Image caption: The SAPOT team will assess whether a novel antenatal malaria intervention reduces malaria and ill-health in infants in Papua New Guinea.

A malaria prevention project which brings together Menzies School of Health Research (Menzies) and the Papua New Guinea Institute of Medical Research has won the prestigious E. W. “AI” Thrasher Award. 

The SAPOT Infant Study (SAPOT-I) will examine how to prevent malaria and other febrile illness in infants through better prevention of malaria in pregnancy. It extends the work being done through the 4-year ‘Sulfadoxine-pyrimethamine Plus Dihydroartemisinin-piperaquine for Intermittent Preventive Treatment in Pregnancy (SAPOT)’ study, which is funded by the Australian Government’s National Health and Medical Research Council (NHMRC). 

The SAPOT study began recruitment in August 2022. In October, the infant follow-up study, ‘A novel prenatal malaria intervention to prevent malaria and ill-health in infancy (SAPOT-I)’ was awarded US$546,285 by the Thrasher Research Fund to begin next month. The US-based philanthropic organisation provides medical research grants to improve the lives of children worldwide. 

Malaria and other infections are principal causes of infant death and poor health in many low resource countries, including Papua New Guinea. Evidence shows that infants are more likely to get malaria and other infections if their mother had malaria during pregnancy. 

The AU$3 million provided by the NHMRC through SAPOT helps researchers look at the impact of using 2 types of anti-malarial drugs each month on mothers, and the impact on their babies up to 4 weeks old. The additional funding from the Thrasher Research Fund for the SAPOT Infant Study will enable researchers to measure the long-term benefits of this approach by following the children up to 12 months old to determine whether improving malaria control in pregnancy could lead to better infant health outcomes. 

Menzies Honorary Research Fellow, Dr Holger Unger, said the World Health Organisation (WHO) endorses monthly intermittent preventative treatment in pregnancy (IPTp) with the drug Sulfadoxine-pyrimethamine (SP). 

“This strategy is used in 35 countries around the globe. The issue is that due to high-grade resistance, SP is failing as an anti-malarial. Despite this, SP remains potent at preventing adverse pregnancy outcomes through non-malarial mechanisms.

“A second drug, Dihydroartemisinin-piperaquine (DP) is a much better anti-malarial, but compared to SP, birthweights are lower.” 

“By combining the two, we hope to control malaria and deliver healthier babies who grow into healthier children,” Dr Unger said. 

The SAPOT Infant study is designed to test the theory that better prevention of malaria in pregnancy can be achieved by giving mothers SP and DP each month to reduce the risk of adverse health outcomes during the first year of life, compared to using SP alone. 

“Proving the benefits of SP plus DP beyond pregnancy outcomes would further support policy change. 

“The SAPOT Infant study addresses a crucial gap in malaria policy prevention for infants, but we must ensure there are good follow-up rates to determine evidence of actual benefits,” Dr Unger said. 

“Our study has the potential to substantially improve infant health in malaria-endemic areas worldwide – and the honour of winning the E. W. Thrasher Award goes a long way to recognising all the hard work by our teams in PNG and Australia."

For more information about the research, head to: SAPOT Clinical Trial: Treatment in pregnancy to prevent malaria - Menzies