BY: Oriyomi Akinyotu – Folasade Bello – Rukiyat Abdus‐Salam – Ayodele Arowojolu

Abstract

Objective
To compare the effectiveness of mefloquine and sulphadoxine–pyrimethamine as intermittent preventive therapy for malaria among pregnant women with HIV.

Methods
The present randomized, controlled, prospective, open‐label study enrolled women with HIV who had reached at least 16 weeks of pregnancy attending prenatal clinics at secondary and tertiary health facilities in South West Nigeria between January 1 and August 31, 2016. Block randomization was used to assign patients to treatment with mefloquine or sulphadoxine–pyrimethamine for malaria prophylaxis. The primary outcome was malaria parasitemia at delivery. Data were compared with the χ2 and t tests on a per‐protocol basis.

Results
Of 142 women enrolled and randomized equally to each group, 131 (92.3%) completed the study (64 in the mefloquine group and 67 in the sulphadoxine‐pyrimethamine group). Blood‐sample malaria parasites were isolated from 6 (9%) and 5 (7%) patients in the mefloquine and sulphadoxine–pyrimethamine groups, respectively, at enrolment, and 6 (9%) and 9 (13%) patients in the mefloquine and sulphadoxine–pyrimethamine groups, respectively, at delivery; the differences between the groups was not significant at enrolment (P=0.693) or delivery (P=0.466).

Conclusion
Outcomes following prophylactic use of mefloquine for intermittent preventive therapy for malaria among pregnant women with HIV were comparable to sulphadoxine–pyrimethamine treatment; mefloquine is a feasible alternative therapy.

ClinicalTrials.gov: NCT02524444.

CREDIT: Read at International Journal of Gynecology & Obstetrics