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Malaria drug in pregnancy protects against sexually transmitted infections
Malaria drug given in pregnancy to protect against the mosquito-borne infection also protects against sexually transmitted infections, a new study has found
New Delhi: A medicine given to pregnant women to protect against malaria has been shown also to safeguard against several sexually transmitted infections, a new study has revealed.
The research, led by the London School of Hygiene & Tropical Medicine, which was on Thursday published in ‘Clinical Infectious Diseases’ says that the medicine provides protection against gonorrhoea, chlamydia, trichomoniasis, and bacterial vaginosis.
World Health Organization recommends providing intermittent preventive treatment (IPTp) using sulphadoxine-pyrimethamine (SP) to pregnant women living in malaria-endemic areas as part of every scheduled antenatal care visit, from the second trimester until delivery, to reduce adverse birth outcomes caused by malaria infection.
This study has produced the first compelling evidence that the same preventive treatment reduces adverse birth outcomes attributable to curable sexually transmitted/reproductive tract infections (STIs/RTIs).
The research involved 1,086 pregnant women in Zambia, and investigated the protective effect that different doses of IPTp-SP had on pregnancy outcomes. The analyses confirmed IPTp-SP protects against adverse birth outcomes but of particular interest to the team was the effect the drug had on the infections themselves.
At delivery, women who experienced an adverse birth outcome who had had two or more doses of IPTp-SP compared to 0-1 dose were 76% less likely to have a malaria infection, 94% less likely to have gonorrhoea or chlamydia, and 66% less likely to have trichomoniasis or bacterial vaginosis.
There are 880,000 stillbirths and 1.2 million newborn deaths each year in sub-Saharan Africa, many of which are linked to maternal infection.
A 2012 School study found that nearly 4 of every 10 women at health facilities have a malaria infection.
An even higher number of women, if added together, are infected with the STIs/RTIs syphilis, gonorrhoea, chlamydia, tichomononiasis and bacterial vaginosis.
“Sexually transmitted and reproductive tract infections are linked to devastating birth consequences for pregnant women, including spontaneous abortion, stillbirth and premature and low birthweight,” said lead author, assistant professor Matthew Chico.
“While sulfadoxine-pyrimethamine has been thought to offer pregnant women protection against other infections, no evidence existed - until now. The findings show that IPTp-SP offers unrecognised potential that extends beyond its life-saving protection against malaria.”
The authors hope that these results will serve as a catalyst for scaling-up coverage of preventive treatment. Currently only 24% of pregnant women in sub-Saharan Africa receive two SP doses, well below national and international targets.
“Sulphadoxine-pyrimethamine is a cheap ‘double protection’ drug – 20 US cents per dose. For that bargain price, pregnant women receive broad protection against a range of infections which can lead to very serious consequences,” said Chico.
