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      Plasma folate level and high-dose folate supplementation predict sulfadoxine-pyrimethamine treatment failure in pregnant women in Western kenya who have uncomplicated malaria.

      The Journal of Infectious Diseases
      Adult, Animals, Antimalarials, therapeutic use, Dietary Supplements, Drug Combinations, Female, Folic Acid, administration & dosage, blood, Humans, Kenya, Malaria, drug therapy, Pregnancy, Pregnancy Complications, Parasitic, Pyrimethamine, Risk Factors, Sulfadoxine, Survival Analysis, Treatment Failure, Young Adult

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          Abstract

          Sulfadoxine-pyrimethamine (SP) inhibits folate metabolism by the malaria parasite. We investigated the association between folate levels and SP failure in pregnant women. Data from a trial to assess the effect that folate supplementation has on SP failure in 467 pregnant women were analyzed. Plasma folate levels were determined at enrollment and at day 7. High baseline folate levels, high parasite densities, and age <20 years were risk factors for SP failure. High-dose (5 mg daily) folate supplementation or high folate levels at day 7 were independent risk factors. Therefore, pregnant women receiving SP should receive low-/moderate-dose folate supplementation. http://www.clinicaltrials.gov identifier: NCT00130065.

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