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. 2025 Jan 23;12(2):ofaf037.
doi: 10.1093/ofid/ofaf037. eCollection 2025 Feb.

Choice of Drug for Malaria Prevention During Pregnancy Does Not Affect Infant Serologic Responses to Plasmodium falciparum Erythrocyte Membrane Proteins 1

Amed Ouattara  1 , Liana R Andronescu  1 , Matthew Adams  1 , Ankur Sharma  1 , Rie Nakajima  2 , Aarti Jain  2 , Omid Taghavian  2 , Algis Jasinskas  2 , Philip L Felgner  2 , Don P Mathanga  3 , Jobiba Chinkhumba  3 , Miriam K Laufer  1 , Mark A Travassos  1
Affiliations

Choice of Drug for Malaria Prevention During Pregnancy Does Not Affect Infant Serologic Responses to Plasmodium falciparum Erythrocyte Membrane Proteins 1

Amed Ouattara et al. Open Forum Infect Dis. .

Abstract

While sulfadoxine-pyrimethamine has been the primary drug in intermittent preventive treatment in pregnancy, dihydroartemisinin-piperaquine (DP) is being considered as an alternative. DP may lead to lower antimalarial antibodies in the mother, resulting in higher risk of malaria in infancy. We probed cord blood sera collected from women enrolled in a clinical trial of sulfadoxine-pyrimethamine vs DP on a protein microarray containing diverse Plasmodium falciparum erythrocyte membrane proteins 1 to measure the impact of intermittent preventive treatment in pregnancy on proteins associated with malaria disease susceptibility. These results suggest that effective maternal malaria prevention may not alter the susceptibility of infants to malaria.

Keywords: chemoprophylaxis; dihydroartemisinin-piperaquine; infants; pfEMP1; sulfadoxine-pyrimethamine.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts.

Figures

Figure 1.
Figure 1.
Heat map of seroreactivity against 247 malaria protein features in children born to pregnant women undergoing intermittent preventive treatment in pregnancy with SP or DP. Columns: Individuals are arranged according to treatment arms (SP and DP) and negative controls (malaria-naive North American adults). Rows: Antigen features are arranged with increasing signal intensities. The color indicates the magnitude of the response to each antigen, ranging from gray (weak) to black (intermediate) and red (intense). DP, dihydroartemisinin-piperaquine; PfEMP1s, Plasmodium falciparum erythrocyte membrane proteins 1; SP, sulfadoxine-pyrimethamine.
Figure 2.
Figure 2.
(A) Serorecognition of microarray protein features in Malawian children. Protein features included PfEMP1s from the 3D7 reference strain, non-3D7 PfEMP1s, and several non-PfEMP1 malaria antigens. The percentage of individuals with serorecognition is on the y-axis. Columns represent the percentage of individuals with serorecognition for a given protein feature. SP columns are in blue whereas DP columns are in orange. P values are displayed on the secondary y-axis in gray. (B) Mean fluorescence intensities to microarray malaria protein features in children born to pregnant women under SP or DP intermittent preventive treatment in pregnancy. Protein features included PfEMP1s from the 3D7 reference strain, non-3D7 PfEMP1s, and several non-PfEMP1 malaria antigens. Fluorescence intensities values for each protein feature are on the y-axis. SP columns are in blue whereas DP columns are in orange. P values are displayed on the secondary y-axis in gray. DP, dihydroartemisinin-piperaquine; PfEMP1s, Plasmodium falciparum erythrocyte membrane proteins 1; SP, sulfadoxine-pyrimethamine.
See this image and copyright information in PMC

References

    1. World Health Organization . WHO policy brief for the implementation of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP). Geneva: World Health Organization, 2014. WHO/HTM/GMP/2014.4.
    1. Olaleye A, Okusanya BO, Oduwole O, Esu E, Meremikwu M. A systematic review and meta-analysis of dihydroartemisinin-piperaquine versus sulphadoxine-pyrimethamine for malaria prevention in pregnancy. Int J Gynaecol Obstet 2019; 146:43–55. - PubMed
    1. Kakuru A, Jagannathan P, Muhindo MK, et al. . Dihydroartemisinin-piperaquine for the prevention of malaria in pregnancy. N Engl J Med 2016; 374:928–39. - PMC - PubMed
    1. Dobbs KR, Dent AE. Plasmodium malaria and antimalarial antibodies in the first year of life. Parasitology 2016; 143:129–38. - PMC - PubMed
    1. Natama HM, Moncunill G, Vidal M, et al. . Associations between prenatal malaria exposure, maternal antibodies at birth, and malaria susceptibility during the first year of life in Burkina Faso. Infect Immun 2023; 91:e0026823. - PMC - PubMed