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Review
. 2025 Feb;152(2):133-142.
doi: 10.1017/S0031182025000071.

A roadmap for understanding sulfadoxine-pyrimethamine in malaria chemoprevention

Thiery Masserey  1   2 , Lydia Braunack-Mayer  1   2 , R Scott Miller  3 , Jörg J Möhrle  1   2 , Melissa A Penny  1   2   4   5
Affiliations
Review

A roadmap for understanding sulfadoxine-pyrimethamine in malaria chemoprevention

Thiery Masserey et al. Parasitology. 2025 Feb.

Abstract

Sulfadoxine-pyrimethamine (SP) is the standard of care for Plasmodium falciparum malaria chemoprevention among pregnant women, infants and children. Developing alternative chemoprevention products and other prevention products, such as vaccines and monoclonal antibodies, requires significant investment. However, knowledge gaps surrounding the activity of SP and resistance put these investments at risk. Therefore, we reviewed SP's combined antimalarial action, including the individual antiplasmodial components, other antimicrobial effects, impact on malaria immunity development and continued effectiveness in settings with high SP resistance. We created a roadmap of non-clinical and clinical evidence to better understand the effectiveness of SP for chemoprevention and inform the development of new prevention tools.

Keywords: malaria; mechanisms of action; prevention; resistance; sulfadoxine-pyrimethamine.

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Conflict of interest statement

JJM was an employee of the Medicines for Malaria Venture. RSM is an employee of the Gates Medical Research Institute. MAP was a member of the WHO Guidelines Development Group for Malaria Chemoprevention in 2020–2021. All other authors declare that they have no competing interests.

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References

    1. Abla N, Howgate E, Rowland-Yeo K, Dickins M, Bergagnini-Kolev MC, Chen K-F, McFeely S, Bonner JJ, Santos LGA, Gobeau N, Burt H, Barter Z, Jones HM, Wesche D, Charman SA, Moehrle JJ, Burrows JN and Almond LM (2023) Development and application of a PBPK modeling strategy to support antimalarial drug development. CPT: Pharmacometrics & Systems Pharmacology 12, 1335–1346. doi:10.1002/psp4.13013. - DOI - PMC - PubMed
    1. ACCESS-SMC Partnership (2020) Effectiveness of seasonal malaria chemoprevention at scale in west and Central Africa: An observational study. The Lancet 396, 1829–1840. doi: 10.1016/S0140-6736(20)32227-3. - DOI - PMC - PubMed
    1. Aleshnick M, Florez-Cuadros M, Martinson T and Wilder BK (2022) Monoclonal antibodies for malaria prevention. Molecular Therapy 30, 1810–1821. doi:10.1016/j.ymthe.2022.04.001. - DOI - PMC - PubMed
    1. Arya A, Kojom Foko LP, Chaudhry S, Sharma A and Singh V (2021) Artemisinin-based combination therapy (ACT) and drug resistance molecular markers: A systematic review of clinical studies from two malaria endemic regions - India and sub-Saharan Africa. International Journal for Parasitology. Drugs and Drug Resistance 15, 43–56. doi:10.1016/j.ijpddr.2020.11.006. - DOI - PMC - PubMed
    1. Bacon DJ, Tang D, Salas C, Roncal N, Lucas C, Gerena L, Tapia L, Llanos-Cuentas AA, Garcia C, Solari L, Kyle D and Magill AJ (2009) Effects of point mutations in Plasmodium falciparum dihydrofolate reductase and dihydropterate synthase genes on clinical outcomes and in vitro susceptibility to sulfadoxine and pyrimethamine. PLoS One 4, e6762. doi:10.1371/journal.pone.0006762. - DOI - PMC - PubMed

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