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Am J Trop Med Hyg ; 74(6): 960-4, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16760504

RESUMO

Folic acid is frequently given to pregnant women at the same time as intermittent preventive treatment (IPTp) with sulfadoxine/pyrimethamine (SP), but it is not known if it interferes with the anti-malarial activity of SP. To investigate this concern, 1,035 Gambian primigravidae were randomized to receive either folic acid (500-1,500 microg/day) together with oral iron (522) or oral iron alone (513) for 14 days at the same time as they received IPTp with SP. On presentation, 261 women (25%) had Plasmodium falciparum asexual parasitemia. Prevalences of parasitemia on day 14 after treatment were similar in both groups: 5.7% (26 of 458) in the iron plus folic acid group and 4.9% (22 of 446) in the iron alone group (risk difference = 0.74%, 95% confidence interval [CI] = -2.2% to 3.7%). Parasitologic cure was observed in 116 (91%) of 128 of women who were parasitemic on presentation and who received iron and folic acid and in 122 (92%) of 133 women who received iron alone (difference = 1.1%, 95% CI = -5.6% to 8.0%). Women who received folic acid and iron had a slightly higher mean hemoglobin concentration at day 14 than women who had received iron alone (difference = 0.14 g/dL, 95% CI = 0.01-0.27 g/dL). The results of this study suggest that in an area of low SP resistance, administration of folic acid to pregnant women in a dose of 500-1,500 mug/day will not interfere with the protective effect of SP when used for IPTp.


Assuntos
Antimaláricos/uso terapêutico , Ácido Fólico/farmacologia , Hematínicos/farmacologia , Malária Falciparum/prevenção & controle , Complicações Parasitárias na Gravidez/prevenção & controle , Pirimetamina/uso terapêutico , Sulfadoxina/uso terapêutico , Adolescente , Adulto , Anemia/prevenção & controle , Animais , Antimaláricos/administração & dosagem , Antimaláricos/antagonistas & inibidores , Suplementos Nutricionais , Combinação de Medicamentos , Feminino , Ácido Fólico/administração & dosagem , Ácido Fólico/uso terapêutico , Gâmbia , Número de Gestações , Hematínicos/administração & dosagem , Hematínicos/uso terapêutico , Hemoglobinas/análise , Humanos , Malária Falciparum/tratamento farmacológico , Parasitemia/tratamento farmacológico , Parasitemia/prevenção & controle , Gravidez , Complicações Parasitárias na Gravidez/tratamento farmacológico , Pirimetamina/administração & dosagem , Pirimetamina/antagonistas & inibidores , Sulfadoxina/administração & dosagem , Sulfadoxina/antagonistas & inibidores
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