A comparison of sulfadoxine-pyrimethamine with chloroquine and pyrimethamine for prevention of malaria in pregnant Nigerian women

Abstract

Few studies have documented the effectiveness in west Africa of intermittent preventive treatment of malaria with sulfadoxine-pyrimethamine (SP) in pregnancy. Pregnant Nigerian women were assigned to receive either SP given twice or presumptive chloroquine (CQ) treatment followed by weekly pyrimethamine (CQ + P); 250 were enrolled in each group. Of those completing follow-up, 4 (1.8%) in the SP group and 22 (9.8%) in the CQ + P groups had a febrile illness (P = 0.005). None in the SP group but 11 (4.9%) in the CQ + P group had peripheral parasitemia prior to or during delivery (P = 0.002). Two (1.2%) in the SP group and 9 (5.0%) in the CQ + P group were anemic at delivery (P = 0.04). There were six low birth weight infants in the SP group and eight in the CQ + P group (P = 0.21). Intermittent preventive treatment with SP is superior to CQ + P for prevention of malaria and anemia in pregnant women in Nigeria.