Last Updated: 24/11/2025

Sulfadoxine-Pyrimethamine IPTp in Malawi: Effects on the gut and vaginal microbiomes

Objectives

The aim of this project is to test the hypothesis that the beneficial effects of SP are mediated by an effect on the gut or vaginal microbiome.

Principal Investigators / Focal Persons

Steven Richard Meshnick
Ian Michael Hastings

Rationale and Abstract

Sulfadoxine-Pyrimethamine IPTp in Malawi: Effects on the gut and vaginal microbiomes Abstract Adverse birth outcomes, such as low birth weight, are common in sub-Saharan Africa. Much of it can be attributed to malaria. For nearly 20 years, pregnant women have been given therapeutic doses of sulfadoxine-pyrimethamine (SP) as intermittent preventive therapy (IPTp) to protect against malaria. SP-resistant malaria has become widespread; yet, paradoxically, IPTp with SP remains protective against adverse birth outcomes. SP is an antifolate with broad-spectrum antibacterial activity. 

Study Design

Ancillary study on 50 pregnant women who are subjects in a large randomized control trial comparing SP and dihydroartemisinin-piperaquine as IPTp agents.

Methodology:

Faecal samples and vaginal swabs will be obtained and sent to UNC where the 16S ribosomal RNA gene will be deep-sequenced by MiSeq and analyzed by QIIME.

 

Date

Jul 2016 — Jun 2019

Total Project Funding

$418,000

Project Site

Malawi

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