Cotrimoxazole versus sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria in HIV-infected pregnant women in Bangui, Central African Republic: A pragmatic randomised controlled trial

被引:1
作者
Manirakiza, Alexandre [1 ]
Tondeur, Laura [2 ]
Ketta, Marie Yvette Batoumbou [1 ]
Sepou, Abdoulaye [3 ]
Serdouma, Eugene [4 ]
Gondje, Samuel [5 ]
Bata, Ghislain Geraud Banthas [6 ]
Boulay, Aude [2 ]
Moyen, Jean Methode [7 ]
Sakanga, Olga [1 ]
Le-Fouler, Lenaig [2 ]
Kazanji, Mirdad [8 ]
Briand, Valerie [9 ]
Lombart, Jean Pierre [1 ]
Vray, Muriel [2 ,10 ]
机构
[1] Int Network Inst Pasteur, Inst Pasteur Bangui, Bangui, Cent Afr Republ
[2] Inst Pasteur Paris, Unite Epidemiol Malad Emergentes, Paris, France
[3] Minist Hlth, Hop Communautaire Bangui, Bangui, Cent Afr Republ
[4] Minist Hlth, Hop Amitie, Bangui, Cent Afr Republ
[5] Minist Hlth, Maternite Gendarmerie, Bangui, Cent Afr Republ
[6] Minist Hlth, Maternite Ctr Sante Castors, Bangui, Cent Afr Republ
[7] Minist Hlth, Malaria Programme Div, Bangui, Cent Afr Republ
[8] Inst Pasteur, Cayenne, French Guiana
[9] Univ Bordeaux, Inst Rech Dev, INSERM, Bordeaux, France
[10] Natl Inst Med Res, Paris, France
关键词
malaria; pregnant women; prophylaxis HIV; SUB-SAHARAN AFRICA; PLASMODIUM-FALCIPARUM; PROPHYLAXIS; PREVALENCE; THERAPY; COINFECTION; RESISTANCE; FREQUENCY; CHILDREN; ALLELES;
D O I
10.1111/tmi.13668
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objective The main objective of the MACOMBA (Maternity and Control of Malaria-HIV co-infection in Bangui) trial was to show that cotrimoxazole (CTX) is more effective than sulphadoxine-pyremethamine-IPTp (IPTp-SP) to prevent placental malaria infection (primary end point) among HIV-positive pregnant women with a CD4+ count >= 350 cells/mm(3) in Bangui, CAR. Methods MACOMBA is a multicentre, open-label randomised trial conducted in four maternity hospitals in Bangui. Between 2013 and 2017, 193 women were randomised and 112 (59 and 53 in CTX and IPTp-SP arms, respectively) were assessed for placental infection defined by microscopic parasitaemia or PCR. Results Thirteen women had a placental infection: five in the CTX arm (one by microscopic placental parasitaemia and four by PCR) and eight by PCR in the SP-IPTp (8.5% vs. 15.1%, p = 0.28). The percentage of newborns with low birthweight (<2500 g) did not differ statistically between the two arms. Self-reported compliance to CTX prophylaxis was good. There was a low overall rate of adverse events in both arms. Conclusion Although our results do not allow us to conclude that CTX is more effective, drug safety and good compliance among women with this treatment favour its widespread use among HIV-infected pregnant women, as currently recommended by WHO.
引用
收藏
页码:1314 / 1323
页数:10
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