{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T08:18:10Z","timestamp":1762157890840},"reference-count":34,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T00:00:00Z","timestamp":1667174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 HD080471","5U54MD007605\u201028"],"award-info":[{"award-number":["R01 HD080471","5U54MD007605\u201028"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Until late 2015, Botswana recommended preventive treatment for pregnant women in malarial regions with chloroquine and proguanil (CP). The guideline change provided an opportunity to evaluate CP and adverse birth outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Tsepamo Study performed birth outcomes surveillance at large delivery centres throughout Botswana. We evaluated adverse birth outcomes from 2015 to 2017 at three hospitals where 93% of CP use was recorded. Outcomes included neonatal death (NND), small for gestational age (SGA), very SGA, stillbirth (SB), preterm delivery (PTD) and very PTD. Logistic regression analysis (unadjusted and adjusted) was conducted for each adverse birth outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study period, 5883 (26%) of 23,033 deliveries were exposed to CP, with the majority (65%) in the most malaria\u2010endemic region. At this site, there was a trend or an association between CP use and reduction of three adverse birth outcomes: PTD (aOR 0.85, 95% CI 0.76\u20130.96), vPTD (aOR 0.83, 95% CI 0.68\u20131.01) and NND (aOR 0.65, 95% CI 0.42\u20131.00). However, at the least malaria\u2010endemic site, the association was in the opposite direction for SB (aOR 1.54, 95% CI 1.08\u20132.22), SGA (aOR 1.24, 95% CI 1.06\u20131.44) and vSGA (aOR 1.42, 95% CI 1.14\u20131.77). The association between CP and reduced PTD was present among women without HIV (aOR 0.77, 95% CI 0.67\u20130.89) but not among women with HIV (aOR 1.09, 95% CI 0.78\u20131.35).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Antimalarial prophylaxis was associated with improved birth outcomes in the most malaria\u2010endemic region of Botswana, but not elsewhere. This finding supports current WHO guidance to use prophylaxis strategies among pregnant women in highly malaria\u2010endemic regions. Further studies of the risks and benefits of specific antimalarial regimens in pregnancy are warranted, particularly in areas with lower incidence of malaria.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13823","type":"journal-article","created":{"date-parts":[[2022,10,2]],"date-time":"2022-10-02T07:04:36Z","timestamp":1664694276000},"page":"990-998","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of prophylactic antimalarials in pregnant women living with Human Immunodeficiency Virus\u00a0on birth outcomes in Botswana"],"prefix":"10.1111","volume":"27","author":[{"given":"Omonike Arike","family":"Olaleye","sequence":"first","affiliation":[{"name":"College of Pharmacy and Health Sciences, Texas Southern University  Houston Texas USA"},{"name":"Department of Immunology and Infectious Diseases Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Zash","sequence":"additional","affiliation":[{"name":"Department of Immunology and Infectious Diseases Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"},{"name":"Botswana Harvard AIDS Institute Partnership  Gaborone Botswana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Modiegi","family":"Diseko","sequence":"additional","affiliation":[{"name":"Botswana Harvard AIDS Institute Partnership  Gaborone Botswana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gloria","family":"Mayondi","sequence":"additional","affiliation":[{"name":"Botswana Harvard AIDS Institute Partnership  Gaborone Botswana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith","family":"Mabuta","sequence":"additional","affiliation":[{"name":"Botswana Harvard AIDS Institute Partnership  Gaborone Botswana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahin","family":"Lockman","sequence":"additional","affiliation":[{"name":"Department of Immunology and Infectious Diseases Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"},{"name":"Botswana Harvard AIDS Institute Partnership  Gaborone Botswana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Lendsey","family":"Melton","sequence":"additional","affiliation":[{"name":"Department of Immunology and Infectious Diseases Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mompati","family":"Mmalane","sequence":"additional","affiliation":[{"name":"Botswana Harvard AIDS Institute Partnership  Gaborone Botswana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Makhema","sequence":"additional","affiliation":[{"name":"Department of Immunology and Infectious Diseases Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"},{"name":"Botswana Harvard AIDS Institute Partnership  Gaborone Botswana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger L.","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Department of Immunology and Infectious Diseases Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"},{"name":"Botswana Harvard AIDS Institute Partnership  Gaborone Botswana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,10,31]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"WHO policy brief for the implementation of intermittent preventive treatment of malaria in pregnancy using sulfadoxine\u2010pyrimethamine (IPTp\u2010SP)","author":"World Health Organization","year":"2014"},{"key":"e_1_2_7_3_1","volume-title":"Malaria in pregnant women","author":"World Health Organization","year":"2017"},{"key":"e_1_2_7_4_1","volume-title":"A strategic framework for malaria prevention and control during pregnancy in the African region","author":"World Health Organization","year":"2004"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1179\/146532809X440699"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1004.030303"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200311210-00020"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2003.69.447"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2004.71.41"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(11)70031-7"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jis553"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2017.2222"},{"key":"e_1_2_7_13_1","first-page":"513","volume-title":"Guidelines for the diagnosis and treatment of malaria in Botswana","author":"Botswana Ministry of Health","year":"2007"},{"key":"e_1_2_7_14_1","volume-title":"Revised guidelines for the diagnosis and treatment of malaria in Botswana","author":"Botswana Ministry of Health","year":"2015"},{"key":"e_1_2_7_15_1","volume-title":"Malaria 2017 country profile: Botswana","author":"World Health Organization","year":"2017"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir374"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0096017"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-019-2397-1"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30064-1"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00310-4"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1509150"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1086\/522142"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3156.2003.01066.x"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.30875\/7e6f8c91-en"},{"key":"e_1_2_7_25_1","first-page":"CD000169","article-title":"Drugs for preventing malaria in pregnant women in endemic areas: any drug regimen versus placebo or no treatment","author":"Radeva\u2010Petrova D","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.216231"},{"issue":"1","key":"e_1_2_7_27_1","first-page":"CD000169","article-title":"Drugs for preventing malaria\u2010related illness in pregnant women and death in the newborn","author":"Garner P","year":"2003","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(12)70222-0"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002914"},{"key":"e_1_2_7_30_1","volume-title":"Malaria in HIV\/AIDS patients","author":"World Health Organization","year":"2017"},{"key":"e_1_2_7_31_1","volume-title":"Malaria and HIV. 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