Prevention Strategy for Papua New Guinea

Intermittent preventive treatment with azithromycin-containing regimens for the prevention of malarial infections and anaemia and the control of sexually transmitted infections in pregnant women in Papua New Guinea

Project Coordinator:           Prof Stephen J Rogerson (University of Melbourne, Australia)

European Collaborators:   Prof Clara Menendez (IS Global, Spain)

Site PI's:                                Drs Ivo Mueller and Peter Siba (IMR, PNG)


To examine whether repeated (three throughout the pregnancy) doses of intermittent preventive treatment in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) and azithromycin improves babies’ birth weights compared to a single treatment dose of SP and chloroquine.

Study design

A randomised control trial of IPTp, in the form of three-monthly doses of SP and AZ given twice daily for two days, compared to a single dose of SP and chloroquine followed by two doses of placebo in women enrolled at 14-26 weeks gestation. The study took place in Madang District, Papua New Guinea. Almost 2800 women were enrolled over two years, at the local hospital and nearby health centres.

Results and Conclusion

SP plus azithromycin was associated with a reduction in low birth weight and preterm delivery; maternal parasitaemia and active placental malaria as well as reduced carriage of gonorrhoea. SPAZ was efficacious and safe in reducing LBW, possibly acting through multiple mechanisms including the effect on malaria and on sexually transmitted infections.

Impact of the research

During the trial the Ministry of Health in Papua New Guinea adopted a regime of three monthly SP doses. The results were shared with WHO ERG in July 2013 and at a meeting in 2017 on control strategy in Asia and the South Pacific

VIVAX Working Group Meeting; 9th-11th October 2017, Bali


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