{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T11:04:53Z","timestamp":1790679893822,"version":"4.1.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T00:00:00Z","timestamp":1599609600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"French Agence Nationale de la Recherche","award":["ANR-13-JSV1\u20130004"],"award-info":[{"award-number":["ANR-13-JSV1\u20130004"]}]},{"name":"Fondation Simone Beer under the auspices of the Fondation de France","award":["00074147"],"award-info":[{"award-number":["00074147"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Harmful maternal and neonatal health outcomes result from malaria in pregnancy, the prevention of which primarily relies on intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP). The World Health Organization recommends IPTp-SP in sub-Saharan Africa, but implementation is highly heterogeneous and often suboptimal in terms of the number of doses and their timing. In this study, we assessed the impact of this heterogeneity on malaria in pregnancy, mainly with respect to submicroscopic Plasmodium falciparum infections.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used data from 273 Beninese women followed throughout pregnancy. Screening for P. falciparum infections, using both microscopy-based and polymerase chain reaction (PCR)\u2013based methods, was performed monthly, and information on IPTp-SP doses was collected. Gestational age was estimated by repeated ultrasound scans. Using a negative binomial model, we investigated the effect of IPTp-SP doses and timing after 17 weeks of gestation on the number of P. falciparum infections, focusing on submicroscopic infections detectable only by PCR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>At least 2 IPTp-SP doses were taken by 77.3% of the women. The median gestational age at the first IPTp-SP dose was 22 weeks. A late first IPTp-SP dose (&amp;gt;21.2 weeks) was marginally associated with an increased number of P. falciparum infections (adjusted incidence rate ratio [aIRR]\u2005=\u20051.3; P\u2005=\u2005.098). The number of IPTp-SP doses was not associated with the number of submicroscopic infections (aIRR\u2005=\u20051.2, P\u2005=\u2005.543).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>A late first IPTp-SP dose failed to provide optimal protection against P. falciparum, especially submicroscopic infections. This highlights the need for a new antimalarial drug for IPTp that could be taken early in pregnancy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciaa1355","type":"journal-article","created":{"date-parts":[[2020,9,4]],"date-time":"2020-09-04T19:14:19Z","timestamp":1599246859000},"page":"e3759-e3767","source":"Crossref","is-referenced-by-count":11,"title":["Suboptimal Intermittent Preventive Treatment in Pregnancy (IPTp) is Associated With an Increased Risk of Submicroscopic <i>Plasmodium falciparum<\/i> Infection in Pregnant Women: A Prospective Cohort Study in Benin"],"prefix":"10.1093","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7058-496X","authenticated-orcid":false,"given":"Corn\u00e9lia P A","family":"Hounkonnou","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Paris, M\u00e8re et Enfant en Milieu Tropical: Pathog\u00e8nes, Syst\u00e8me de Sant\u00e9 et Transition \u00c9pid\u00e9miologique, Institut de Recherche pour le D\u00e9veloppement (IRD), Paris, France"},{"name":"Sorbonne Universit\u00e9, Universit\u00e9 Pierre et Marie-Curie, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicaise Tuikue","family":"Ndam","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, M\u00e8re et Enfant en Milieu Tropical: Pathog\u00e8nes, Syst\u00e8me de Sant\u00e9 et Transition \u00c9pid\u00e9miologique, Institut de Recherche pour le D\u00e9veloppement (IRD), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"Fievet","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, M\u00e8re et Enfant en Milieu Tropical: Pathog\u00e8nes, Syst\u00e8me de Sant\u00e9 et Transition \u00c9pid\u00e9miologique, Institut de Recherche pour le D\u00e9veloppement (IRD), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manfred","family":"Accrombessi","sequence":"additional","affiliation":[{"name":"Institut de Recherche Clinique du B\u00e9nin, Abomey-Calavi, B\u00e9nin"},{"name":"Faculty of Infectious and Tropical Diseases, Disease Control Department, London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Yovo","sequence":"additional","affiliation":[{"name":"Institut de Recherche Clinique du B\u00e9nin, Abomey-Calavi, B\u00e9nin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atikatou","family":"Mama","sequence":"additional","affiliation":[{"name":"Institut de Recherche Clinique du B\u00e9nin, Abomey-Calavi, B\u00e9nin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darius","family":"Sossou","sequence":"additional","affiliation":[{"name":"Institut de Recherche Clinique du B\u00e9nin, Abomey-Calavi, B\u00e9nin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertin","family":"Vianou","sequence":"additional","affiliation":[{"name":"Institut de Recherche Clinique du B\u00e9nin, Abomey-Calavi, B\u00e9nin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achille","family":"Massougbodji","sequence":"additional","affiliation":[{"name":"Institut de Recherche Clinique du B\u00e9nin, Abomey-Calavi, B\u00e9nin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Briand","sequence":"additional","affiliation":[{"name":"IRD, Inserm, Universit\u00e9 de Bordeaux, Infectious Diseases in Low Income Countries Team, Unit\u00e9 Mixte de Recherche, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Cot","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, M\u00e8re et Enfant en Milieu Tropical: Pathog\u00e8nes, Syst\u00e8me de Sant\u00e9 et Transition 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