@article{fdi:010083900,
  title = {{S}uboptimal intermittent preventive treatment in pregnancy ({IPT}p) is associated with an increased risk of submicroscopic {P}lasmodium falciparum infection in pregnant women : a prospective cohort study in {B}enin},
  author = {{H}ounkonnou, {C}. {P}. {A}. and {T}uikue {N}dam, {N}icaise and {F}ievet, {N}adine and {A}ccrombessi, {M}. and {Y}ovo, {E}. and {M}ama, {A}. and {S}ossou, {D}. and {V}ianou, {B}. and {M}assougbodji, {A}. and {B}riand, {V}al{\'e}rie and {C}ot, {M}ichel and {C}ottrell, {G}illes},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground. {H}armful maternal and neonatal health outcomes result from malaria in pregnancy, the prevention of which primarily relies on intermittent preventive treatment in pregnancy ({IPT}p) with sulfadoxine-pyrimethamine ({SP}). {T}he {W}orld {H}ealth {O}rganization recommends {IPT}p-{SP} in sub-{S}aharan {A}frica, but implementation is highly heterogeneous and often suboptimal in terms of the number of doses and their timing. {I}n this study, we assessed the impact of this heterogeneity on malaria in pregnancy, mainly with respect to submicroscopic {P}lasmodium falciparum infections. {M}ethods. {W}e used data from 273 {B}eninese women followed throughout pregnancy. {S}creening for {P}. falciparum infections, using both microscopy-based and polymerase chain reaction ({PCR})-based methods, was performed monthly, and information on {IPT}p-{SP} doses was collected. {G}estational age was estimated by repeated ultrasound scans. {U}sing a negative binomial model, we investigated the effect of {IPT}p-{SP} doses and timing after 17 weeks of gestation on the number of {P}. falciparum infections, focusing on submicroscopic infections detectable only by {PCR}. {R}esults. {A}t least 2 {IPT}p-{SP} doses were taken by 77.3% of the women. {T}he median gestational age at the first {IPT}p-{SP} dose was 22 weeks. {A} late first {IPT}p-{SP} dose (>21.2 weeks) was marginally associated with an increased number of {P}. falciparum infections (adjusted incidence rate ratio [a{IRR}] = 1.3; {P} = .098). {T}he number of {IPT}p-{SP} doses was not associated with the number of submicroscopic infections (a{IRR} = 1.2, {P} = .543). {C}onclusions. {A} late first {IPT}p-{SP} dose failed to provide optimal protection against {P}. falciparum, especially submicroscopic infections. {T}his highlights the need for a new antimalarial drug for {IPT}p that could be taken early in pregnancy.},
  keywords = {submicroscopic {P}. falciparum infection ; pregnancy ; intermittent ; preventive treatment ; prospective cohort ; sub-{S}aharan {A}frica ; {BENIN}},
  booktitle = {},
  journal = {{C}linical {I}nfectious {D}iseases},
  volume = {73},
  numero = {11},
  pages = {{E}3759--{E}3767 [9 ]},
  ISSN = {1058-4838},
  year = {2021},
  DOI = {10.1093/cid/ciaa1355},
  URL = {https://www.documentation.ird.fr/hor/fdi:010083900},
}