Beyond malaria: can intermittent preventive treatment with sulphadoxine-pyrimethamine reduce the number of small vulnerable newborns globally?

Unger, HW; Ataide, R; Roh, ME; Rahman, A; Price, RN; van Eijk, AM; Dorsey, G; Ter Kuile, FO; Rogerson, SJ

Author(s): Unger, HW; Ataide, R; Roh, ME; Rahman, A; Price, RN; van Eijk, AM; Dorsey, G; Ter Kuile, FO; Rogerson, SJ;
Details: Publication Year 2026-01-01,Volume 14,Issue #1,Page e157-e163
Journal Title: Lancet Global Health
Abstract: Efforts to reduce the global burden of small vulnerable newborns (SVNs) by scaling up existing preventive interventions must be complemented with new preventive approaches to achieve global targets. Intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP) was originally designed to protect pregnant women from malaria infection, but appears to retain efficacy against low birthweight even when Plasmodium infection is absent or the parasite is highly resistant to sulphadoxine-pyrimethamine. This specific effect might occur through the antimicrobial activity of sulphadoxine-pyrimethamine against maternal genitourinary tract infections and pathogenic gut bacteria, direct effects on maternal gut physiology that might reverse environmental enteric dysfunction, or anti-inflammatory actions. Refining our understanding of the pathways underlying the protective efficacy of sulphadoxine-pyrimethamine will require mechanistic studies and placebo-controlled randomised trials of IPTp-SP in non-malarious settings. These studies will be crucial to confirm whether sulphadoxine-pyrimethamine could be considered for reducing the risk of SVNs in settings with high prevalence of SVNs and little or no malaria transmission.
Publisher: Elsevier
Keywords: Humans; *Pyrimethamine/therapeutic use/administration & dosage; *Sulfadoxine/therapeutic use/administration & dosage; Drug Combinations; *Antimalarials/therapeutic use/administration & dosage; Infant, Newborn; *Malaria/prevention & control; Female; Pregnancy; Global Health; *Infant, Low Birth Weight
Research Division(s): Infection and Global Health
PubMed ID: 41265465
Publisher's Version: https://doi.org/10.1016/S2214-109X(25)00405-X
Open Access at Publisher's Site: https://doi.org/10.1016/S2214-109X(25)00405-X
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-12-15 09:44:05

Last Modified: 2025-12-15 09:44:10