@article{fdi:010073631,
  title = {{H}igh folate levels are not associated with increased malaria risk but with reduced anaemia rates in the context of high-dosed folate supplements and intermittent preventive treatment against malaria in pregnancy with sulphadoxine-pyrimethamine in {B}enin},
  author = {{M}oya-{A}lvarez, {V}. and {O}uedraogo, {S}. and {A}ccrombessi, {M}. and {C}ot, {M}ichel},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjectives{T}o investigate whether high-dosed folate supplements might diminish the efficacy of malaria intermittent preventive treatment in pregnancy ({IPT}p) with sulphadoxine-pyrimethamine ({SP}) in a cohort of pregnant women in {B}enin, where malaria is holoendemic. {M}ethods{W}e followed 318 women during the entire pregnancy and analysed haematological and {P}lasmodium falciparum indicators in the context of an intermittent preventive treatment trial in {B}enin. {D}uring the follow-up, women received two-dose {IPT}p (1500/75 mg of {SP} per dose) at the maternity clinic and 600 mg of albendazole, 200 mg ferrous sulphate and 5 mg folic acid per day for home treatment. {R}esults{H}igh folate levels were not associated with increased malaria risk (adjusted {OR} (a{OR}) = 0.51 (95% {CI}: 0.17; 1.56, {P}-value = 0.24)), nor with increased {P}. falciparum density (beta coefficient = -0.26 (95% {CI}: -0.53; 0.02), {P}-value = 0.07) in a randomised trial of {IPT}p in {B}enin. {O}n the contrary, higher iron levels were statistically associated with increased odds of a positive blood smear (a{OR} = 1.7 95% {CI} (1.2; 2.3), {P}-value < 0.001) and {P}. falciparum parasite density (beta coefficient = 0.2 95% {CI} (0.1; 0.3), {P}-value < 0.001). {H}igh folate levels were statistically associated with decreased odds of anaemia (a{OR} = -0.30 95% {CI} (0.10; 0.88), {P}-value = 0.03). {C}onclusions{H}igh folate levels are not associated with increased malarial risk in a prospective longitudinal cohort in the context of both iron and high-dosed folate supplements and {IPT}p. {T}hey are associated with reduced risk of anaemia, which is particularly important because iron, also given to treat anaemia, might be associated with increased malaria risk. {A}bstract {O}bjectifs{E}xaminer si des supplements de folates a forte dose pourraient diminuer l'efficacite du traitement preventif intermittent du paludisme pendant la grossesse ({TPI}g) par la sulfadoxine- pyrimethamine ({SP}) dans une cohorte de femmes enceintes au {B}enin, o{U} le paludisme est holoendemique. {M}ethodes{N}ous avons suivi 318 femmes pendant toute la grossesse et analyse les indicateurs hematologiques et de {P}. falciparum dans le cadre d'un essai de traitement preventif intermittent au {B}enin. {D}urant le suivi, les femmes ont recu deux doses de {TPI}g (1500/75 mg de {SP} par dose) a la clinique de maternite et 600 mg d'albendazole, 200 mg de sulfate ferreux et 5 mg d'acide folique par jour pour le traitement a domicile. {R}esultats{D}es taux eleves de folates n'etaient pas associes a un risque accru de paludisme ({OR} ajuste ({OR}a) = 0,51; {IC}95%: 0,17; 1,56; p = 0,24), ni a une augmentation de la densite de {P}. falciparum (coefficient beta = -0,26; {IC}95%: -0,53; 0,02; p = 0,07) dans un essai randomise de {TPI}g au {B}enin. {P}ar contre, des niveaux de fer plus eleves etaient statistiquement associes a une augmentation de la probabilite d'un frottis sanguin positif ({OR}a = 1,7; {IC}95%: 1,2- 2,3; p <0,001) et de la densite parasitaire de {P}. falciparum (coefficient beta = 0,2; {IC}95%: 0,1-0,3; p <0,001). {L}es taux eleves de folates etaient statistiquement associes a une diminution de la probabilite d'anemie ({OR}a = -0,30; {IC}95%: 0,10; 0,88; p = 0,03). {C}onclusions{L}es niveaux eleves de folates ne sont pas associes a une augmentation du risque de paludisme dans une cohorte longitudinale prospective dans le contexte de supplements de fer et de folates a forte dose et du {TPI}g. {I}ls sont associes a un risque reduit d'anemie, ce qui est particulierement important puisque le fer, egalement administre pour traiter l'anemie, pourrait etre associe a un risque accru de paludisme.},
  keywords = {pregnancy-associated malaria ; folate supplements ; iron supplements ; anaemia ; {W}est {A}frica ; {BENIN}},
  booktitle = {},
  journal = {{T}ropical {M}edicine and {I}nternational {H}ealth},
  volume = {23},
  numero = {6},
  pages = {582--588},
  ISSN = {1360-2276},
  year = {2018},
  DOI = {10.1111/tmi.13064},
  URL = {https://www.documentation.ird.fr/hor/fdi:010073631},
}