2.17, 95% CI 1.45-3.25, p<0.001), but not female infants (aIRR 0.74, 95% CI 0.46-1.20, p=0.22). There were no significant associations between active PM or mild-moderate past PM and malaria incidence in male or female infants. Male infants born to mothers given IPTp with DP had significantly less malaria in infancy than males born to mothers given SP, and 89.7% of this effect was mediated through prevention of PM. Conclusion PM may have more severe consequences for male infants, and interventions which reduce PM could mitigate these sex-specific adverse outcomes. More research is needed to better understand this sex-bias between PM and infant malaria risk. Trial registration: ClinicalTrials.gov, NCT02793622. Registered 8 June 2016, https://clinicaltrials.gov/ct2/show/NCT02793622

scholarly journals Infant sex modifies associations between placental malaria and risk of malaria in infancy

2020 ◽  
Author(s):  
Abel Kakuru ◽  
Michelle E. Roh ◽  
Richard Kajubi ◽  
Teddy Ochieng ◽  
John Ategeka ◽  
...  
Keyword(s):  
Malaria Incidence ◽  
Placental Malaria ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Adverse Outcomes ◽  
Trial Registration ◽  
Adjusted Incidence Rate ◽  
Infant Sex ◽  
Adjusted Incidence

Abstract BackgroundPlacental malaria (PM) has been associated with a higher risk of malaria during infancy. However, it is unclear whether this association is causal, and is modified by infant sex, and whether intermittent preventive treatment in pregnancy (IPTp) can reduce infant malaria by preventing PM. MethodsData from a birth cohort of 656 infants born to HIV-uninfected mothers randomized to IPTp with dihydroartemisinin-piperaquine (DP) or sulfadoxine-pyrimethamine (SP) was analyzed. PM was categorized as no PM, active PM (presence of parasites), mild-moderate past PM (>0-20% high powered fields [HPFs] with pigment), or severe past PM (>20% HPFs with pigment). The association between PM and incidence of malaria in infants stratified by infant sex was examined. Causal mediation analysis was used to test whether IPTp can impact infant malaria incidence via preventing PM. ResultsThere were 1088 malaria episodes diagnosed among infants during 596.6 person years of follow-up. Compared to infants born to mothers with no PM, the incidence of malaria was higher among infants born to mothers with active PM (adjusted incidence rate ratio [aIRR] 1.30, 95% CI 1.00-1.71, p=0.05) and those born to mothers with severe past PM (aIRR 1.28, 95% CI 0.89-1.83, p=0.18), but the differences were not statistically significant. However, when stratifying by infant sex, compared to no PM, severe past PM was associated a higher malaria incidence in male (aIRR 2.17, 95% CI 1.45-3.25, p<0.001), but not female infants (aIRR 0.74, 95% CI 0.46-1.20, p=0.22). There were no significant associations between active PM or mild-moderate past PM and malaria incidence in male or female infants. Male infants born to mothers given IPTp with DP had significantly less malaria in infancy than males born to mothers given SP, and 89.7% of this effect was mediated through prevention of PM.ConclusionPM may have more severe consequences for male infants, and interventions which reduce PM could mitigate these sex-specific adverse outcomes. More research is needed to better understand this sex-bias between PM and infant malaria risk.Trial registrationTrial registration: ClinicalTrials.gov, NCT02793622. Registered 8 June 2016, https://clinicaltrials.gov/ct2/show/NCT02793622

scholarly journals Infant Sex Modifies Associations Between Placental Malaria and Risk of Malaria in Infancy

2020 ◽  
Author(s):  
Abel kakuru ◽  
Michelle E. Roh ◽  
Richard Kajubi ◽  
Teddy Ochieng ◽  
John Ategeka ◽  
...  
Keyword(s):  
Malaria Incidence ◽  
Placental Malaria ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Adverse Outcomes ◽  
Trial Registration ◽  
Adjusted Incidence Rate ◽  
Infant Sex ◽  
Adjusted Incidence

Abstract Background Placental malaria (PM) has been associated with a higher risk of malaria during infancy. However, it is unclear whether this association is causal, and is modified by infant sex, and whether intermittent preventive treatment in pregnancy (IPTp) can reduce infant malaria by preventing PM.MethodsData from a birth cohort of 656 infants born to HIV-uninfected mothers randomized to IPTp with dihydroartemisinin-piperaquine (DP) or sulfadoxine-pyrimethamine (SP) was analyzed. PM was categorized as no PM, active PM (presence of parasites), mild-moderate past PM (>0-20% high powered fields [HPFs] with pigment), or severe past PM (>20% HPFs with pigment). The association between PM and incidence of malaria in infants stratified by infant sex was examined. Causal mediation analysis was used to test whether IPTp can impact infant malaria incidence via preventing PM. ResultsThere were 1088 malaria episodes diagnosed among infants during 596.6 person years of follow-up. Compared to infants born to mothers with no PM, the incidence of malaria was higher among infants born to mothers with active PM (adjusted incidence rate ratio [aIRR] 1.30, 95% CI 1.00-1.71, p=0.05) and those born to mothers with severe past PM (aIRR 1.28, 95% CI 0.89-1.83, p=0.18), but the differences were not statistically significant. However, when stratifying by infant sex, compared to no PM, severe past PM was associated a higher malaria incidence in male (aIRR 2.17, 95% CI 1.45-3.25, p<0.001), but not female infants (aIRR 0.74, 95% CI 0.46-1.20, p=0.22). There were no significant associations between active PM or mild-moderate past PM and malaria incidence in male or female infants. Male infants born to mothers given IPTp with DP had significantly less malaria in infancy than males born to mothers given SP, and 89.7% of this effect was mediated through prevention of PM.ConclusionPM may have more severe consequences for male infants, and interventions which reduce PM could mitigate these sex-specific adverse outcomes. More research is needed to better understand this sex-bias between PM and infant malaria risk.Trial registrationTrial registration: ClinicalTrials.gov, NCT02793622. Registered 8 June 2016, https://clinicaltrials.gov/ct2/show/NCT02793622

Emotional states and future risk of venous thromboembolism

2012 ◽  
Vol 107 (03) ◽  
pp. 485-493 ◽  
Author(s):  
Sigrid K. Brækkan ◽  
Ida J. Hansen-Krone ◽  
John-Bjarne Hansen ◽  
Kristin F. Enga
Keyword(s):  
Venous Thromboembolism ◽  
Incidence Rate ◽  
Population Based ◽  
Emotional States ◽  
Depressive Feelings ◽  
Increased Risk ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence ◽  
Reduced Risk

SummaryEmotional states of depression and loneliness are reported to be associated with higher risk and optimism with lower risk of arterial cardiovascular disease (CVD) and death. The relation between emotional states and risk of venous thromboembolism (VTE) has not been explored previously. We aimed to investigate the associations between self-reported emotional states and risk of incident VTE in a population-based, prospective study. The frequency of feeling depressed, lonely and happy/optimistic were registered by self-administered questionnaires, along with major co-morbidities and lifestyle habits, in 25,964 subjects aged 25–96 years, enrolled in the Tromsø Study in 1994–1995. Incident VTE-events were registered from the date of inclusion until September 1, 2007. There were 440 incident VTE-events during a median of 12.4 years of follow-up. Subjects who often felt depressed had 1.6-fold (95% CI:1.02–2.50) higher risk of VTE compared to those not depressed in analyses adjusted for other risk factors (age, sex , body mass index, oes-trogens), lifestyle (smoking, alcohol consumption, educational level) and co-morbidities (diabetes, CVD, and cancer). Often feeling lonely was not associated with VTE. However, the incidence rate of VTE in subjects who concurrently felt often lonely and depressed was higher than for depression alone (age-and sex-adjusted incidence rate: 3.27 vs. 2.21). Oppositely, subjects who often felt happy/optimistic had 40% reduced risk of VTE (HR 0.60, 95% CI: 0.41–0.87). Our findings suggest that self-reported emotional states are associated with risk of VTE. Depressive feelings were associated with increased risk, while happiness/ optimism was associated with reduced risk of VTE.

scholarly journals Epidemiology of New Onset Seizures and Epilepsy Cases: A Prospective Cohort Study

2020 ◽  
Vol 06 (01) ◽  
pp. 30-38
Author(s):  
Deepak Goel ◽  
Pradeep Aggarwal ◽  
Sunil Dutt Kandpal ◽  
Rakesh Kakkar ◽  
Deepak Negi ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Significant Risk ◽  
Developed Countries ◽  
Annual Incidence ◽  
Time Interval ◽  
Incidence Studies ◽  
Adjusted Incidence Rate ◽  
Adjusted Incidence ◽  
New Onset

Abstract Introduction Incidence is the number of new epilepsy cases occurring during a given time interval, usually in 1 year, in a specified population. Most incidence studies of epilepsy are from developed countries with a rate of 40 to 70 per 100,000 population. Aims We conducted this survey to study incidence of all new onset unprovoked in rural and semiurban areas of the Uttarakhand State. This study is conducted on more than 100,000 of population with longitudinal follow-up of 3 years. Methods This was a community-based, longitudinal, observational study in two blocks of Dehradun district of Uttarakhand state. Total population of approximately 100,000 from two blocks will be surveyed (50,000 in each block). This door-to-door survey was conducted annually for 3 years duration from May 2014 to April 2017. The initial data were collected on National Institute of Mental Health and Neurosciences (NIMHANS) questionnaire by door-to-door survey. Results After longitudinal follow-up for 3 years of 103,610 of population in two blocks of Uttarakhand state, we found age-adjusted prevalence rate of unprovoked seizures to the tune of 623.63 cases per 100,000 of population. Age-adjusted incidence rate of epilepsy was 38.28 per 100,000 population and annual incidence of acute symptomatic seizures was 14.79 per 100,000 of population. Overall annual incidence rate of all afebrile seizures was 51.63 per of 100,000 people. Among all sociodemographic factors, age, poverty, diet, and hygiene were significantly associated with seizures. Conclusion Age-adjusted incidence rate of unprovoked seizure in Uttarakhand state was 38.28 per 100,000 people. Diet and hygiene were significant risk factors for seizures.

Hyperprolactinemia and the Association with All-Cause Mortality and Cardiovascular Mortality

2017 ◽  
Vol 49 (06) ◽  
pp. 411-417 ◽  
Author(s):  
Jesper Krogh ◽  
Christian Selmer ◽  
Christian Torp-Pedersen ◽  
Gunnar Gislason ◽  
Caroline Kistorp
Keyword(s):  
Antipsychotic Medication ◽  
Cardiovascular Mortality ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
University Hospitals ◽  
All Cause Mortality ◽  
Adjusted Incidence Rate ◽  
Male Patients ◽  
Adjusted Incidence

AbstractHyperprolactinemia has been suspected to increase mortality risk, but the available data are conflicting. The objective of this study was to estimate the association between hyperprolactinemia and all-cause and cardiovascular mortality among patients referred for assessment of prolactin. For this study, adults with no prio pituitary disease who underwent prolactin assessment at 3 university Hospitals in Denmark between 2001 and 2011 were included in a retrospective cohort study. A total of 3 633 patients with a median follow-up time of 5.3 years (IQR 2.7–5.7) were included. Mean (SD) age 39.7 (15.5) years and 78% female. 373/3 633 (10.3%) had hyperprolactinemia and during follow-up 330/3 633 (9.1%) patients died of any cause, and 113/3 633 (3.1%) patients died of cardiovascular causes. In males, hyperprolactinemia was associated with age-adjusted incidence rate ratio (IRR) of 1.86 for all-cause mortality (95% CI 1.22–2.82) and 2.55 (95% CI 1.43–4.55) for cardiovascular mortality. The IRR for all-cause mortality was reduced to 1.37 (0.90–2.08) when adjusted for the use of antipsychotic medication. The association between hyperprolactinemia and cardiovascular mortality remained after adjusting for confounders, for example, chronic renal failure, diabetes, and antipsychotic medication. In females, hyperprolactinemia was not associated with all-cause mortality (IRR 1.45; CI 0.86–2.47) or cardiovascular mortality (IRR 0.58; CI 0.14–2.39). In conclusion, hyperprolactinemia was associated with increased cardiovascular mortality in male patients. This association was not found in female patients. Focus on increased cardiovascular risk in males with hyperprolactinemia is warranted.

scholarly journals Monitoring Compliance and Acceptability of Intermittent Preventive Treatment of Malaria Using Sulfadoxine Pyrimethamine after Ten Years of Implementation in Tanzania

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Mdetele B. Ayubu ◽  
Winifrida B. Kidima
Keyword(s):  
Pregnant Women ◽  
Placental Malaria ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Antenatal Clinic ◽  
Drug Uptake ◽  
Cross Sectional ◽  
Start Date ◽  
Malaria During Pregnancy ◽  
Endemic Areas

Intermittent preventive treatment using SP (IPTp-SP) is still a superior interventional approach to control malaria during pregnancy. However its rate of use has gone down tremendously in malaria endemic areas. This study forms part of a larger study aimed at monitoring the compliance of IPTp-SP policy in malaria endemic areas of Tanzania. Two cross-sectional studies were conducted in Dar es Salaam and Njombe Regions of Tanzania. Overall, 540 pregnant women and 21 healthcare workers were interviewed using structured questionnaires. This study revealed that 63% of women were not willing to take SP during pregnancy while 91% would only take it if they tested positive for malaria during antennal visits. 63% of the interviewed women did not know the recommended dose of SP required during pregnancy, despite the fact that 82% of the women were aware of the adverse effect of malaria during pregnancy. It was found out that 54% of pregnant women (30–40 weeks) took single dose, 34% took two doses, and 16% did not take SP at the time of interview. It was also found that SP was not administered under direct observed therapy in 86% of women. There was no significant relationship between number of doses received by pregnant women and antenatal clinic (ANC) start date (r2 = 0.0033, 95% CI (−0.016 to 0.034)). However positive correlation between drug uptake and drug availability was revealed (p=0.0001). Knowledge on adverse effects of placental malaria among pregnant women was significantly associated with drug uptake (OR 11.81, 95% CI (5.755–24.23), p=0.0001). We conclude that unavailability of drugs in ANC is the major reason hindering the implementation of IPTp-SP.

scholarly journals Reaching the unreached: Effectiveness and Satisfaction with Community-Directed Distribution of Suphadoxine-Pyrimethamine for preventing Malaria in Pregnancy in rural South-East, Nigeria

2020 ◽  
Author(s):  
Ijeoma Nkem Okedo-Alex ◽  
Ifeyinwa Chizoba Akamike ◽  
Chihurumnanya Alo ◽  
Adaoha Pearl Agu ◽  
Chinyere Benedicta Nzeh ◽  
...  
Keyword(s):  
Rural Areas ◽  
Large Scale ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Malaria Prevention ◽  
Antenatal Clinic ◽  
Post Intervention ◽  
Birth Attendants ◽  
Itn Use

Abstract Background Innovative community strategies to increase Intermittent Preventive Treatment with Suphadoxine-Pyrimethamine (IPTp-SP) coverage is advocated particularly in rural areas, where health infrastructures are weakest and malaria transmission highest. This study was a proof-of-concept implementation research to determine satisfaction with and effectiveness of community-directed distribution of IPTp-SP on uptake among pregnant women in Ebonyi State, Nigeria.Methods This before-after study was carried out in 2019 in a rural community in Ebonyi State Nigeria. The intervention involved advocacy visits, community-wide sensitizations on malaria prevention, house to house directly observed IPTp-SP administration and follow-up visits by trained community-selected Community Directed Distributors (CDDs). Monthly coverage IPTp-SP coverage was assessed over five months using SPSS version 20.Results During the study, 229, 232, 217, 121 and 34 women received 1-5 IPT doses respectively. The uptake of ≥3 IPTp doses increased from 31.4% to 71.6% (P<0.001). Sleeping under Insecticide Treated Net (ITN) the night before the survey increased from 62.4% to 84.3% (P<0.001) while reporting of fever during pregnancy decreased from 64.9% to 17.0% (P<0.001). Although antenatal clinic utilization increased in the primary health center serving the community, traditional birth attendants and patent medicine vendors in the community remained more patronized. Post-intervention, most mothers rated CDD services well (93.6%), were satisfied (97.6%) and preferred community IPTp administration to facility administration (92.3%).Conclusions Community-directed distribution of IPTp-SP improved uptake of IPTp-SP and ITN use. Mothers were satisfied with the services. We recommend sustained large-scale implementation of community-directed distribution of IPTp with active community engagement.

scholarly journals Placental Malaria is Rare Among Zanzibari Pregnant Women who did not Receive Intermittent Preventive Treatment in Pregnancy

2014 ◽  
Vol 91 (2) ◽  
pp. 367-373 ◽  
Author(s):  
Marya Plotkin ◽  
Khadija Said ◽  
Mwinyi I. Msellem ◽  
Rachel P. Chase ◽  
Natalie Hendler ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Placental Malaria ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
In Pregnancy

scholarly journals Gestational malaria in Kisangani : Efficacy of Mefloquine vs Sulfadoxine-Pyrimethamine in Intermittent Preventive Treatment : A Study Protocol for a randomized controlled clinical trial

2019 ◽  
Author(s):  
Labama Otuli Noël ◽  
Bosenge Nguma ◽  
Maindo Alongo Mike-Antoine ◽  
Katenga Bosunga Gédéon ◽  
Losimba Likwela Joris ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Pregnant Women ◽  
Randomized Clinical Trials ◽  
Democratic Republic ◽  
Placental Malaria ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Sub Saharan Africa ◽  
Controlled Clinical Trial

Abstract Background : In order to reduce malaria-related morbidity and mortality during pregnancy, WHO recommends : Insecticide-treated mosquito nets, Intermittent Preventive Treatment of malaria in pregnancy, Prompt and effective case management. Nevertheless, several cases of resistance to Sulfadoxine-Pyrimethamine, used in intermittent preventive treatment, and to Chloroquine are reported in sub-Saharan Africa and in the Democratic Republic of the Congo. The prevalence of malaria among pregnant women remains high in Africa in general, and in the Democratic Republic of Congo in particular. This issue leads us to conduct this study, which aims at proposing an alternative to SP for preventing malaria in pregnant women. Materials and methods : From June 1 to October 31, 2019, we enrolled pregnant women from five health facilities in Kisangani for randomized, single-blind controlled clinical trials to compare the efficacy of two intermittent preventive treatment regimens in Kisangani pregnant women, selected before 18 th weeks of amenorrhea. The first regimen consists of 4 doses of Sulfadoxine-Pyrimethamine starting at the selection time and spaced at least 4 weeks during pregnancy. Each dose is made of 3 tablets of 525 mg Sulfadoxine-Pyrimethamine. The second regimen consists of 2 doses of Mefloquine during pregnancy. The first dose is taken at the selection time and the second dose between the 28 th and 32 nd weeks of amenorrhea. Each dose is made of 3 tablets of 250 mg Mefloquine. The efficacy criteria for these two regimens are placental malaria parasitemia, low birth weight of newborn and maternal anemia at delivery. The safety criterion was the occurrence of major side effects. Discussion : There are not enough randomized clinical trials assessing the efficacy of Mefloquine for the intermittent preventive treatment of malaria in African pregnant women, hence the recommendation for clinical trials. The present study is the only one that conducts such assessment in a hyper-endemic area with resistance to Sulfadoxine-Pyrimethamine and Chloroquine. The findings are therefore intended to promote the use of Mefloquine as the best alternative to Sulfadoxine-Pyrimethamine in the intermittent preventive treatment of malaria. Clinical trial registration : PACTR201905899965726. Key words : Intermittent preventive treatment, efficacy, safety, Mefloquine, Sulfadoxine-Pyrimethamine, Kisangani.

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