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Comparaison de l’efficacité de la chloroquine versus sulfadoxine-pyriméthamine dans la prévention du paludisme chez la femme enceinte dans la région de Toamasina (Madagascar)

Comparison of efficacy of chloroquine versus sulfadoxine-pyrimethamine in malaria prevention in pregnant women in the Toamasina region (Madagascar)

  • Thérapeutique / Therapeutics
  • Published:
Bulletin de la Société de pathologie exotique

Résumé

Nous avons mené une étude prospective comparant l’efficacité de la chimioprophylaxie par la prise hebdomadaire de chloroquine (CQ) et le traitement présomptif intermittent par la sulfadoxine-pyriméthamine (SP) durant deux ans, du 1er janvier 2006 au 31 décembre 2008, dans une zone de paludisme stable dans la région de Toamasina (Madagascar). Cinq cent dix-neuf femmes enceintes ont été incluses dans cette étude (CQ = 285 ; SP = 256). Les caractères sociodémographiques de chaque groupe sont identiques. On a observé dans le groupe CQ un nombre plus élevé de parasitémies périphériques positives (CQ = 8,07 % vs SP = 2,73 % ; p = 0,0068) et de cas de paludisme grave (CQ = 1,75 % vs SP = 0 % ; p = 0,0332). L’anémie était plus fréquente dans le groupe CQ (CQ = 4,21 % vs SP = 0,35 % ; p = 0,0038). Le taux d’infestation placentaire est également plus élevé dans le groupe CQ (CQ = 7,01 % vs SP = 0,39 % ; p = 0,00001). Le taux de nouveau-nés à faible poids à la naissance et de mort in utero est plus faible dans le groupe SP respectivement (CQ = 4,21 % vs SP = 0,78 % ; p = 0,0121) et (CQ = 1,75 % vs SP = 0 % ; p = 0,0332).

Abstract

Malaria still represents a great cause of death in sub-Saharan African areas, mainly among pregnant women. We conducted this prospective study during two years in a malaria-endemic stable region in the east of Madagascar (Toamasina) with an aim to compare the efficacy of weekly chloroquine (CQ) and the use of intermittent presumptive treatment by sulfadoxine-pyrimethamine (SP). 519 pregnant women were included in this study (CQ = 285; SP = 256). Socio-demographical characteristics of each group were identical. We found more peripheral parasitemia (CQ = 8.07% vs SP = 2.73%; P = 0.0068) and severe malaria in the CQ group (CQ = 1.75% vs SP = 0%; P = 0.0332). Anemia was more frequent in the CQ group (CQ = 4.21% vs SP = 0.35%; P = 0.0038). Placental infestation rate was also higher in the CQ group (CQ = 7.01% vs SP = 0.39%; P = 0.00001). Low birth weight and fetal death were lower in the SP group respectively [(CQ = 4.21% vs SP = 0.78%; P = 0.0121) and (CQ = 1.75%vs SP = 0%; P = 0.0332)].

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Authors and Affiliations

  1. Service de gynécologie-obstétrique, département Mère-Enfant, CHU de Toamasina, BP 513, Toamasina, 501, Madagascar

    J. A. Randriambelomanana & B. A. Zafindravola

  2. Service de pédiatrie, département Mère-Enfant, CHU de Toamasina, BP 513, Toamasina, 501, Madagascar

    H. Rakotoarisoa

  3. Service de chirurgie, CHU de Toamasina, BP 513, Toamasina, 501, Madagascar

    S. A. Herinirina

  4. Service gynécologie-obstétrique de Befelatanana, CHU d’Antananarivo, Antananarivo, 101, Madagascar

    H. R. Andrianampanalinarivo

Authors
  1. J. A. Randriambelomanana
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  2. H. Rakotoarisoa
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  3. S. A. Herinirina
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  4. B. A. Zafindravola
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  5. H. R. Andrianampanalinarivo
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Correspondence to J. A. Randriambelomanana.

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Randriambelomanana, J.A., Rakotoarisoa, H., Herinirina, S.A. et al. Comparaison de l’efficacité de la chloroquine versus sulfadoxine-pyriméthamine dans la prévention du paludisme chez la femme enceinte dans la région de Toamasina (Madagascar). Bull. Soc. Pathol. Exot. 104, 243–249 (2011). https://doi.org/10.1007/s13149-011-0151-7

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  • DOI: https://doi.org/10.1007/s13149-011-0151-7

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